Anxiety scales for

Mania Rating Scale Public domam. Journal of American Academy of Child Adolescent Psychiatry 1992 31 252—257 (appendix) Multidimensional Anxiety Scale for Children (MASC) Multi-Health Systems Inc., 908 Niagra Falls Blvd., North Tonowanda, NY 14120—... 

March, J.S., Conners, C.K., Arnold, L.E., Epstein, J., Parker, S., Hinshaw, S., Abikoff, H., Molina, B., Wells, K., Newcorn,/., Schuck, S., Pelham, W.E., and Hoza, B. (1999) The Multidimensional Anxiety Scale for Children (MASC) confirmatory factor analysis in a pediatric ADHD sample./ Attention Disord 3 85-90. 

March, J. (1998b) Manual for the Multidimensional Anxiety Scale for Children (MASC). Toronto MultiHealth Systems. 

Among the many self-report instruments that exist, some, such as the Multidimensional Anxiety Scale for Children (MASC March et ah, 1997) and the Screen for Anxiety-Related Emotional Disorders (SCARED Birmaher et ah, 1997 1999), assess a broad range of anxiety symptoms, while others assess one specific disorder or domain of anxiety (e.g., obsessive and compulsive behaviors, social anxiety, worry, fears, etc.). 

Pharmacotherapy of SAD should lead to improvement in physiologic symptoms of anxiety and fear, functionality, and overall well-being.26 Many patients may not achieve full remission of symptoms but should have significant improvement. Monitor patients weekly during acute treatment (e.g., initiation and titration of pharmacotherapy). Once patients are stabilized, monitor monthly. Inquire about adverse effects and SAD symptoms at each visit. To aid in assessing improvement, ask patients to keep a diary to record fears, anxiety levels, and behaviors in social situations.26 You may administer the Leibowitz Social Anxiety Scale (LSAS) to rate SAD severity and change, and the Social Phobia Inventory can be used as a self-assessment tool for SAD patients. 

Patients with panic disorder should be seen every 2 weeks during the first few weeks to adjust medication doses based on symptom improvement and to monitor side effects. Once stabilized, they can be seen every 2 months. The Hamilton Rating Scale for Anxiety (score less than or equal to 7 to 10) can be used to measure anxiety, and the Sheehan Disability Scale (with a goal of less than or equal to 1 on each item) can be used to measure for disability. During drug discontinuation, the frequency of appointments should be increased. 

Patients with SAD should be monitored for symptom response, adverse effects, and overall functionality and quality of life. Patients should be seen weekly during dosage titration and monthly once stabilized. Patients should be asked to keep a diary to record symptoms and their severity. The clinician-related Liebowitz Social Anxiety Scale and the patient-rated Social Phobia Inventory can be used to monitor severity of symptoms and symptom change. 

Hamilton Anxiety Scale. The Hamilton Anxiety (HAMA) scale was designed to be used in adult patients who already have a diagnosis of anxiety neurosis rather than for making a diagnosis of anxiety in patients who have other problems. The test contains 14 items, each with a five-point scale, and is completed by a physician or psychologist. The test emphasizes the patient s subjective state. The two subscales determined are somatic anxiety and psychic anxiety. 

Hamilton Depression Scale. The HAMD is one of the most widely used tests to evaluate the severity of depressive illness quantitatively in adults. The most widely used form of this test contains 21 items covering a broad range of symptomatology, with a three- to five-point scale for most items. The minimum time required to complete this test is usually 10 to 20 minutes, and it requires a skilled interviewer. Either the present time or the period within the last week is rated. Six subscales are obtained in the HAMD anxiety/somatization, weight, cognitive disturbance, diurnal variation, retardation, and sleep disturbance. 

In practice, the drugs are evaluated using psychometric scales for anxiety, depression or other symp-... 

Sertraline. Sertraline, the second SSRI to receive FDA approval for depression, has also been suggested as a treatment for social phobia. Katzelnick et al. (1994) carried out a double-blind, placebo-controlled, crossover study comparing sertraline and placebo. Twelve subjects were randomized to either sertraline or placebo for 12 weeks. The agent was then tapered and the subjects received no treatment for 2 weeks. They were then switched to the other treatment arm for an additional 12 weeks. Using the Liebowitz Social Anxiety Scale, analysis revealed statistically significant improvement with sertraline treatment but not with placebo. Forty-two percent of patients were rated as moderately or markedly improved while receiving the sertraline ther-... 

The Hamilton Rating Scale for Anxiety (HRSA) is the most widely used instrument for the assessment of anxiety symptoms in patients suffering from diagnosed anxiety disorders. The HRSA consists of 14 items and focuses to a great extent (7/14 items) on somatic symptoms (Hamilton, 1959). 

The Covi Anxiety Scale is a simple three-item scale for the assessment of severity of anxiety symptoms. The scale measures three dimensions verbal report, behavior and somatic symptoms of anxiety. Administration of the Covi Scale is very easy but, owing to a lack of specificity, it is recommended that it be combined with other, more specific instillments (e.g. some self-administered scale or the HRSA see Lipman, 1982). 

The Liebowitz Social Anxiety Scale (LSAS) measures fear, anxiety and avoidant behavior in 24 commonly feared social situations and performances. There are 13 performance-related items and 11 items that rate the social situations (Heimberg et al, 1999). The LSAS is the standard established outcome measure in most of the pivotal trials for social anxiety. Cut-offs of 30 for social anxiety disorder and 60 for its generalized subtype on the LSAS total scores represent a balance of specificity and sensitivity. There are two valid versions of the LSAS a clinician-administered version and a self-rating version (Fresco et al.. 2001). 

The Krawiecka Goldberg Scale (or Manchester Scale) is a brief ten-item scale for assessment of changes in the clinical status of patients suffering from psychosis. The items include depression, anxiety, delusions and hallucinations, incoherence, flattened affect, poverty of speech and psychomotor retardation. The absence of items typical of schizoaffective and manic psychoses limits the use of this instrument. It is, however, useful for follow-up of inpatients and outpatients for longer periods of time (Krawiecka et al.y 1977). 

Cassano GB, Castrogiovanni P, Conti I. Drug responses in different anxiety states under benzodiazepine treatment some multivariate analyses for evaluation of Rating Scale for Depression scores. In Garratini E, Mussini S, Randall LO, eds. The benzodiazapines. Ne w York Raven Press, 1973. 

The client rates himself on a five-point scale for anxiety, depression, dependence, coping with life, relationships with family, leisure activities, and confidence. 

Tyrer, P., Owen, R.T., and Ciccheiti, D.V. (1984) The brief scale for anxiety a subdivision of the comprehensive psychopathological rating scale , Journal of Neurology, Neurosurgery and Psychiatry, 47 970-3. 

In 24 patients treated with kava for generalized anxiety disorder for 4 weeks in an open, crossover, randomized trial, two dosage schedules were compared 120 mg od and 45 mg tds (5). There were significant reductions in mean Hamilton Anxiety Rating Scale scores, irrespective of dose schedule, treatment order, or sex. The impact of adverse effects was relatively low, and only one patient had to withdraw from the study (tds schedule) because of nausea. There was daytime drowsiness in 33% of patients taking the thrice-daily regimen compared with 9% in those taking a once-daily dose. 

Hamilton Anxiety Scale (HAM-A or HAM-AS or HAMRS) Clinician-rated 14 items, 5-point scales scores of >18-20 for moderate anxiety Consists of subscales to measure somatic and psychic anxiety... 

During the acute phase of treatment, patients should be seen weekly while the drug dosage is titrated. Once the patient responds and the dosage is stabilized, the patient can be seen monthly. At each visit, the patient should be asked about adverse effects and improvement in symptoms. The patient should be instructed to keep a diary to record fear levels, physical symptoms, cognitions, and anxious behaviors in actual exposures to social situations. The Liebowitz Social Anxiety Scale is a clinician-rated scale that rates clinical severity and change in SAD that can be used to monitor response. Patients can use the Social Phobia Inventory for self-assessment of SAD symptoms. Full remission is a complete resolution of symptoms across the three... 

SAD domains that is maintained for 3 months or a Liebowitz Social Anxiety Scale score of <30. ... 

---