From the Guidelines
Anxiety assessment should be conducted using a valid and reliable tool, such as the Generalized Anxiety Disorder-7 (GAD-7) scale, as recommended by the American Society of Clinical Oncology guideline update 1.
Key Assessment Components
- A thorough clinical interview to discuss symptoms, their duration, severity, and impact on daily functioning
- Use of standardized assessment tools, with the GAD-7 scale being specifically recommended for assessing generalized anxiety disorder
- Evaluation of physical symptoms, including heart palpitations, shortness of breath, muscle tension, and sleep disturbances
- Ruling out medical conditions that might mimic anxiety symptoms, such as thyroid disorders, cardiac issues, or medication side effects
Importance of Regular Reassessment
Regular reassessment using the same tools helps track treatment progress over time. Anxiety often coexists with other mental health conditions like depression, so screening for comorbidities is essential for developing an effective treatment plan.
Special Considerations
- For children or those unable to self-report, behavioral observations and information from family members become particularly important
- Culturally sensitive assessments and treatments should be used, and assessments should be tailored for those with learning disabilities or cognitive impairments 1
- Referral to a psychiatrist, psychologist, or equivalently trained professional may be necessary for patients with moderate to severe or severe symptomatology, or those with certain accompanying factors and/or symptoms 1
From the Research
Assessing Anxiety
To assess anxiety, several steps can be taken:
- Excluding a medical cause for the symptoms 2
- Identifying features of specific anxiety disorders as well as other coexisting psychiatric disorders 2
- Assessing the degree of distress 2
- Using patient self-reported symptoms to identify anxiety disorders and monitor treatment 3
- Utilizing instruments that provide psychometrically sound assessments of anxiety, such as the Hamilton Anxiety Rating Scale (HAM-A) 4
Assessment Tools
Various assessment tools are available, including:
- The Hamilton Anxiety Rating Scale (HAM-A) 4
- Other instruments that provide psychometrically sound assessments of anxiety 3
- Patient self-reported symptoms 3
Considerations
When assessing anxiety, it is essential to consider:
- The high prevalence of anxiety disorders and their potential comorbidity with other psychiatric and medical disorders 2
- The importance of regular review to monitor for clinical improvement 2
- The potential need for specialist psychological or psychiatric referral for more complex presentations 2
- The limitations of current assessment tools and the need for careful consideration of their successful use 3