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Accuracy of anxiety and depression screening tools in heart transplant recipients
Aaron Conway1, Judith Sheridan2, Joanne Maddicks-Law3
1Institute of Health and Biomedical Innovation, Queensland University of Technology (QUT), Kelvin Grove, QLD 4059, Australia.
Purpose:
The aim of this study was to assess the validity and reliability of psychological screening tools in outpatient heart transplant recipients.
Methods:
Forty-eight heart transplant recipients completed the Patient Health Questionnaire 9-item scale (PHQ-9), Generalized Anxiety Disorder 7-item Scale (GAD-7), Kessler Psychological Distress 10-item Scale (K-10) and Medical Outcomes Short Form 36-item Health Survey. A structured psychological interview (Mini International Neuropsychiatric Interview Version 6) was conducted after completion of the questionnaires. Internal consistency, criterion validity and construct validity of the PHQ-9, GAD-7 and K-10 were evaluated.
Results:
Internal consistency supported the reliability of the screening tools. The optimal cut-off on the PHQ-9 for depression was 10 (sensitivity=0.86; specificity=0.93). A score of 6 on the GAD-7 maximized sensitivity (0.75) and specificity (0.89) for anxiety. A score of 17 on the K-10 was the optimal cut-off for diagnosis of either anxiety or depression (sensitivity=0.83; specificity=0.84). Increasing scores on the screening tools were associated with lower health-related quality of life.
Conclusion:
Psychometric analyses support the reliability and validity of the PHQ-9, GAD-7 and K-10 as screening tools for detection of anxiety and depression in heart transplant recipients.