Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale
Identifieur interne : 000116 ( Istex/Corpus ); précédent : 000115; suivant : 000117Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale
Auteurs : Albert F. G. Leentjens ; Kathy Dujardin ; Laura Marsh ; Irene H. Richard ; Sergio E. Starkstein ; Pablo Martinez-MartinSource :
- Movement Disorders [ 0885-3185 ] ; 2011-02-15.
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Abstract
Background:: Anxiety is a prevalent and disabling condition in Parkinson's disease (PD). The lack of anxiety rating scales validated for this population hampers research into anxiety in PD. The aim of this study is to assess the clinimetric properties of the Hamilton anxiety rating scale (HARS), the Beck anxiety inventory (BAI), and the hospital anxiety and depression scale (HADS) in PD patients. Design:: Three hundred forty‐two PD patients underwent a standardized assessment including a structured interview for diagnostic and statistical manual diagnoses of anxiety disorders and completion of the HARS, BAI, and HADS. Inter‐rater reliability of the HARS was assessed in 60 patients; test‐retest reliability of the BAI and HADS in 213 and 217 patients, respectively. Results:: Thirty‐four percent of patients suffered from an anxiety disorder, whereas an additional 11.4% had clinically significant anxiety symptoms in the absence of a diagnosis of anxiety disorder. Acceptability, score distribution, and known groups validity over different levels of anxiety were adequate. Inter‐rater reliability for the HARS and test‐retest reliability for the BAI and HADS were good. The HARS, but not the BAI and HADS, had a satisfactory inter‐item correlation, convergent validity and factorial structure. For all scales, the positive predictive value was poor, and the negative predictive value was moderate. Conclusions:: Given the adequate known groups validity of all three rating scales, each of these scales is likely to be useful in clinical practice or research for evaluation of symptom severity. Limitations in the construct validity of the anxiety scales in this study raise questions regarding suitability for their use in PD. © 2011 Movement Disorder Society
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DOI: 10.1002/mds.23184
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Leentjens</name><affiliation><mods:affiliation>Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name><affiliation><mods:affiliation>Neurology and Movement Disorders Unit, Lille University Hospital, Lille, France</mods:affiliation></affiliation></author><author><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><affiliation><mods:affiliation>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Current Address: Laura Marsh Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center and Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Richard, Irene H" sort="Richard, Irene H" uniqKey="Richard I" first="Irene H." last="Richard">Irene H. Richard</name><affiliation><mods:affiliation>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Starkstein, Sergio E" sort="Starkstein, Sergio E" uniqKey="Starkstein S" first="Sergio E." last="Starkstein">Sergio E. 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G." last="Leentjens">Albert F. G. Leentjens</name><affiliation><mods:affiliation>Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands</mods:affiliation></affiliation></author><author><name sortKey="Dujardin, Kathy" sort="Dujardin, Kathy" uniqKey="Dujardin K" first="Kathy" last="Dujardin">Kathy Dujardin</name><affiliation><mods:affiliation>Neurology and Movement Disorders Unit, Lille University Hospital, Lille, France</mods:affiliation></affiliation></author><author><name sortKey="Marsh, Laura" sort="Marsh, Laura" uniqKey="Marsh L" first="Laura" last="Marsh">Laura Marsh</name><affiliation><mods:affiliation>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Current Address: Laura Marsh Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center and Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA</mods:affiliation></affiliation></author><author><name sortKey="Richard, Irene H" sort="Richard, Irene H" uniqKey="Richard I" first="Irene H." last="Richard">Irene H. Richard</name><affiliation><mods:affiliation>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</mods:affiliation></affiliation></author><author><name sortKey="Starkstein, Sergio E" sort="Starkstein, Sergio E" uniqKey="Starkstein S" first="Sergio E." last="Starkstein">Sergio E. Starkstein</name><affiliation><mods:affiliation>School of Psychiatry, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia</mods:affiliation></affiliation></author><author><name sortKey="Martinez Artin, Pablo" sort="Martinez Artin, Pablo" uniqKey="Martinez Artin P" first="Pablo" last="Martinez-Martin">Pablo Martinez-Martin</name><affiliation><mods:affiliation>Area of Applied Epidemiology and CIBERNED, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-02-15">2011-02-15</date><biblScope unit="vol">26</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="407">407</biblScope><biblScope unit="page" to="415">415</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">08277AF9837056E4B0F595949AA5A9C168BB6F93</idno><idno type="DOI">10.1002/mds.23184</idno><idno type="ArticleID">MDS23184</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Parkinson's disease</term><term>anxiety</term><term>clinimetrics</term><term>depression</term><term>psychometrics</term><term>rating scales</term><term>reliability</term><term>validity</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Background:: Anxiety is a prevalent and disabling condition in Parkinson's disease (PD). The lack of anxiety rating scales validated for this population hampers research into anxiety in PD. The aim of this study is to assess the clinimetric properties of the Hamilton anxiety rating scale (HARS), the Beck anxiety inventory (BAI), and the hospital anxiety and depression scale (HADS) in PD patients. Design:: Three hundred forty‐two PD patients underwent a standardized assessment including a structured interview for diagnostic and statistical manual diagnoses of anxiety disorders and completion of the HARS, BAI, and HADS. Inter‐rater reliability of the HARS was assessed in 60 patients; test‐retest reliability of the BAI and HADS in 213 and 217 patients, respectively. Results:: Thirty‐four percent of patients suffered from an anxiety disorder, whereas an additional 11.4% had clinically significant anxiety symptoms in the absence of a diagnosis of anxiety disorder. Acceptability, score distribution, and known groups validity over different levels of anxiety were adequate. Inter‐rater reliability for the HARS and test‐retest reliability for the BAI and HADS were good. The HARS, but not the BAI and HADS, had a satisfactory inter‐item correlation, convergent validity and factorial structure. For all scales, the positive predictive value was poor, and the negative predictive value was moderate. Conclusions:: Given the adequate known groups validity of all three rating scales, each of these scales is likely to be useful in clinical practice or research for evaluation of symptom severity. Limitations in the construct validity of the anxiety scales in this study raise questions regarding suitability for their use in PD. © 2011 Movement Disorder Society</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Albert F.G. Leentjens MD, PhD</name><affiliations><json:string>Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands</json:string></affiliations></json:item><json:item><name>Kathy Dujardin PhD</name><affiliations><json:string>Neurology and Movement Disorders Unit, Lille University Hospital, Lille, France</json:string></affiliations></json:item><json:item><name>Laura Marsh MD</name><affiliations><json:string>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</json:string><json:string>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</json:string><json:string>Current Address: Laura Marsh Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center and Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA</json:string></affiliations></json:item><json:item><name>Irene H. Richard MD</name><affiliations><json:string>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</json:string><json:string>Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</json:string></affiliations></json:item><json:item><name>Sergio E. Starkstein MD</name><affiliations><json:string>School of Psychiatry, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia</json:string></affiliations></json:item><json:item><name>Pablo Martinez‐Martin MD, PhD</name><affiliations><json:string>Area of Applied Epidemiology and CIBERNED, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Parkinson's disease</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>anxiety</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>depression</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>clinimetrics</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>psychometrics</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rating scales</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>validity</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>reliability</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Background:: Anxiety is a prevalent and disabling condition in Parkinson's disease (PD). The lack of anxiety rating scales validated for this population hampers research into anxiety in PD. The aim of this study is to assess the clinimetric properties of the Hamilton anxiety rating scale (HARS), the Beck anxiety inventory (BAI), and the hospital anxiety and depression scale (HADS) in PD patients. Design:: Three hundred forty‐two PD patients underwent a standardized assessment including a structured interview for diagnostic and statistical manual diagnoses of anxiety disorders and completion of the HARS, BAI, and HADS. Inter‐rater reliability of the HARS was assessed in 60 patients; test‐retest reliability of the BAI and HADS in 213 and 217 patients, respectively. Results:: Thirty‐four percent of patients suffered from an anxiety disorder, whereas an additional 11.4% had clinically significant anxiety symptoms in the absence of a diagnosis of anxiety disorder. Acceptability, score distribution, and known groups validity over different levels of anxiety were adequate. Inter‐rater reliability for the HARS and test‐retest reliability for the BAI and HADS were good. The HARS, but not the BAI and HADS, had a satisfactory inter‐item correlation, convergent validity and factorial structure. For all scales, the positive predictive value was poor, and the negative predictive value was moderate. Conclusions:: Given the adequate known groups validity of all three rating scales, each of these scales is likely to be useful in clinical practice or research for evaluation of symptom severity. Limitations in the construct validity of the anxiety scales in this study raise questions regarding suitability for their use in PD. © 2011 Movement Disorder Society</abstract><qualityIndicators><score>8</score><pdfVersion>1.3</pdfVersion><pdfPageSize>612 x 810 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractCharCount>1769</abstractCharCount><pdfWordCount>6017</pdfWordCount><pdfCharCount>39203</pdfCharCount><pdfPageCount>9</pdfPageCount><abstractWordCount>264</abstractWordCount></qualityIndicators><title>Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale</title><genre><json:string>Serial article</json:string></genre><host><volume>26</volume><pages><total>9</total><last>415</last><first>407</first></pages><issn><json:string>0885-3185</json:string></issn><issue>3</issue><subject><json:item><value>Research Article</value></json:item></subject><genre></genre><language><json:string>unknown</json:string></language><title>Movement Disorders</title><doi><json:string>10.1002/(ISSN)1531-8257</json:string></doi></host><publicationDate>2011</publicationDate><copyrightDate>2011</copyrightDate><doi><json:string>10.1002/mds.23184</json:string></doi><id>08277AF9837056E4B0F595949AA5A9C168BB6F93</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/08277AF9837056E4B0F595949AA5A9C168BB6F93/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/08277AF9837056E4B0F595949AA5A9C168BB6F93/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/08277AF9837056E4B0F595949AA5A9C168BB6F93/fulltext/tei"><teiHeader type="text"><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><availability><p>Wiley Subscription Services, Inc., A Wiley Company</p></availability><date>2011</date></publicationStmt><notesStmt><note type="content">*Relevant conflict of interest/financial disclosures: Nothing to report. This study was sponsored by a grant from the Michael J Fox Foundation for Parkinson Research (MJFF; www.michaeljfox.org).Full financial disclosures and author roles may be found in the online version of this article.</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale</title><author><persName><forename type="first">Albert F.G.</forename><surname>Leentjens</surname><roleName type="degree">MD, PhD</roleName></persName><note type="correspondence"><p>Correspondence: Department of Psychiatry, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands</p></note><affiliation>Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands</affiliation></author><author><persName><forename type="first">Kathy</forename><surname>Dujardin</surname><roleName type="degree">PhD</roleName></persName><affiliation>Neurology and Movement Disorders Unit, Lille University Hospital, Lille, France</affiliation></author><author><persName><forename type="first">Laura</forename><surname>Marsh</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</affiliation><affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</affiliation><affiliation>Current Address: Laura Marsh Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center and Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA</affiliation></author><author><persName><forename type="first">Irene H.</forename><surname>Richard</surname><roleName type="degree">MD</roleName></persName><affiliation>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</affiliation><affiliation>Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</affiliation></author><author><persName><forename type="first">Sergio E.</forename><surname>Starkstein</surname><roleName type="degree">MD</roleName></persName><affiliation>School of Psychiatry, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia</affiliation></author><author><persName><forename type="first">Pablo</forename><surname>Martinez‐Martin</surname><roleName type="degree">MD, PhD</roleName></persName><affiliation>Area of Applied Epidemiology and CIBERNED, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain</affiliation></author></analytic><monogr><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="pISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><idno type="DOI">10.1002/(ISSN)1531-8257</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-02-15"></date><biblScope unit="vol">26</biblScope><biblScope unit="issue">3</biblScope><biblScope unit="page" from="407">407</biblScope><biblScope unit="page" to="415">415</biblScope></imprint></monogr><idno type="istex">08277AF9837056E4B0F595949AA5A9C168BB6F93</idno><idno type="DOI">10.1002/mds.23184</idno><idno type="ArticleID">MDS23184</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2011</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Background:: Anxiety is a prevalent and disabling condition in Parkinson's disease (PD). The lack of anxiety rating scales validated for this population hampers research into anxiety in PD. The aim of this study is to assess the clinimetric properties of the Hamilton anxiety rating scale (HARS), the Beck anxiety inventory (BAI), and the hospital anxiety and depression scale (HADS) in PD patients. Design:: Three hundred forty‐two PD patients underwent a standardized assessment including a structured interview for diagnostic and statistical manual diagnoses of anxiety disorders and completion of the HARS, BAI, and HADS. Inter‐rater reliability of the HARS was assessed in 60 patients; test‐retest reliability of the BAI and HADS in 213 and 217 patients, respectively. Results:: Thirty‐four percent of patients suffered from an anxiety disorder, whereas an additional 11.4% had clinically significant anxiety symptoms in the absence of a diagnosis of anxiety disorder. Acceptability, score distribution, and known groups validity over different levels of anxiety were adequate. Inter‐rater reliability for the HARS and test‐retest reliability for the BAI and HADS were good. The HARS, but not the BAI and HADS, had a satisfactory inter‐item correlation, convergent validity and factorial structure. For all scales, the positive predictive value was poor, and the negative predictive value was moderate. Conclusions:: Given the adequate known groups validity of all three rating scales, each of these scales is likely to be useful in clinical practice or research for evaluation of symptom severity. Limitations in the construct validity of the anxiety scales in this study raise questions regarding suitability for their use in PD. © 2011 Movement Disorder Society</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>Parkinson's disease</term></item><item><term>anxiety</term></item><item><term>depression</term></item><item><term>clinimetrics</term></item><item><term>psychometrics</term></item><item><term>rating scales</term></item><item><term>validity</term></item><item><term>reliability</term></item></list></keywords></textClass><textClass><keywords scheme="Journal Subject"><list><head>Article category</head><item><term>Research Article</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2010-01-11">Received</change><change when="2010-03-23">Registration</change><change when="2011-02-15">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/08277AF9837056E4B0F595949AA5A9C168BB6F93/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8257</doi><issn type="print">0885-3185</issn><issn type="electronic">1531-8257</issn><idGroup><id type="product" value="MDS"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="MOVEMENT DISORDERS">Movement Disorders</title><title type="short">Mov. Disord.</title></titleGroup></publicationMeta><publicationMeta level="part" position="30"><doi origin="wiley" registered="yes">10.1002/mds.v26.3</doi><numberingGroup><numbering type="journalVolume" number="26">26</numbering><numbering type="journalIssue">3</numbering></numberingGroup><coverDate startDate="2011-02-15">15 February 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="100" status="forIssue"><doi origin="wiley" registered="yes">10.1002/mds.23184</doi><idGroup><id type="unit" value="MDS23184"></id></idGroup><countGroup><count type="pageTotal" number="9"></count></countGroup><titleGroup><title type="articleCategory">Research Article</title><title type="tocHeading1">Research Articles</title></titleGroup><copyright ownership="thirdParty">Copyright © 2011 Movement Disorder Society</copyright><eventGroup><event type="manuscriptReceived" date="2010-01-11"></event><event type="manuscriptRevised" date="2010-03-12"></event><event type="manuscriptAccepted" date="2010-03-23"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:3.0.1 mode:FullText" date="2012-01-12"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-03-07"></event><event type="publishedOnlineFinalForm" date="2011-03-31"></event><event type="firstOnline" date="2011-03-07"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-02"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-31"></event></eventGroup><numberingGroup><numbering type="pageFirst">407</numbering><numbering type="pageLast">415</numbering></numberingGroup><correspondenceTo>Department of Psychiatry, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:MDS.MDS23184.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="0"></count><count type="tableTotal" number="7"></count><count type="referenceTotal" number="42"></count><count type="wordTotal" number="8355"></count></countGroup><titleGroup><title type="main" xml:lang="en">Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale<link href="#fn1"></link></title><title type="short" xml:lang="en">Validation of Anxiety Rating Scales in PD</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1" corresponding="yes"><personName><givenNames>Albert F.G.</givenNames><familyName>Leentjens</familyName><degrees>MD, PhD</degrees></personName><contactDetails><email>a.leentjens@np.unimaas.nl</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Kathy</givenNames><familyName>Dujardin</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af3 #af4" currentRef="#curr1"><personName><givenNames>Laura</givenNames><familyName>Marsh</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af5 #af6"><personName><givenNames>Irene H.</givenNames><familyName>Richard</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af7"><personName><givenNames>Sergio E.</givenNames><familyName>Starkstein</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af8"><personName><givenNames>Pablo</givenNames><familyName>Martinez‐Martin</familyName><degrees>MD, PhD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="NL" type="organization"><unparsedAffiliation>Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="FR" type="organization"><unparsedAffiliation>Neurology and Movement Disorders Unit, Lille University Hospital, Lille, France</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="US" type="organization"><unparsedAffiliation>Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</unparsedAffiliation></affiliation><affiliation xml:id="af7" countryCode="AU" type="organization"><unparsedAffiliation>School of Psychiatry, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia</unparsedAffiliation></affiliation><affiliation xml:id="af8" countryCode="ES" type="organization"><unparsedAffiliation>Area of Applied Epidemiology and CIBERNED, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain</unparsedAffiliation></affiliation><affiliation xml:id="curr1" countryCode="US"><unparsedAffiliation>Laura Marsh Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center and Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Parkinson's disease</keyword><keyword xml:id="kwd2">anxiety</keyword><keyword xml:id="kwd3">depression</keyword><keyword xml:id="kwd4">clinimetrics</keyword><keyword xml:id="kwd5">psychometrics</keyword><keyword xml:id="kwd6">rating scales</keyword><keyword xml:id="kwd7">validity</keyword><keyword xml:id="kwd8">reliability</keyword></keywordGroup><supportingInformation><p> Additional Supporting Information may be found in the online version of this article. </p><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23184:MDS_23184_sm_suppinfo"></mediaResource><caption>Supporting Information</caption></supportingInfoItem><supportingInfoItem><mediaResource alt="supporting information" href="urn-x:wiley:08853185:media:mds23184:MDS_23184_sm_suppinfoauthorrolesanddisclosures"></mediaResource><caption>Supporting Information Author Roles and Disclosures</caption></supportingInfoItem></supportingInformation><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Background:</title><p>Anxiety is a prevalent and disabling condition in Parkinson's disease (PD). The lack of anxiety rating scales validated for this population hampers research into anxiety in PD. The aim of this study is to assess the clinimetric properties of the Hamilton anxiety rating scale (HARS), the Beck anxiety inventory (BAI), and the hospital anxiety and depression scale (HADS) in PD patients.</p></section><section xml:id="abs1-2"><title type="main">Design:</title><p>Three hundred forty‐two PD patients underwent a standardized assessment including a structured interview for diagnostic and statistical manual diagnoses of anxiety disorders and completion of the HARS, BAI, and HADS. Inter‐rater reliability of the HARS was assessed in 60 patients; test‐retest reliability of the BAI and HADS in 213 and 217 patients, respectively.</p></section><section xml:id="abs1-3"><title type="main">Results:</title><p>Thirty‐four percent of patients suffered from an anxiety disorder, whereas an additional 11.4% had clinically significant anxiety symptoms in the absence of a diagnosis of anxiety disorder. Acceptability, score distribution, and known groups validity over different levels of anxiety were adequate. Inter‐rater reliability for the HARS and test‐retest reliability for the BAI and HADS were good. The HARS, but not the BAI and HADS, had a satisfactory inter‐item correlation, convergent validity and factorial structure. For all scales, the positive predictive value was poor, and the negative predictive value was moderate.</p></section><section xml:id="abs1-4"><title type="main">Conclusions:</title><p>Given the adequate known groups validity of all three rating scales, each of these scales is likely to be useful in clinical practice or research for evaluation of symptom severity. Limitations in the construct validity of the anxiety scales in this study raise questions regarding suitability for their use in PD. © 2011 Movement Disorder Society</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn1"><p><b>Relevant conflict of interest/financial disclosures:</b> Nothing to report. This study was sponsored by a grant from the Michael J Fox Foundation for Parkinson Research (MJFF; <url href="http://www.michaeljfox.org">www.michaeljfox.org</url>).</p><p>Full financial disclosures and author roles may be found in the online version of this article.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><!--Version 0.6 générée le 4-12-2015--><mods version="3.6"><titleInfo lang="en"><title>Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Validation of Anxiety Rating Scales in PD</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Anxiety rating scales in Parkinson's disease: A validation study of the Hamilton anxiety rating scale, the Beck anxiety inventory, and the hospital anxiety and depression scale</title></titleInfo><name type="personal"><namePart type="given">Albert F.G.</namePart><namePart type="family">Leentjens</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Department of Psychiatry, Maastricht University Medical Center, Maastricht, The Netherlands</affiliation><description>Correspondence: Department of Psychiatry, Maastricht University Medical Center, P.O. Box 5800, 6202 AZ Maastricht, The Netherlands</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Kathy</namePart><namePart type="family">Dujardin</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Neurology and Movement Disorders Unit, Lille University Hospital, Lille, France</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Laura</namePart><namePart type="family">Marsh</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</affiliation><affiliation>Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA</affiliation><affiliation>Current Address: Laura Marsh Mental Health Care Line, Michael E. DeBakey Veterans Administration Medical Center and Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Irene H.</namePart><namePart type="family">Richard</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Department of Neurology, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</affiliation><affiliation>Department of Psychiatry, University of Rochester School of Medicine and Dentistry, Rochester, New York, USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Sergio E.</namePart><namePart type="family">Starkstein</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>School of Psychiatry, University of Western Australia and Fremantle Hospital, Fremantle, Western Australia, Australia</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Pablo</namePart><namePart type="family">Martinez‐Martin</namePart><namePart type="termsOfAddress">MD, PhD</namePart><affiliation>Area of Applied Epidemiology and CIBERNED, National Centre for Epidemiology, Carlos III Institute of Health, Madrid, Spain</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre authority="originalCategForm">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-02-15</dateIssued><dateCaptured encoding="w3cdtf">2010-01-11</dateCaptured><dateValid encoding="w3cdtf">2010-03-23</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="tables">7</extent><extent unit="references">42</extent><extent unit="words">8355</extent></physicalDescription><abstract lang="en">Background:: Anxiety is a prevalent and disabling condition in Parkinson's disease (PD). The lack of anxiety rating scales validated for this population hampers research into anxiety in PD. The aim of this study is to assess the clinimetric properties of the Hamilton anxiety rating scale (HARS), the Beck anxiety inventory (BAI), and the hospital anxiety and depression scale (HADS) in PD patients. Design:: Three hundred forty‐two PD patients underwent a standardized assessment including a structured interview for diagnostic and statistical manual diagnoses of anxiety disorders and completion of the HARS, BAI, and HADS. Inter‐rater reliability of the HARS was assessed in 60 patients; test‐retest reliability of the BAI and HADS in 213 and 217 patients, respectively. Results:: Thirty‐four percent of patients suffered from an anxiety disorder, whereas an additional 11.4% had clinically significant anxiety symptoms in the absence of a diagnosis of anxiety disorder. Acceptability, score distribution, and known groups validity over different levels of anxiety were adequate. Inter‐rater reliability for the HARS and test‐retest reliability for the BAI and HADS were good. The HARS, but not the BAI and HADS, had a satisfactory inter‐item correlation, convergent validity and factorial structure. For all scales, the positive predictive value was poor, and the negative predictive value was moderate. Conclusions:: Given the adequate known groups validity of all three rating scales, each of these scales is likely to be useful in clinical practice or research for evaluation of symptom severity. Limitations in the construct validity of the anxiety scales in this study raise questions regarding suitability for their use in PD. © 2011 Movement Disorder Society</abstract><note type="content">*Relevant conflict of interest/financial disclosures: Nothing to report. This study was sponsored by a grant from the Michael J Fox Foundation for Parkinson Research (MJFF; www.michaeljfox.org). Full financial disclosures and author roles may be found in the online version of this article.</note><subject lang="en"><genre>Keywords</genre><topic>Parkinson's disease</topic><topic>anxiety</topic><topic>depression</topic><topic>clinimetrics</topic><topic>psychometrics</topic><topic>rating scales</topic><topic>validity</topic><topic>reliability</topic></subject><relatedItem type="host"><titleInfo><title>Movement Disorders</title></titleInfo><titleInfo type="abbreviated"><title>Mov. 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