The 14-item short health anxiety inventory (SHAI-14) used as a screening tool: appropriate interpretation and diagnostic accuracy of the Swedish version.
Health anxiety
Hypochondriasis
Psychometrics
ROC curve
Screening
Short health anxiety inventory
Journal
BMC psychiatry
ISSN: 1471-244X
Titre abrégé: BMC Psychiatry
Pays: England
ID NLM: 100968559
Informations de publication
Date de publication:
14 11 2022
14 11 2022
Historique:
received:
14
07
2022
accepted:
04
11
2022
entrez:
15
11
2022
pubmed:
16
11
2022
medline:
18
11
2022
Statut:
epublish
Résumé
The 14-item Short Health Anxiety Inventory (SHAI-14) is a common measure of health anxiety but its screening properties have not been studied. The aims of this study were to evaluate the SHAI-14 as a screening instrument, identify cut-offs for clinically significant health anxiety and investigate which scores correspond to different severity levels. The study included 1729 psychiatric patients and 85 healthy controls. Participants completed the SHAI-14 and underwent a diagnostic interview. Cut-off scores were evaluated in three scenarios to approximate screening 1) in a psychiatric clinic, 2) in a low prevalence setting and, 3) of healthy volunteers (cut-off for remission). Receiver operating characteristics were used. Classification of severity was based on the distribution of SHAI-14 scores reported by patients with clinically significant health anxiety. The area under the curve (AUC) values were high in all scenarios (above 0.95). The optimal cut-off scores on the SHAI-14 were 22 in the psychiatric context, 29 in a setting with low prevalence of psychiatric disorders and 18 versus healthy controls. SHAI-14 scores of 0-27 represented no or mild health anxiety, 28-32 moderate health anxiety and 33-42 substantial health anxiety. Brief self-report measures used as screening instruments are a simple way of gathering information about the presence of specific symptoms and thus a way to detect the likelihood of a diagnosis. The SHAI-14 shows evidence of good diagnostic utility in both clinical and non-clinical settings. However, which cut-off score is to be used, depends on the intended purpose and the setting where the cut-off is used.
Sections du résumé
BACKGROUND
The 14-item Short Health Anxiety Inventory (SHAI-14) is a common measure of health anxiety but its screening properties have not been studied. The aims of this study were to evaluate the SHAI-14 as a screening instrument, identify cut-offs for clinically significant health anxiety and investigate which scores correspond to different severity levels.
METHOD
The study included 1729 psychiatric patients and 85 healthy controls. Participants completed the SHAI-14 and underwent a diagnostic interview. Cut-off scores were evaluated in three scenarios to approximate screening 1) in a psychiatric clinic, 2) in a low prevalence setting and, 3) of healthy volunteers (cut-off for remission). Receiver operating characteristics were used. Classification of severity was based on the distribution of SHAI-14 scores reported by patients with clinically significant health anxiety.
RESULTS
The area under the curve (AUC) values were high in all scenarios (above 0.95). The optimal cut-off scores on the SHAI-14 were 22 in the psychiatric context, 29 in a setting with low prevalence of psychiatric disorders and 18 versus healthy controls. SHAI-14 scores of 0-27 represented no or mild health anxiety, 28-32 moderate health anxiety and 33-42 substantial health anxiety.
CONCLUSION
Brief self-report measures used as screening instruments are a simple way of gathering information about the presence of specific symptoms and thus a way to detect the likelihood of a diagnosis. The SHAI-14 shows evidence of good diagnostic utility in both clinical and non-clinical settings. However, which cut-off score is to be used, depends on the intended purpose and the setting where the cut-off is used.
Identifiants
pubmed: 36376898
doi: 10.1186/s12888-022-04367-3
pii: 10.1186/s12888-022-04367-3
pmc: PMC9664720
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
701Informations de copyright
© 2022. The Author(s).
Références
Behav Ther. 2007 Mar;38(1):86-94
pubmed: 17292697
BMJ Open. 2016 Nov 3;6(11):e012914
pubmed: 27810977
J Anxiety Disord. 2010 Dec;24(8):931-5
pubmed: 20650601
Soc Psychiatry Psychiatr Epidemiol. 2014 Oct;49(10):1677-89
pubmed: 24632782
Br J Psychiatry. 2013 Jan;202(1):56-61
pubmed: 22500013
N Engl J Med. 1978 Oct 26;299(17):926-30
pubmed: 692598
J Anxiety Disord. 2015 Apr;31:32-7
pubmed: 25723780
Psychol Med. 2003 May;33(4):611-22
pubmed: 12785463
Depress Anxiety. 2012 Jul;29(7):652-64
pubmed: 22504935
BMC Med. 2019 Jan 23;17(1):16
pubmed: 30670044
J Psychosom Res. 2006 Feb;60(2):155-61
pubmed: 16439268
Compr Psychiatry. 2015 Nov;63:30-5
pubmed: 26555489
J Affect Disord. 2015 Mar 15;174:64-9
pubmed: 25486275
Biometrics. 1988 Sep;44(3):837-45
pubmed: 3203132
PLoS One. 2010 Mar 24;5(3):e9873
pubmed: 20352043
J Anxiety Disord. 2012 Jan;26(1):246-51
pubmed: 22169014
Stat Med. 2012 Oct 15;31(23):2676-86
pubmed: 22307964
Clin Psychol Psychother. 2009 Sep-Oct;16(5):431-43
pubmed: 19618479
Am J Psychiatry. 1993 Feb;150(2):197-206
pubmed: 8422070
Behav Res Ther. 2011 Nov;49(11):719-28
pubmed: 21839987
Expert Rev Pharmacoecon Outcomes Res. 2019 Dec;19(6):663-676
pubmed: 31859542
JAMA. 2004 Mar 24;291(12):1464-70
pubmed: 15039413
Depress Anxiety. 2002;15(4):183-5
pubmed: 12112724
J Psychosom Res. 2015 Apr;78(4):384-90
pubmed: 25592160
Stat Med. 1987 Jun;6(4):411-23
pubmed: 3114858
Bull World Health Organ. 2010 Nov 1;88(11):815-23
pubmed: 21076562
J Psychosom Res. 2017 Dec;103:9-14
pubmed: 29167052
J Neurosci Rural Pract. 2020 Jan;11(1):125-129
pubmed: 32140015
Med Care. 2001 Jul;39(7):705-15
pubmed: 11458135
Behav Res Ther. 2002 Jun;40(6):701-15
pubmed: 12051488
Eur Arch Psychiatry Clin Neurosci. 2013 Jun;263(4):353-64
pubmed: 23001456
J Clin Psychopharmacol. 1993 Oct;13(5):327-31
pubmed: 8227491
Cogn Behav Ther. 2016 Jun;45(4):259-69
pubmed: 27096407
Int J Epidemiol. 2014 Apr;43(2):476-93
pubmed: 24648481
BMC Psychiatry. 2007 Feb 06;7:7
pubmed: 17284321
Acta Psychiatr Scand. 1994 Jan;89(1):21-8
pubmed: 8140903
Anxiety Stress Coping. 2016;29(2):219-39
pubmed: 25846805
J Anxiety Disord. 2011 May;25(4):612-4
pubmed: 21354766
J Behav Med. 2009 Apr;32(2):150-61
pubmed: 19015971
Eur Psychiatry. 1998;13(1):26-34
pubmed: 19698595
Int J Soc Psychiatry. 2019 Nov;65(7-8):566-569
pubmed: 31379243
Psychol Med. 2009 Feb;39(2):277-85
pubmed: 18485260
BMC Med Res Methodol. 2003 Nov 10;3:25
pubmed: 14606960
J Gen Intern Med. 2006 Mar;21(3):267-75
pubmed: 16336622
J Anxiety Disord. 2013 Jan;27(1):68-78
pubmed: 23247202
J Psychosom Res. 2009 May;66(5):363-77
pubmed: 19379952
Psychol Med. 2002 Jul;32(5):843-53
pubmed: 12171378
J Psychosom Res. 2011 Dec;71(6):392-4
pubmed: 22118381