IntroductionAnxiety disorders are common but often under-recognized in primary care. Validation data for the GAD-7 and GAD-2 in Eastern European primary care settings remain limited. To determine the reliability and diagnostic performance of the GAD-7 and GAD-2 for the most prevalent anxiety disorders in Latvian primary care using the Mini International Neuropsychiatric Interview (MINI) as the reference standard.MethodsConsecutive adult patients from 24 primary care practices completed the GAD-7 and GAD-2 prior to consultation. Within two weeks, blinded psychiatrists conducted MINI interviews by telephone. Internal consistency was assessed using Cronbach’s alpha. Diagnostic accuracy was evaluated using receiver operating characteristic analyses, sensitivity, specificity, and likelihood ratios.ResultsThe final analytical sample comprised 1,467 participants. The most prevalent MINI-defined anxiety disorders were agoraphobia (8.0%), generalized anxiety disorder (6.1%), and social phobia (4.7%). Internal consistency was 0.86 for the GAD-7 and 0.72 for the GAD-2. For generalized anxiety disorder, optimal cut-offs were ≥6 (GAD-7; sensitivity 71.9%, specificity 76.3%, AUC = 0.799) and ≥2 (GAD-2; sensitivity 80.9%, specificity 65.8%, AUC = 0.772). GAD-7 and GAD-2 performance for social phobia, agoraphobia and any anxiety disorders was relatively weak. For any anxiety disorder, the optimal thresholds were identified as ≥4 (GAD-7; sensitivity 70.6%, specificity 61.6%, AUC = 0.718) and ≥2 (GAD-2; sensitivity 64.9%, specificity 68.1%, AUC = 0.691).ConclusionThe GAD-7 and GAD-2 demonstrate satisfactory reliability and the strongest diagnostic accuracy to screen for generalized anxiety disorder in Latvian primary care, whereas performance for other anxiety disorder subtypes was comparatively more limited. Subtypes of anxiety disorders should be considered and specific cut-offs calculated to improve the detection of different anxiety disorders in routine general practice.
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