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Does presence of metabolic syndrome impact anxiety and depressive disorder screening results in middle aged and elderly patients?
Date Issued |
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2016-09-17 |
Bibliogr.: p. S393
Introduction: Mental disorders are common in the general population with reported point-prevalence rate in Lithuania reaching 23% [1]. Timely identification of patients suffering from mental disorders is very important for effective treatment outcomes. The Hospital Anxiety and Depression scale (HADS) is commonly used and widely studied instrument for screening of depressive and anxiety disorders in Lithuania and has demonstrated good psychometric properties [2]. Metabolic syndrome (MetS) is often co-morbid with mental disorders [3] and MetS somatic symptoms can impair recognition of mental disorders [4]. The aim of the present study was to investigate if presence of MetS can impact the accuracy of current major depressive disorder and generalized anxiety disorder screening results using the HADS scale. Methods: From February 2003 until January 2004 a total of 1115 (562 men; mean age 62.0±9.6 years) individuals of 45 years. and older were randomly selected from primary care practice and evaluated for the MetS by using the World Health Organization criteria; severity of depression and anxiety symptoms was evaluated using the HADS (the HADS-Depression (HAD-D) and the HAD-A)); for diagnoses of current Major depressive episode (MDE) and current Generalized anxiety disorder (GAD) the Mini International Neuropsychiatric Interview (MINI 5.0.0) was used. The study protocol and informed consent procedures were approved by the Regional Bioethics Committee at the Lithuanian University of Health Sciences, Kaunas, Lithuania. Results: Area under the ROC curve (AUC) of the HADS-D subscale for current MDE in patients with MetS and without MetS were at levels of 0.83 (95% CI: 0.79–0.87) and 0.86 (95% CI: 0.82–0.89), respectively. Optimal cut-off values of the HADS-D were 9 in patients with MetS (sensitivity = 87%, specificity = 73% and PPV = 52%) and 8 in patients without MetS (sensitivity = 81%, spe[...].