Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder
- PMID:20718076
- PMCID: PMC6878292
- DOI: 10.1002/mpr.323
Identifying HAM-A cutoffs for mild, moderate, and severe generalized anxiety disorder
Abstract
The aim of the current study was to identify and evaluate cutoffs for mild, moderate, and severe ranges of Hamilton Anxiety Rating Scale (HAM-A) scores. Data were from a four-week randomized trial of treatment for generalized anxiety disorder. Measures included the HAM-A, SF-36, Hospital Anxiety and Depression Scale (HADS), and Clinical Global Impressions of Severity (CGI-S) scale. HAM-A cutoffs were identified based on literature review, expert panel input, and MANOVA models. The optimal cutoff set was evaluated based on association with clinician CGI-S ratings. The sample included 144 patients (56.3% female; 73.6% white; mean age = 35.7 years; mean baseline HAM-A score = 23.7). The optimal HAM-A score ranges were: mild anxiety = 8-14; moderate = 15-23; severe ≥ 24 (scores ≤ 7 were considered to represent no/minimal anxiety). Analysis of variance (ANOVA) models found statistically significant differences among these groups in the SF-36 and HADS. The HAM-A severity ranges closely corresponded to clinicians' CGI-S ratings. The study represents the first step towards developing severity ranges for the HAM-A. These cutoffs should be used with caution and validated in larger samples. If the proposed cutoffs are accepted for general use, they could make results more meaningful and interpretable for researchers, clinicians, and patients.
Copyright © 2010 John Wiley & Sons, Ltd.
Similar articles
- Gepirone extended-release treatment of anxious depression: evidence from a retrospective subgroup analysis in patients with major depressive disorder.Alpert JE, Franznick DA, Hollander SB, Fava M.Alpert JE, et al.J Clin Psychiatry. 2004 Aug;65(8):1069-75.J Clin Psychiatry. 2004.PMID:15323591Clinical Trial.
- Lurasidone for major depressive disorder with mixed features and anxiety: a post-hoc analysis of a randomized, placebo-controlled study.Tsai J, Thase ME, Mao Y, Ng-Mak D, Pikalov A, Loebel A.Tsai J, et al.CNS Spectr. 2017 Apr;22(2):236-245. doi: 10.1017/S1092852917000074. Epub 2017 Mar 30.CNS Spectr. 2017.PMID:28357969Clinical Trial.
- Fluoxetine treatment of depressed patients with comorbid anxiety disorders.Sonawalla SB, Farabaugh A, Johnson MW, Morray M, Delgado ML, Pingol MG, Rosenbaum JF, Fava M.Sonawalla SB, et al.J Psychopharmacol. 2002 Sep;16(3):215-9. doi: 10.1177/026988110201600304.J Psychopharmacol. 2002.PMID:12236627
- Novel Augmentation Strategies in Major Depression.Martiny K.Martiny K.Dan Med J. 2017 Apr;64(4):B5338.Dan Med J. 2017.PMID:28385173Review.
- Relationship between the clinical global impression of severity for schizoaffective disorder scale and established mood scales for mania and depression.Turkoz I, Fu DJ, Bossie CA, Sheehan JJ, Alphs L.Turkoz I, et al.J Affect Disord. 2013 Aug 15;150(1):17-22. doi: 10.1016/j.jad.2013.01.047. Epub 2013 Mar 18.J Affect Disord. 2013.PMID:23517884Review.
Cited by
- Evaluation of risk factors for impulse control disorder in Parkinson's disease in northern China.Ren W, Qi Y, Liu Y, Yan Y, Zheng X, Jin S, Chang Y.Ren W, et al.Front Aging Neurosci. 2023 Nov 21;15:1257618. doi: 10.3389/fnagi.2023.1257618. eCollection 2023.Front Aging Neurosci. 2023.PMID:38076540Free PMC article.
- What is the clinical evidence on psilocybin for the treatment of psychiatric disorders? A systematic review.Castro Santos H, Gama Marques J.Castro Santos H, et al.Porto Biomed J. 2021 Feb 11;6(1):e128. doi: 10.1097/j.pbj.0000000000000128. eCollection 2021 Jan-Feb.Porto Biomed J. 2021.PMID:33884324Free PMC article.Review.
- Efficacy of Silexan in patients with anxiety disorders: a meta-analysis of randomized, placebo-controlled trials.Dold M, Bartova L, Volz HP, Seifritz E, Möller HJ, Schläfke S, Kasper S.Dold M, et al.Eur Arch Psychiatry Clin Neurosci. 2023 Oct;273(7):1615-1628. doi: 10.1007/s00406-022-01547-w. Epub 2023 Jan 30.Eur Arch Psychiatry Clin Neurosci. 2023.PMID:36717399Free PMC article.
- Safety and efficacy of adjunctive transcranial direct current stimulation in treatment-resistant obsessive-compulsive disorder: An open-label trial.Kumar S, Kumar N, Verma R.Kumar S, et al.Indian J Psychiatry. 2019;61(4):327-334. doi: 10.4103/psychiatry.IndianJPsychiatry_509_18.Indian J Psychiatry. 2019.PMID:31391634Free PMC article.
- Effects of Psychosomatic Mutual Aid Treatment on Anxiety and Depression in Turner Syndrome.Ye M, Lin H, Lash GE, Yuan L, Li L.Ye M, et al.Front Psychiatry. 2021 May 10;12:644147. doi: 10.3389/fpsyt.2021.644147. eCollection 2021.Front Psychiatry. 2021.PMID:34040554Free PMC article.
References
- Aben I., Verhey F., Lousberg R., Lodder J., Honig A. (2002) Validity of the Beck Depression Inventory, Hospital Anxiety and Depression Scale, SCL‐90, and Hamilton Depression Rating Scale as screening instruments for depression in stroke patients. Psychosomatics, 43, 386–393. - PubMed
- Allgulander C., Dahl A.A., Austin C., Morris P.L., Sogaard J.A., Fayyad R., Kutcher S.P., Clary C.M. (2004) Efficacy of sertraline in a 12‐week trial for generalized anxiety disorder. American Journal of Psychiatry, 161, 1642–1649. - PubMed
- Bagby R.M., Ryder A.G., Schuller D.R., Marshall M.B. (2004) The Hamilton Depression Rating Scale: has the gold standard become a lead weight? American Journal of Psychiatry, 161, 2163–2177. - PubMed
- Bech P., Grosby H., Husum B., Rafaelsen L. (1984) Generalized anxiety or depression measured by the Hamilton Anxiety Scale and the Melancholia Scale in patients before and after cardiac surgery. Psychopathology, 17, 253–263. - PubMed
- Belzer K.D., Schneier F.R. (2006) Tools for assessing generalized anxiety disorder. Psychiatric Times, 25(3).