Hostname: page-component-cd9895bd7-dzt6s Total loading time: 0 Render date: 2024-12-22T12:34:52.316Z Has data issue: false hasContentIssue false
  • English
  • Français

Validation of the geriatric anxiety inventory in a duloxetine clinical trial for elderly adults with generalized anxiety disorder

Published online by Cambridge University Press:  30 April 2015

Susan G. Ball ,
Sarah Lipsius  and
Rodrigo Escobar
Susan G. Ball*
Affiliation:
Eli Lilly and Company, Corporate Center DC 1542, Indianapolis, IN 46285, USA Indiana University School of Medicine, Indianapolis, IN 46202, USA
Sarah Lipsius
Affiliation:
Biostatistician InVentiv Health Clinical, 1787 Sentry Parkway, Suite 300, Bldg 16, Blue Bell, PA 19422, USA
Rodrigo Escobar
Affiliation:
Eli Lilly and Company DC 1546, Corporate Center, Indianapolis, IN 46285, USA
*
Correspondence should be addressed to: Susan G. Ball, Ph.D. Principal Clinical Research Scientist, Eli Lilly and Company, Corporate Center DC 1542, Indianapolis, IN 46285, USA. Phone: (317) 292-8735; Fax: (317) 277-2049. Email: [email protected].
Get access

Abstract

Background:

The Generalized Anxiety Inventory (GAI) has been developed for use in the assessment of anxiety symptoms in older adults (≥ 65 years), but previous validation work has not examined the psychometric qualities of the instrument in relation to treatment. The objective of this study was to examine the performance of the GAI for its internal reliability, convergent and divergent validity, and its sensitivity to treatment.

Methods:

Elderly patients with generalized anxiety disorder (GAD) participated in a 10-week double-blind study of duloxetine treatment for patients with GAD. Anxiety symptoms were assessed with the Hamilton Anxiety Rating Scale (HAMA), the Hospital Anxiety and Depression Scale (HADS) anxiety and depression subscales, and the GAI. Internal reliability of the GAI was assessed with Cronbach's α. Correlations among the HAMA, HADS, and GAI scores were analyzed to determine convergent and divergent validity. Patients were also compared on remission status using recommended cut-off scores for the GAI.

Results:

Patients with GAD, who were at least 65 years of age, were randomly assigned to double-blind treatment with either duloxetine (N = 151) or placebo (N = 140) for 10 weeks acute therapy. The mean change on the GAI was significantly greater with duloxetine compared with placebo treatment (−8.36 vs. −4.96, respectively, p ≤ 0.001). The GAI demonstrated good internal consistency, good convergent and divergent validity, but suggested cut-off values for caseness with the GAI did not correspond to remission status as measured by the HAMA.

Conclusions:

Within an elderly patient population with GAD, the GAI demonstrated sound psychometric qualities and sensitivity to change with treatment.

Keywords

anxietyclinical assessmentscales
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 9 , September 2015 , pp. 1533 - 1539
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alaka, K. J. et al. (2014). Efficacy and safety of duloxetine in the treatment of older adult patients with generalized anxiety disorder: a randomized, double-blind, placebo-controlled trial. International Journal of Geriatric Psychiatry, 29, 978–986. doi: 10.1002 /gps.4088 CrossRefGoogle Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text rev. Washington, DC: Author.Google Scholar
Byers, A. L., Yaffe, K., Covinsky, K. E., Friedman, M. B. and Bruce, M. L. (2010). High occurrence of mood and anxiety disorders among older adults: the national comorbidity survey replication. Archives of General Psychiatry, 67, 489–496. doi: 10.1001 /archgenpsychiatry.2010.35.CrossRefGoogle ScholarPubMed
Cheung, G., Patrick, C., Sullivan, G., Cooray, M. and Chang, C. L. (2012). Sensitivity and specificity of the geriatric anxiety inventory and the hospital anxiety and depression scale in the detection of anxiety disorders in older people with chronic obstructive pulmonary disease. International Psychogeriatrics, 24, 128–136.Google Scholar
Diefenbach, G. J., Bragdon, L. B. and Blank, K. (2014). Geriatric anxiety inventory: factor structure and associations with cognitive status. American Journal of Geriatric Psychiatry, 22, 1418–1426. doi: 10.1016 /j.jagp.2013.04.014.Google Scholar
Diefenbach, G. J., Tolin, D. F., Munier, S. A. and Gilliam, C. M. (2009). Assessment of anxiety in older home care recipients. Gerontologist, 49, 141–153.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
Gerolimatos, L. A., Gregg, J. J. and Edelstein, B. A. (2013). Assessment of anxiety in long-term care: examination of the geriatric anxiety inventory (GAI) and its short form. International Psychogeriatrics, 25, 1533–1542. doi: 10.1017 /S1041610213000847.Google Scholar
Golden, J. et al. (2011). The spectrum of worry in the community-dwelling elderly. Aging and Mental Health, 15, 985–994. doi: 10.1080 /13607863.2011.583621.Google Scholar
Guy, W. (1976). The clinical global severity and improvement scale. ECDEU Assessment Manual for Psychopharmacology. US Dept Health, Education and Welfare publication (ADM) 76–338. Rockville, Md: National Institute of Mental Health.Google Scholar
Guy, W. (1976). The patient's global severity and improvement scale. ECDEU Assessment Manual for Psychopharmacology. US Dept Health, Education and Welfare publication (ADM) 76–338. Rockville, Md: National Institute of Mental Health.Google Scholar
Hamilton, M. (1959). The assessment of anxiety states by rating. British Journal of Medical Psychology, 32, 50–55.Google Scholar
Lipman, R. S., Covi, L. and Downing, R. W. (1981). Pharmacotherapy of anxiety and depression: rationale and study design. Psychopharmacology Bulletin, 17, 91–95.Google Scholar
Marquez-Gonzalez, M., Losada, A., Fernandez-Fernandez, V. and Pachana, N. A. (2012). Psychometric properties of the Spanish version of the geriatric anxiety inventory. International Psychogeriatrics, 24, 137–144.CrossRefGoogle ScholarPubMed
Matheson, S. F. et al. (2012). Validity and reliability of the geriatric anxiety inventory in Parkinson's disease. Australian Journal of Ageing, 31, 13–16.Google Scholar
Matza, L. S., Morlock, R., Sexton, C., Malley, K. and Feltner, D. (2010). Identifying HAM-A cutoffs for milid, moderate and severe generalized anxiety disorder. International Journal of Methods in Psychiatric Research, 19, 223–232. doi: 10.1002 /mpr.323.CrossRefGoogle Scholar
Pachana, N. A., Byrne, G. J., Siddle, H., Koloski, N., Harley, E. and Arnold, E. (2007). Development and validation of the geriatric anxiety inventory. International Psychogeriatrics, 19, 103–114.CrossRefGoogle ScholarPubMed
Raskin, A., Schulterbrandt, J., Reatig, N. and McKeon, J. J. (1969). Replication of factors of psychopathology in interview, ward behavior and self-report ratings of hospitalized depressives, Journal of Nervous and Mental Disease, 148, 8798.Google Scholar
Roemer, L., Molina, S. and Borkovec, T. D. (1997). An investigation of worry content among generally anxious individuals. Journal of Nervous and Mental Disease, 185, 314–319.Google Scholar
Shear, M. K. et al. (2001). Reliability and validity of a structured interview guide for the Hamilton anxiety rating scale (SIGH-A). Depression and Anxiety, 13, 166–178.Google Scholar
Sheehan, D. V. et al. (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59 (Suppl. 20), 22–33.Google ScholarPubMed
Thiessen, Z. and Hunsley, J. (2012). Assessment of anxiety in older adults: a systematic review of commonly used measures. Aging and Mental Health, 16, 1–16.Google Scholar
Zigmond, A. S. and Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67, 361–370.Google Scholar