title: An international risk prediction algorithm for the onset of generalized anxiety and panic syndromes in general practice attendees: predictA.
abstract: BACKGROUND
  There are no risk models for the prediction of anxiety that may help in prevention. We aimed to develop a risk algorithm for the onset of generalized anxiety and panic syndromes.
  
  
  METHODS
  Family practice attendees were recruited between April 2003 and February 2005 and followed over 24 months in the UK, Spain, Portugal and Slovenia (Europe4 countries) and over 6 months in The Netherlands, Estonia and Chile. Our main outcome was generalized anxiety and panic syndromes as measured by the Patient Health Questionnaire. We entered 38 variables into a risk model using stepwise logistic regression in Europe4 data, corrected for over-fitting and tested it in The Netherlands, Estonia and Chile.
  
  
  RESULTS
  There were 4905 attendees in Europe4, 1094 in Estonia, 1221 in The Netherlands and 2825 in Chile. In the algorithm four variables were fixed characteristics (sex, age, lifetime depression screen, family history of psychological difficulties); three current status (Short Form 12 physical health subscale and mental health subscale scores, and unsupported difficulties in paid and/or unpaid work); one concerned country; and one time of follow-up. The overall C-index in Europe4 was 0.752 [95% confidence interval (CI) 0.724-0.780]. The effect size for difference in predicted log odds between developing and not developing anxiety was 0.972 (95% CI 0.837-1.107). The validation of predictA resulted in C-indices of 0.731 (95% CI 0.654-0.809) in Estonia, 0.811 (95% CI 0.736-0.886) in The Netherlands and 0.707 (95% CI 0.671-0.742) in Chile.
  
  
  CONCLUSIONS
  PredictA accurately predicts the risk of anxiety syndromes. The algorithm is strikingly similar to the predictD algorithm for major depression, suggesting considerable overlap in the concepts of anxiety and depression.
authors.affiliation: Department of Mental Health Sciences, UCL Medical School, UK. m.king@medsch.ucl.ac.uk
authors.forename: M
authors.initials: M
authors.lastname: King
authors.forename: C
authors.initials: C
authors.lastname: Bottomley
authors.forename: J A
authors.initials: JA
authors.lastname: Bellón-Saameño
authors.forename: F
authors.initials: F
authors.lastname: Torres-Gonzalez
authors.forename: I
authors.initials: I
authors.lastname: Švab
authors.forename: J
authors.initials: J
authors.lastname: Rifel
authors.forename: H-I
authors.initials: HI
authors.lastname: Maaroos
authors.forename: A
authors.initials: A
authors.lastname: Aluoja
authors.forename: M I
authors.initials: MI
authors.lastname: Geerlings
authors.forename: M
authors.initials: M
authors.lastname: Xavier
authors.forename: I
authors.initials: I
authors.lastname: Carraça
authors.forename: B
authors.initials: B
authors.lastname: Vicente
authors.forename: S
authors.initials: S
authors.lastname: Saldivia
authors.forename: I
authors.initials: I
authors.lastname: Nazareth
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000465:Algorithms; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D058006:General Practice / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016584:Panic Disorder / Q000175:diagnosis* / Q000523:psychology; D011569:Psychiatric Status Rating Scales / Q000592:standards; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D055815:Young Adult