Q. What validated outcome measures, in the form of scales, would you recommend to diagnose GAD in 12- to 18-year-olds? I would like to do a case series and would prefer shorter forms to use on a routine basis, and perhaps self administered forms for older adolescents.

A. There are several scales used to diagnose and/or follow treatment response for children and adolescents with generalized anxiety disorder (GAD) are related conditions. For example, in a recent study (Rynn et al, Am J Psychiatry 2001 Dec;158(12):2008-14), the study subjects were 22 children and adolescents age 5-17 years who met the DSM-IV criteria for generalized anxiety disorder according to the Anxiety Disorders Interview Schedule for Children-Revised and who had a Hamilton Anxiety Rating Scale (HAM-A) score >/=16.

The HAM-A score was used to monitor response to treatment. The Pediatric Anxiety Rating Scale has also been used in this population ( see N Engl J Med 2001 Apr 26;344(17):1279-85) and The MASC (Multidimensional Anxiety Scale for Children) is a promising self-report scale for assessing anxiety in children and adolescents (March et al, J Am Acad Child Adolesc Psychiatry 1997 Apr;36(4):554-65).

January 2002

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