A clinically useful anxiety outcome scale.
OBJECTIVE
Standardized scales are increasingly being recommended to measure outcome when treating psychiatric disorders in routine clinical practice. If the standard of care is to change and scales are to be incorporated into clinical practice, then it will be necessary to develop measures that are feasible to use as well as have good psychometric properties. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services project, we describe the reliability and validity of the Clinically Useful Anxiety Outcome Scale (CUXOS). The CUXOS was designed to be a brief (completed in less than 2 minutes), quickly scored (in less than 15 seconds), clinically useful measure that is reliable, valid, and sensitive to change.


METHODS
Nearly 1,000 psychiatric outpatients completed the CUXOS and were rated on clinician severity indices of depression, anxiety, and anger. A subset of patients completed other self-report symptom severity scales in order to examine discriminant and convergent validity, and a subset completed the CUXOS twice in order to examine test-retest reliability. Sensitivity to change was examined in patients with panic disorder and generalized anxiety disorder.


RESULTS
On average, the CUXOS took less than 1.5 minutes to complete. The scale had high internal consistency and test-retest reliability, and was more highly correlated with other self-report measures of anxiety than with measures of depression, substance use problems, eating disorders, and anger. The CUXOS was more highly correlated with clinician severity ratings of anxiety than with depression and anger, and CUXOS scores were significantly higher in psychiatric outpatients with anxiety disorders than in patients with other psychiatric disorders. Finally, the CUXOS was a valid measure of symptom change.


CONCLUSIONS
The results of this large validation study of the CUXOS show that it is a reliable and valid measure of anxiety that is feasible to incorporate into routine clinical practice.
Zimmerman
Mark
M
Bayside Medical Center, 235 Plain St, Providence, RI 02905, USA. mzimmerman@lifespan.org
Chelminski
Iwona
I
Young
Diane
D
Dalrymple
Kristy
K
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000786:Anger; D001007:Anxiety / Q000175:diagnosis* / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis / Q000523:psychology; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005163:Factor Analysis, Statistical; D001068:Feeding and Eating Disorders / Q000175:diagnosis / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D019966:Substance-Related Disorders / Q000175:diagnosis / Q000523:psychology; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult