Accuracy of screening for symptoms of anxiety and depression among patients with fibromyalgia in physiotherapy

Abstract

Objectives

This study compares the accuracy of physiotherapists’ screening for anxiety and depression in fibromyalgia patients using observer-report versions of the Patient Health Questionnaire-2 for depression and the Generalized Anxiety Disorder-2 for anxiety versus the 0–10 numeric rating scale.

Design

Observational cross-sectional study.

Setting

Private physiotherapy practices in Flanders, Belgium.

Participants

Fifty-three physiotherapists (37.6 (10.3) years; 24 male; 12.9 (11.0) years of experience) assessed 169 newly referred fibromyalgia patients (mean age = 49.6 (13.6); 33 male; illness duration = 96.3 (91.6) months) after two weeks of treatment.

Main outcome measures

Physiotherapists screened for anxiety and depression using observer-report versions of the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 and 0–10 numeric rating scales. Patients reported anxiety and depression levels using the Generalized Anxiety Disorder-7 and the Patient Health Questionnaire-9, respectively. The area under the curve values, calculated with DeLong's method, were used to compare the accuracy of the screening tools.

Results

The prevalence of at least mild, moderate, and severe anxiety was 79.3%, 40.2%, and 3.0%, respectively; for depression, this was 75.1%, 50.9%, and 9.5%, respectively. The brief screening tools showed higher accuracy than the numeric rating scales in all cases except for severe depression.

Conclusions

Physiotherapists can effectively use the Generalized Anxiety Disorder-2 and Patient Health Questionnaire-2 in routine assessments for fibromyalgia patients, facilitating timely interventions and improving physiotherapy adherence.