The Value of Chinese Version GAD-7 and PHQ-9 to Screen Anxiety and Depression in Chinese Outpatients with Atypical Chest Pain

Qiuzhen Lin; Ousseina Bonkano; Keke Wu; Qiming Liu; Toure Ali Ibrahim; Ling Liu

doi:10.2147/TCRM.S305623

The Value of Chinese Version GAD-7 and PHQ-9 to Screen Anxiety and Depression in Chinese Outpatients with Atypical Chest Pain

Ther Clin Risk Manag. 2021 May 18:17:423-431. doi: 10.2147/TCRM.S305623. eCollection 2021.

Authors

Qiuzhen Lin^{1

2

3

4}, Ousseina Bonkano^{1

2

3

4

5}, Keke Wu^{1

2

3

4}, Qiming Liu^{1

2

3

4}, Toure Ali Ibrahim⁵, Ling Liu^{1

2

3

4}

Affiliations

¹ Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, People's Republic of China.
² Research Institute of Blood Lipid and Atherosclerosis, Central South University, Changsha, People's Republic of China.
³ Modern Cardiovascular Disease Clinical Technology Research Center of Hunan Province, Changsha, People's Republic of China.
⁴ Cardiovascular Disease Research Center of Hunan Province, Changsha, Hunan, 410011, People's Republic of China.
⁵ Department of Cardiovascular and Internal Medicine Niger, Niamey Amirou Boubacar Diallo National Hospital, Abdou Moumouni University, Niamey, Niger.

Abstract

Background: Atypical chest pain in some outpatients could derive from mental disorders. It is necessary for them to have a preliminary emotional assessment in the outpatient department of Cardiology before psychiatric outpatient visits.

Methods: This study included 122 Chinese outpatients with atypical chest pain in the department of Cardiology. They accepted routine examinations, including treadmill test, and were judged by the three-question method as highly likely to have emotional disorders. Then, a standard questionnaire package containing the Chinese version of the seven-item scale for General Anxiety Disorder (GAD-7), Self-rating Anxiety Scale (SAS), the nine-item Patient Health Questionnaire (PHQ-9) and Self-rating Depression Scale (SDS) was administered to evaluate anxiety and depression.

Results: The percentages of anxiety evaluated by GAD-7 and SAS were 62.3% and 26.2%, respectively. Analogously, the assessment by PHQ-9 showed a significantly higher percentage of depression than that by SDS (61.5% vs 29.5%) (P < 0.05). Kappa analysis showed that the consistency between GAD-7 and SAS, or that between PHQ-9 and SDS was not very good. About 73% outpatients suffered from emotional disorders, presenting as anxiety/depression evaluated by GAD-7 and PHQ-9. Furthermore, sleep disorders accounted for more than 80% of patients with mental disorders. Finally, the suicidal tendency of depression patients was about 17% that should not be ignored.

Conclusion: Compared with SAS and SDS, GAD-7 and PHQ-9 detected more participants with emotional disorders in the Chinese outpatients with atypical chest pain, indicating that GAD-7 and PHQ-9 could be briefly well-validated tools to screen emotional disorders in the outpatient department of Cardiology before psychiatric visits.

Keywords: anxiety; atypical chest pain; depression; screen.

Grants and funding

This project was supported by the National Natural Science Foundation of China [grant numbers: 81270956, 81470577] and the Fundamental Research Funds for the Central Universities of Central South University [grant number 2020zzts289].