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This article reports on the test–retest reliability and sensitivity to change of a set of brief dimensional self-rating questionnaires for social anxiety disorder (SAD-D), specific phobia (SP-D), agoraphobia (AG-D), panic disorder (PD-D), and generalized anxiety disorder (GAD-D), as well as a general cross-cutting anxiety scale (Cross-D), which were developed to supplement categorical diagnoses in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5).
The German versions of the dimensional anxiety scales were administered to 218 students followed up approximately 2 weeks later (Study 1) and 55 outpatients (23 with anxiety diagnoses) followed-up 1 year later (Study 2). Probable diagnostic status in students was determined by the DIA-X/M-CIDI stem screening-questionnaire (SSQ). In the clinical sample, Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) diagnoses were assessed at Time 1 using the DIA-X/M-CIDI. At Time 2, the patient-version of the Clinical Global Impression—Improvement scale (CGI-I) was applied to assess change.
Good psychometric properties, including high test–retest reliability, were found for the dimensional scales except for SP-D. In outpatients, improvement at Time 2 was associated with significant decrease in PD-D, GAD-D, and Cross-D scores.
Major advantages of the scales include that they are brief, concise, and based on a consistent template to measure the cognitive, physiological, and behavioral symptoms of fear and anxiety. Further replication in larger samples is needed. Given its modest psychometric properties, SP-D needs refinement.
Increasing evidence from diverse samples suggests clinical utility of the dimensional anxiety scales.
Although (hypo)manic symptoms are common in adolescence, transition to
adult bipolar disorder is infrequent.
To examine whether the risk of transition to bipolar disorder is
conditional on the extent of persistence of subthreshold affective
In a 10-year prospective community cohort study of 3021 adolescents and
young adults, the association between persistence of affective symptoms
over 3 years and the 10-year clinical outcomes of incident DSM–IV
(hypo)manic episodes and incident use of mental healthcare was
Transition to clinical outcome was associated with persistence of
symptoms in a dose-dependent manner. Around 30–40% of clinical outcomes
could be traced to prior persistence of affective symptoms.
In a substantial proportion of individuals, onset of clinical bipolar
disorder may be seen as the poor outcome of a developmentally common and
usually transitory non-clinical bipolar phenotype.
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