title: Comparative efficacy of the generalized anxiety disorder 7-item scale and the Edinburgh Postnatal Depression Scale as screening tools for generalized anxiety disorder in pregnancy and the postpartum period.
abstract: OBJECTIVE
  About 24.1% of pregnant women suffer from at least 1 anxiety disorder, 8.5% of whom suffer specifically from generalized anxiety disorder (GAD). GAD is often associated with major depressive disorder (MDD). During the perinatal period, the presence of physical and somatic symptoms often makes differentiation between depression and anxiety more challenging. To date, no screening tools have been developed to detect GAD in the perinatal population. We investigated the psychometric properties of the GAD 7-item Scale (GAD-7) as a screening tool for GAD in pregnant and postpartum women.
  
  
  METHODS
  Two hundred and forty perinatal women (n = 155 pregnant and n = 85 postpartum) referred for psychiatric consultation were enrolled. On the day of initial assessment, all women completed the GAD-7 and the Edinburgh Postnatal Depression Scale (EPDS). Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition-based diagnoses were made by experienced psychiatrists. Scores from the GAD-7 and EPDS were compared with the clinical diagnoses to evaluate the psychometric properties of the GAD-7 and EPDS when used as a screening tool for GAD.
  
  
  RESULTS
  The GAD-7 yielded a sensitivity of 61.3% and specificity of 72.7% at an optimal cut-off score of 13. Compared with the EPDS and the EPDS-3A subscale, the GAD-7 displayed greater accuracy and specificity over a greater range of cut-off scores and more accurately identified GAD in patients with comorbid MDD.
  
  
  CONCLUSIONS
  Our findings suggest that the GAD-7 represents a clinically useful scale for the detection of GAD in perinatal women.
authors.affiliation: Student, MiNDS Neuroscience Program, McMaster University, Hamilton, Ontario.
authors.forename: William
authors.initials: W
authors.lastname: Simpson
authors.affiliation: Student, Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario.
authors.forename: Melanie
authors.initials: M
authors.lastname: Glazer
authors.affiliation: Student, Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, Ontario.
authors.forename: Natalie
authors.initials: N
authors.lastname: Michalski
authors.affiliation: Professor Emeritus, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario; Psychiatrist, Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, Ontario.
authors.forename: Meir
authors.initials: M
authors.lastname: Steiner
authors.affiliation: Associate Professor, Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario; Director, Women's Health Concerns Clinic, St Joseph's Healthcare, Hamilton, Ontario; Academic Head, Mood Disorders Program, St Joseph's Healthcare, Hamilton, Ontario.
authors.forename: Benicio N
authors.initials: BN
authors.lastname: Frey
mesh_terms: D000293:Adolescent; D000328:Adult; D001008:Anxiety Disorders / Q000175:diagnosis* / Q000523:psychology*; D015897:Comorbidity; D019052:Depression, Postpartum / Q000175:diagnosis* / Q000523:psychology*; D003865:Major Depressive Disorder / Q000175:diagnosis* / Q000523:psychology*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009864:Ontario; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000523:psychology*; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D055815:Young Adult