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Screening for anxiety and depression: reassessing the utility of the Zung scales

Overview of attention for article published in BMC Psychiatry, September 2017
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Title
Screening for anxiety and depression: reassessing the utility of the Zung scales
Published in
BMC Psychiatry, September 2017
DOI 10.1186/s12888-017-1489-6
Pubmed ID
Authors

Debra A. Dunstan, Ned Scott, Anna K. Todd

Abstract

While the gold standard for the diagnosis of mental disorders remains the structured clinical interview, self-report measures continue to play an important role in screening and measuring progress, as well as being frequently employed in research studies. Two widely-used self-report measures in the area of depression and anxiety are Zung's Self-Rating Depression Scale (SDS) and Self Rating Anxiety Scale (SAS). However, considerable confusion exists in their application, with clinical cut-offs often applied incorrectly. This study re-examines the credentials of the Zung scales by comparing them with the Depression Anxiety Stress Scale (DASS) in terms of their ability to predict clinical diagnoses of anxiety and depression made using the Patient Health Questionnaire (PHQ). A total sample of 376 adults, of whom 87 reported being in receipt of psychological treatment, completed the two-page version of the PHQ relating to depression and anxiety, together with the SDS, the SAS and the DASS. Overall, although the respective DASS scales emerged as marginally stronger predictors of PHQ diagnoses of anxiety and depression, the Zung indices performed more than acceptably in comparison. The DASS also had an advantage in discriminative ability. Using the current recommended cut-offs for all scales, the DASS has the edge on specificity, while the Zung scales are superior in terms of sensitivity. There are grounds to consider making the Zung cut-offs more conservative, and doing this would produce comparable numbers of 'Misses' and 'False Positives' to those obtained with the DASS. Given these promising results, further research is justified to assess the Zung scales ability against full clinical diagnoses and to further explore optimum cut-off levels.

Mendeley readers

Mendeley readers

The data shown below were compiled from readership statistics for 280 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 280 100%

Demographic breakdown

Readers by professional status Count As %
Student > Bachelor 42 15%
Student > Master 30 11%
Researcher 16 6%
Student > Postgraduate 16 6%
Student > Ph. D. Student 16 6%
Other 46 16%
Unknown 114 41%
Readers by discipline Count As %
Medicine and Dentistry 54 19%
Nursing and Health Professions 33 12%
Psychology 33 12%
Neuroscience 6 2%
Agricultural and Biological Sciences 6 2%
Other 22 8%
Unknown 126 45%
Attention Score in Context

Attention Score in Context

This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 08 September 2017.
All research outputs
#20,446,373
of 23,001,641 outputs
Outputs from BMC Psychiatry
#4,259
of 4,738 outputs
Outputs of similar age
#276,054
of 316,058 outputs
Outputs of similar age from BMC Psychiatry
#71
of 79 outputs
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