Measurement tools suitable for primary care should be brief, easy to administer, reliable, valid, and applicable to all anxiety disorders. These measures may be of limited utility for busy primary care settings where time-constraints are of concern 21, 22. Most of them are relatively lengthy, disorder-specific, or do not capture functional impairments according to which the clinical significance of symptoms should be evaluated. Various self-report instruments for the assessment of anxiety are available 20. Against this background, it seems of utmost importance to further improve the quality of diagnosis and treatment of mental disorders in primary care. However, there is a shortage of mental health specialists in many (especially rural) areas 17, 18, resulting, for example, in an average waiting time for psychotherapeutic outpatient treatment in Germany of about 19 weeks 19. Treatment progress (including the severity of anxiety symptoms) should be monitored by primary care physicians, and patients should be referred to mental health specialists if the interventions offered in primary care prove to be not successful 15, 16. However, an under-recognition of anxiety disorders in primary care has often been reported 12, 13, 14.Īccording to current clinical guidelines, the recognition, diagnosis, and initial (behavioral or pharmacological) treatment for patients with anxiety disorders should be carried out in primary care 15, 16. Many affected individuals present in primary care settings first and tend to have themselves frequently re-examined in internal or emergency wards 10, 11. It is important to identify anxiety disorders in primary care where their prevalence is higher than in the general population 8, 9. At the same time, only a minority of affected individuals receive adequate treatments 7. Effective treatment options are available and should be applied once the psychopathology has been detected 6. These disorders are associated with severe reductions in quality of life and considerable health-economic costs 3, 4, 5. With more than 300 million people being affected worldwide, anxiety disorders are the most common psychiatric diagnoses and a leading cause of disability burden 1, 2. Caution is warranted when using the scale to compare groups that differ in age or gender. In sum, the findings support the transcultural validity of the OASIS and indicate its applicability to naturalistic primary care settings. Analyses of validity and optimal cut-off score were solely based on self-report measures, which may have introduced method effects. Rasch analyses of measurement invariance detected noninvariant subgroups associated with age and gender. A Rasch analysis of local item independence suggested response dependency between the first two items. A difference score of ≥ 5 was indicative of reliable individual change. A sum score (range 0–20) of ≥ 8 emerged as optimal cut-score for screening purposes. Convergent as well as discriminant validity with other self-report measures was found. The internal consistency was good to excellent. Factor analyses suggested a unitary (latent) factor structure. Psychometric properties were analyzed using classical test theory as well as probabilistic test theory. This study evaluates a German version (OASIS-D) that was administered to a convenience sample of 1398 primary care patients of whom 419 were diagnosed with panic disorder with/without agoraphobia. The Overall Anxiety Severity and Impairment Scale (OASIS) is a 5-item self-report measure that captures symptoms of anxiety and associated functional impairments.
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