title: Anxiety treatment improves physical functioning with oblique scoring of the SF-12 short form health survey.
abstract: OBJECTIVE
  No studies have found a positive effect of anxiety treatment on physical functioning, but recent investigations of the 12-item Short Form Health Questionnaire (SF-12), which is frequently used to assess physical functioning, have suggested that orthogonal scoring of the summary measure may distort representations of physical health. The current study reanalyzes whether anxiety treatment improves physical functioning using oblique scoring in the Coordinated Anxiety Learning and Management (CALM) randomized clinical trial for the treatment of anxiety disorders. Replication was tested in reanalysis of data from the earlier Collaborative Care for Anxiety and Panic (CCAP) randomized clinical trial for the treatment of panic disorder.
  
  
  METHODS
  The CALM study included 1004 primary care patients with panic, social anxiety, generalized anxiety or posttraumatic stress disorders. Patients received usual care (UC) or an evidence-based intervention (cognitive behavioral therapy, psychotropic medication or both; ITV). Physical functioning (SF-12v2) was assessed at baseline and at 6, 12 and 18 months. Oblique and orthogonal scoring methods for the physical functioning aggregate measure from SF-12 scale items were compared.
  
  
  RESULTS
  In CALM, physical functioning improved to a greater degree in ITV than UC for oblique but not orthogonal scoring. Findings were replicated in the CCAP data.
  
  
  CONCLUSIONS
  Evidence-based treatment for anxiety disorders in primary care improves physical functioning when measured using oblique scoring of the SF-12. Due to this scoring issue, effects of mental health treatment on physical functioning may have been understated.
authors: Department of Psychology, University of California, Los Angeles, CA, USA.
authors: Andrea N
authors: AN
authors: Niles
authors: Cathy D
authors: CD
authors: Sherbourne
authors: Peter P
authors: PP
authors: Roy-Byrne
authors: Murray B
authors: MB
authors: Stein
authors: Greer
authors: G
authors: Sullivan
authors: Alexander
authors: A
authors: Bystritsky
authors: Michelle G
authors: MG
authors: Craske
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D014151:Anti-Anxiety Agents / Q000627:therapeutic use*; D001008:Anxiety Disorders / Q000628:therapy*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006305:Health Status Indicators; D006306:Health Surveys / Q000295:instrumentation; D006801:Humans; D008297:Male; D008875:Middle Aged; D012107:Research Design / Q000706:statistics & numerical data; D016896:Treatment Outcome
chemical_list: D014151:Anti-Anxiety Agents