Prevalence of Anxiety and Depressive Disorders in a Sample of Moscow Residents: Comparison of the GAD-7 and HADS Results with a Clinical Assessment.

Abstract

Background: Anxiety and depressive disorders are the most common mental disorders. Detecting a disorder at an early stage can prevent the development of severe disorders and preserve the patient's functioning ability. Simple and reliable screening tools based on self-completion of questionnaires can be used for this purpose. However, it is not always the case that the scores of the self-questionnaire align with those of the clinician.

Aim: To estimate the prevalence of anxiety-depressive disorders using the GAD-7 and HADS self-report questionnaires compared to psychiatrist assessment.

Methods: The study included individuals aged 18 to 65 years, living in Moscow, Russia, without psychiatric disorders, who participated in an online study using the HADS (Hospital Anxiety and Depression Scale, HADS-A and HADS-D) and GAD-7 (Generalized Anxiety Disorder 7-item scale). Anxiety disorder was diagnosed when the total score was ≥10 on the GAD-7 and/or ≥10 on the HADS-A scale, and depression was defined when the total score was ≥9 on the HADS-D scale. Then, 82 randomly selected participants attended an anonymous consultation with a psychiatrist.

Results: The study included 1,097 individuals (72% female), median age 29 (23; 37) years. As a result of testing, anxiety disorder was found in 168 (15%); depressive disorder - in 152 (14%) respondents. At medical verification, anxiety was diagnosed in 18 (22%); depression - in 19 (23%) people. The sensitivity of the HADS-D subscale for physician-diagnosed cases of depression was 61%, and specificity was 73%. The sensitivity of the HADS-A and GTR-7 subscale in identifying cases of anxiety disorder was 58%, specificity 59%. Sixteen percent were first diagnosed with a personality disorder or schizotypal disorder.

Conclusion: The level of anxiety and depression in our sample of the population of Moscow, Russia, was higher than the global level. Self-assessment based on the questionnaire seems to not fully reflect the real state of a patient, as evidenced by the differences with the psychiatrist's assessment.