Screening for Anxiety Symptoms With the Generalized Anxiety Disorder-2 Versus Generalized Anxiety Disorder-7 in Children With Headache or Epilepsy.
Publication/Presentation Date
2-4-2026
Abstract
BACKGROUND: To assess the accuracy of the Generalized Anxiety Disorder-2 (GAD-2) Scale for screening anxiety symptoms in children with headache and epilepsy.
METHODS: Single-center and large-scale assessment of the two-item GAD-2 as compared to the seven-item Generalized Anxiety Disorder-7 (GAD-7) to screen for moderate-severe anxiety symptoms in children undergoing follow-up neurology appointments.
RESULTS: The GAD-7 was fully completed for 3960 of 6060 (65%) encounters. Anxiety symptoms were moderate in 534 (13%) encounters and severe in 337 (9%) encounters. The GAD-2 and GAD-7 were very strongly correlated (spearman's rho 0.91; P < 0.001). When assessing moderate-severe anxiety symptoms based on the GAD-7, a GAD-2 score of ≥3 yielded an area under the receiver operating characteristics curve of 0.96, sensitivity 89%, specificity 91%, positive predictive value 74%, and negative predictive value 97%. If assessment stopped with the GAD-2 at the ≥3 cutoff, then 74% of encounters would be considered not to have anxiety symptoms and would not complete additional questions, but 11% of encounters with moderate-severe anxiety symptoms would not be identified, including 0.6% of patients with severe anxiety symptoms.
CONCLUSIONS: Anxiety symptoms were common. Use of the GAD-2 would reduce the number of questions needing completion compared to the GAD-7 for 74% of patients but would fail to identify 11% of patients with moderate-severe anxiety symptoms, including 0.6% of patients with severe anxiety symptoms. These data indicate that the use of the GAD-2 may be appropriate as a briefer alternative to the GAD-7 which may be ideal in clinical settings with a substantial questionnaire burden.
Volume
178
First Page
7
Last Page
14
ISSN
1873-5150
Published In/Presented At
Marshall, A., Kaufman, M. C., Murphy, C., Molisani, S. E., Riisen, A. C., Scotti-Degnan, C. M., Witzman, S., Gonzalez, A. K., Ramos, M. O., Szperka, C. L., & Abend, N. S. (2026). Screening for Anxiety Symptoms With the Generalized Anxiety Disorder-2 Versus Generalized Anxiety Disorder-7 in Children With Headache or Epilepsy. Pediatric neurology, 178, 7–14. Advance online publication. https://doi.org/10.1016/j.pediatrneurol.2026.01.020
Disciplines
Medicine and Health Sciences | Pediatrics
PubMedID
41719872
Department(s)
Department of Pediatrics
Document Type
Article