Psychometric Properties of GAD-7 in Subjects with Morbid Obesity Undergoing Bariatric Surgery
Keywords:
cirugía bariátrica, ansiedad, ansiedad generalizada, GAD-7Abstract
Introduction: The detection of anxiety manifestations in subjects with morbid obesity is a priority in the care of this risk group that increases when they undergo bariatric surgery to improve their health condition. Instruments that are easy to apply, and valid for this growing population are required.
Objective: Assess the psychometric properties of the generalized anxiety scale (GAD-7) in Ecuadorian subjects with anxiety disorders undergoing bariatric surgery.
Methods: An instrumental investigation was conducted in 58 adults (nMEN=28; 48.3 %; nWOMEN=30; 52.7 %) with morbid obesity who underwent bariatric surgery (meanAGE=35.9; SD=8, 92).
Results: The results showed good internal consistency, with a Cronbach's alpha coefficient above the recommended threshold of 0.70 and the CFI = .96.Good reliability and validity were demonstrated for the symptoms of generalized anxiety disorders in morbidity obese individuals who underwent bariatric surgery.
Conclusions: The analysis showed that GAD-7 is a useful tool for the identification of subjects with generalized anxiety, and can be incorporated into the preoperative evaluation process.
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References
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3. Nechita D, Nec hita F, Motorga R. A review of the influence the anxiety exerts on human life. Rom J Morphol Embryol. 2014;59(4). Available from: https://rjme.ro/RJME/resources/files/NechitaDan_RJME_59_4_2018.pdf
4. Nielsen B, Andersen K. Alcohol, anxiety, and depression. Ugeskrift for Laeger. 2022;184(14):V10210816. Available from: https://content.ugeskriftet.dk/sites/default/files/scientific_article_files/2022-03/v10210816_web.pdf
5. Aragonès E, Lluís Piñol J, Labad A. Comorbilidad de la depresión mayor con otros trastornos mentales comunes en pacientes de atención primaria. Aten Prim. 2009 oct;41(10):545–51. Disponible en: https://doi.org/10.1016/j.aprim.2008.11.011
6. Locke AB, Kirst N, Shultz CG. Diagnosis and Management of Generalized Anxiety Disorder and Panic Disorder in Adults. Am Fam Phy. 91(9):617–24. Available from: https://www.aafp.org/content/dam/brand/aafp/pubs/afp/issues/2015/0501/p617.pdf
7. Showraki M, Showraki T, Brown K. Generalized anxiety disorder: Revisited. Psychiatric Quarterly. 2020 May 7;91(3):905–14. Available from: https://doi.org/10.1007/s11126-020-09747-0
8. Andreescu C, Lee S. Anxiety Disorders in the Elderly. In: Advances in Experimental Medicine and Biology [Internet]. Singapore: Springer Singapore; 2020 [cited 2023 Aug 12]. p. 561–76. Available from: http://dx.doi.org/10.1007/978-981-32-9705-0_28
9. Tiller JWG. Depression and anxiety. Med J Aust. 2013 Oct;199(S6). Available from: https://doi.org/10.5694/mja12.10628
10. World Health Organization. Comprehensive mental health action plan 2013-2020-2030 [Internet]. [cited 2023 Aug 12]. Available from: https://www.who.int/initiatives/mental-health-action-plan-2013-2030
11. Organización Panamericana de la Salud. Salud en las Américas 2017 [Internet]. [cited 2023 Aug 12]. Available from: https://www.paho.org/salud-en-las-americas-2017/ro-mental-es.html
12. Sagar R, Gupta T. Psychological Aspects of Obesity in Children and Adolescents. Indian J Pediatr. 2017 Nov 18;85(7):554–9. Available from: https://doi.org/10.1007/s12098-017-2539-2
13. Athanasiadis DI, Martin A, Kapsampelis P, Monfared S, Stefanidis D. Factors associated with weight regain post-bariatric surgery: a systematic review. Surg Endosc 2021 Mar 1;35(8):4069–84. Available from: https://doi.org/10.1007/s00464-021-08329-w
14. Gill H, Kang S, Lee Y, Rosenblat JD, Brietzke E, Zuckerman
H, et al. The long-term effect of bariatric surgery on depression and anxiety. J Affect Disord. 2019 Mar; 246:886–94. Available from: https://doi.org/10.1016/j.jad.2018.12.113
15. de Zwaan M, Enderle J, Wagner S, Mühlhans B, Ditzen B, Gefeller O, et al. Anxiety and depression in bariatric surgery patients: A prospective, follow-up study using structured clinical interviews. J Affect Disord. 2011 Sep;133(1–2):61–8. Available from: https://doi.org/10.1016/j.jad.2011.03.025
16. Troisi A. Anxiety Disorders, OCD, and PTSD. In: Bariatric Psychology and Psychiatry [Internet]. Cham: Springer International Publishing; 2020 [cited 2023 Aug 12]. p. 77–85. Available from: http://dx.doi.org/10.1007/978-3-030-44834-9_8
17. Tae B, Pelaggi ER, Moreira JG, Waisberg J, Matos LL de, D’Elia G. Impact of bariatric surgery on depression and anxiety symptons, bulimic behaviors and quality of life. Rev Col Bras Cir. 2014 Jun;41(3):155–60. Available from: https://doi.org/10.1590/S0100-69912014000300004
18. Maron E, Nutt D. Biological markers of generalized anxiety disorder. Dialogues Clin Neurosci. 2017 Jun 30;19(2):147–58. Available from : https://doi.org/10.31887/DCNS.2017.19.2/dnutt
19. Karlsson J, Taft C, Rydén A, Sjöström L, Sullivan M. Ten-year trends in health-related quality of life after surgical and conventional treatment for severe obesity: the SOS intervention study. Int J Obes (Lond). 2007 Mar 13;31(8):1248–61. Available from:
https://doi.org/10.1038/sj.ijo.0803573
20. Gaudrat B, Florent V, Andrieux S, Rousseau A. “I Want to Lose Weight and it Has to Be Fair”: Predictors of Satisfaction After Bariatric Surgery. OBES SURG. 2020 Nov 12;31(2):763–72. Available from: https://doi.org/10.1007/s11695-020-05069-z
21. Duarte-Guerra LS, Coêlho BM, Santo MA, Lotufo-Neto F, Wang YP. Morbidity persistence and comorbidity of mood, anxiety, and eating disorders among preoperative bariatric patients. Psychiatry Res. 2017 Nov; 257:1–6. Available from: https://doi.org/10.1016/j.psychres.2017.07.020
22. Kalarchian MA, Marcus MD, Levine MD, Courcoulas AP, Pilkonis PA, Ringham RM et al. Psychiatric Disorders Among Bariatric Surgery Candidates: Relationship to Obesity and Functional Health Status. Am J Psychiatry. 2007 Feb;164(2):328–34. Available from: https://ajp.psychiatryonline.org/doi/epdf/10.1176/ajp.2007.164.2.328
23. Cassiani-Miranda CA, Cuadros-Cruz AK, Torres-Pinzón H, Scoppetta O, Pinzón-Tarrazona JH, López-Fuentes WY, et al. Validez del Cuestionario de salud del paciente-9 (PHQ-9) para cribado de depresión en adultos usuarios de Atención Primaria en Bucaramanga, Colombia. Rev Colomb Psiq. 2021 Jan;50(1):11–21. Disponible en: https://doi.org/10.1016/j.rcp.2019.09.001
24. Javaid SF, Hashim IJ, Hashim MJ, Stip E, Samad MA, Ahbabi AA. Epidemiology of anxiety disorders: global burden and sociodemographic associations. Middle East Curr Psychiatry. 2023 May 26;30(1). Available from: https://doi.org/10.1186/s43045-023-00315-3
25. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A Brief Measure for Assessing Generalized Anxiety Disorder. Archives of Internal Medicine. 2006 May 22;166(10):1092. Available from: https://doi.org/10.1001/archinte.166.10.1092
26. Ahn JK, Kim Y, Choi KH. The Psychometric Properties and Clinical Utility of the Korean Version of GAD-7 and GAD-2. Front Psychiatry. 2019 Mar 18;10. Available from: https://doi.org/10.3389/fpsyt.2019.00127
27. García-Campayo J, Zamorano E, Ruiz MA, Pardo A, Pérez-Paramo M, López-Gómez V, et al. Cultural adaptation into Spanish of the generalized anxiety disorder-7 (GAD-7) scale as a screening tool. Health Qual Life Outcomes. 2010;8(1):8. Available from: https://doi.org/10.1186/1477-7525-8-8
28. Gong Y, Zhou H, Zhang Y, Zhu X, Wang X, Shen B, et al. Validation of the 7-item Generalized Anxiety Disorder scale (GAD-7) as a screening tool for anxiety among pregnant Chinese women. J Affect Disord. 2021 Mar;282:98–103. Available from: https://doi.org/10.1016/j.jad.2020.12.129
29. Kertz S, Bigda-Peyton J, Bjorgvinsson T. Validity of the Generalized Anxiety Disorder-7 Scale in an Acute Psychiatric Sample. Clin Psychol Psychother. 2012 May 17. Available from: https://doi.org/10.1002/cpp.1802
30. Rutter LA, Brown TA. Psychometric Properties of the Generalized Anxiety Disorder Scale-7 (GAD-7) in Outpatients with Anxiety and Mood Disorders. J Psychopathol Behav Assess. 2016 Sep 10;39(1):140–6. Available from: https://doi.org/10.1007/s10862-016-9571-9
31. Sousa TV, Viveiros V, Chai MV, Vicente FL, Jesus G, Carnot MJ, et al. Reliability and validity of the Portuguese version of the Generalized Anxiety Disorder (GAD-7) scale. Health Qual Life Outcomes. 2015 Apr 25;13(1). Available from: https://doi.org/10.1186/s12955-015-0244-2
32. Gong Y, Zhou H, Zhang Y, Zhu X, Wang X, Shen B, et al. Validation of the 7-item Generalized Anxiety Disorder scale (GAD-7) as a screening tool for anxiety among pregnant Chinese women. J Affect Disord. 2021 Mar; 282:98–103. Available from: https://doi.org/10.1016/j.jad.2020.12.129
33. Omani-Samani R, Maroufizadeh S, Ghaheri A, Navid B. Generalized Anxiety Disorder-7 (GAD-7) in people with infertility: A reliability and validity study. Middle East Fertility Soc J. 2018 Dec;23(4):446–9. Available from: https://doi.org/10.1016/j.mefs.2018.01.013
34. Lee B, Kim YE. The psychometric properties of the Generalized Anxiety Disorder scale (GAD-7) among Korean university students. Psy and Clin Psy. 2019 Oct 2;29(4):864–71. Available from: https://doi.org/10.1080/24750573.2019.1691320
35. Shrestha S, Ramos K, Fletcher TL, Kraus-Schuman C, Stanley MA, Ramsey D, et al. Psychometric properties of worry and anxiety measures in a sample of african american and caucasian older adults Aging Ment Health. 2019 Feb 27;24(2):315–21. Available from: https://doi.org/10.1080/13607863.2018.1544217
36. Dhira TA, Rahman MA, Sarker AR, Mehareen J. Validity and reliability of the Generalized Anxiety Disorder-7 (GAD-7) among university students of Bangladesh. PLoS One. 2021 Dec 16;16(12):e0261590. doi: 10.1371/journal.pone.0261590. PMID: 34914811; PMCID: PMC8675645. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8675645/
37. Löwe B, Decker O, Müller S, Brähler E, Schellberg D, Herzog W, et al. Validation and Standardization of the Generalized Anxiety Disorder Screener (GAD-7) in the General Population. Med Care. 2008 Mar;46(3):266–74. Available from: http://www.jstor.org/stable/40221654
38. Hinz A, Klein AM, Brähler E, Glaesmer H, Luck T, Riedel-Heller SG, et al. Psychometric evaluation of the Generalized Anxiety Disorder Screener GAD-7, based on a large German general population sample. J Affect Disord. 2017 Mar; 210:338–44. Available from: https://doi.org/10.1016/j.jad.2016.12.012
39. Generalized Anxiety disorder Scale (GAD-7) [Internet]. Available from: https://elcentro.sonhs.miami.edu/research/measures-library/gad-7/index.html
40. R S. Multivariate Data Analysis: Using SPSS and AMOS. Mjp Publishers; 2019. Available from: https://www.amazon.com/MULTIVARIATE-DATA-ANALYSIS-Using-SPSS/dp/8180944123
41. Marsh HW, Hau KT, Wen Z. In Search of Golden Rules: Comment on Hypothesis-Testing Approaches to Setting Cutoff Values for Fit Indexes and Dangers in Overgeneralizing Hu and Bentler’s (1999) Findings. Structural Equation Modeling: Structural Equation Modeling. 2004 Jul;11(3):320–41. Available from: https://doi.org/10.1207/s15328007sem1103_2
42. Fan X, Sivo SA. Sensitivity of Fit Indices to Model Misspecification and Model Types. Multivariate Behavioral Research. 2007 Oct 10;42(3):509–29. Available from: https://doi.org/10.1080/00273170701382864
43. Browne MW, Cudeck R. Alternative Ways of Assessing Model Fit. Soc. Metho. & Res. 1992 Nov;21(2):230–58. Available from: https://doi.org/10.1177/0049124192021002005
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2024-03-14
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Valdevila Figueira JA, Ramírez Coronel AA, Farias Silva DS, Valdevila Santiesteban R, Carvajal Parra ID, Benenaula Vargas LP. Psychometric Properties of GAD-7 in Subjects with Morbid Obesity Undergoing Bariatric Surgery. Rev. Hosp. Psiq. Habana [Internet]. 2024 Mar. 14 [cited 2025 Sep. 11];21(1). Available from: https://revhph.sld.cu/index.php/hph/article/view/388
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