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Abstract
Objective To examine diagnostic accuracy of anxiety detection tools compared with a gold standard in outpatient settings among adults with Parkinson disease (PD).
Methods A systematic review was conducted. MEDLINE, EMABASE, PsycINFO, and Cochrane Database of Systematic Reviews were searched to April 7, 2017. Prevalence of anxiety and diagnostic accuracy measures including sensitivity, specificity, and likelihood ratios were gathered. Pooled prevalence of anxiety was calculated using Mantel-Haenszel-weighted DerSimonian and Laird models.
Results A total of 6,300 citations were reviewed with 6 full-text articles included for synthesis. Tools included within this study were the Beck Anxiety Inventory, Geriatric Anxiety Inventory (GAI), Hamilton Anxiety Rating Scale, Hospital Anxiety and Depression Scale–Anxiety, Parkinson's Anxiety Scale (PAS), and Mini–Social Phobia Inventory. Anxiety diagnoses made included generalized anxiety disorder, social phobia, and any anxiety type. Pooled prevalence of anxiety was 30.1% (95% confidence interval 26.1%–34.0%). The GAI had the best-reported sensitivity of 0.86 and specificity of 0.88. The observer-rated PAS had a sensitivity of 0.71 and the highest specificity of 0.91.
Conclusions While there are 6 tools validated for anxiety screening in PD populations, most tools are only validated in single studies. The GAI is brief and easy to use, with a good balance of sensitivity and specificity. The PAS was specifically developed for PD, is brief, and has self-/observer-rated scales, but with lower sensitivity. Health care practitioners involved in PD care need to be aware of available validated tools and choose one that fits their practice.
Glossary
- BAI=
- Beck Anxiety Inventory;
- CI=
- confidence interval;
- DSM=
- Diagnostic and Statistical Manual of Mental Disorders;
- GAD=
- generalized anxiety disorder;
- GAI=
- Geriatric Anxiety Inventory;
- H&Y=
- Hoehn & Yahr scale;
- HADS-A=
- Hospital Anxiety and Depression Scale–Anxiety;
- HARS=
- Hamilton Anxiety Rating Scale;
- ICD=
- International Classification of Diseases;
- LR=
- likelihood ratio;
- M.I.N.I.=
- Mini-International Neuropsychiatric Interview;
- Mini-SPIN=
- Mini Social Phobia Inventory;
- MMSE=
- Mini-Mental State Examination;
- PAS=
- Parkinson's Anxiety Scale;
- PD=
- Parkinson disease;
- SCID-I=
- Structured Clinical Interview
Footnotes
Go to Neurology.org/N for full disclosures. Funding information and disclosures deemed relevant by the authors, if any, are provided at the end of the article.
- Received July 12, 2017.
- Accepted in final form September 21, 2017.
- Copyright © 2017 American Academy of Neurology
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