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The Composite International Diagnostic Interview – Short Form (CIDI-SF)

(Generalized Anxiety Disorder)

Description: Diagnostic screening assessment to identify whether the respondent meets criteria for probable Generalized Anxiety Disorder (GAD).

Number of Items: 24

Item Question Wording TILDA Variable
1 During the past 12 months, did you ever have a period lasting one month or longer when most of the time you felt worried, tense, or anxious? mh301
2 People differ a lot in how they worry about things. Did you have a time in the past 12 months when you worried a lot more than most people would in your situation? mh302
3 Has that period ended or is it still going on? mh303
4 How many months or years did it go on before it ended? mh304
5 How many months or years has it been going on? MONTHS mh305M
6 How many months or years has it been going on? YEARS mh305Y
7 During that period, was/is your worry stronger than in other people? mh306
8 Did/do you worry most days? mh307
9 Did/Do you usually worry about one particular thing, such as your job security or the failing health of a loved one, or more than one thing? mh308
10 Did/Do you find it difficult to stop worrying? mh309
11 Did/Do you ever have different worries on your mind at the same time? mh310
12 How often was/is your worry so strong that you couldn’t/can’t put it out of your mind no matter how hard you tried/try – often, sometimes, rarely or never? mh311
13 How often did/do you find it difficult to control your worry – often, sometimes, rarely, or never? mh312
14 When you were/are worried or anxious, were/are you also restless? mh314
15 When you were/are worried or anxious, were/are you also keyed up or on edge? mh315
16 When you were/are worried or anxious, were/are you also easily tired? mh316
17 When you were/are worried or anxious, did/do you have difficulty keeping your mind on what you were/are doing? mh317
18 When you were/are worried or anxious, were/are you also more irritable than usual? mh318
19 When you were/are worried or anxious, did/do you have tense, sore or aching muscles? mh319
20 When you were/are worried or anxious, did/do you have trouble falling asleep or staying asleep? mh320
21 Did you tell a doctor about your worry or about the problems it was causing? mh321
22 Did you tell any other professional (such as psychologist, social worker, counsellor, nurse, clergy, or other helping professional)? mh322
23 Did you take medication or use drugs or alcohol more than once for the worry or the problems it was causing? mh323
24 How much did/does the worry or anxiety interfere with your life or activities? mh324

Scoring Method:

Response options differ dependent on item.

• Respondents are classified as having Generalized Anxiety Disorder (GAD) during the previous 12 months if they meet all of the following criteria.

Criterion 1: Persistent worry

  • Respondents must report:

    • A period of excessive worry, tension, or anxiety.

    • Symptoms lasting at least six months.

Criterion 2: Severe worry

  • Respondents must report:

    • Worry stronger than that experienced by most other people.

    • Worry occurring on most days.

    • Worry involving multiple concerns or simultaneous worries.

Criterion 3: Difficulty controlling worry

  • Respondents must report at least one of the following:

    • Difficulty stopping the worry.

    • Worry that cannot be put out of mind.

    • Difficulty controlling the worry.

Criterion 4: Associated anxiety symptoms

  • Respondents must report three or more of the following symptoms:

    • Restlessness.

    • Feeling keyed up or on edge.

    • Fatigue.

    • Difficulty concentrating.

    • Irritability.

    • Muscle tension.

    • Sleep disturbance.

  • The final variable is coded:

    • 0 = No generalised anxiety disorder

    • 1 = Meets criteria for generalised anxiety disorder in the last 12 months

Citation:

  • Kessler, R.C., Andrews, G., Mroczek, D., Üstün, T.B., & Wittchen, H-U. (1998). The World Health Organization Composite International Diagnostic Interview Short Form (CIDI-SF). International Journal of Methods in Psychiatric Research, 7, 171-185.

Example TILDA Papers:

  • McDowell, C.P., Dishman, R.K., Vancampfort, D., Hallgren, M., Stubbs, B., MacDonncha, C. and Herring, M.P. (2018). Physical activity and generalized anxiety disorder: results from The Irish Longitudinal Study on Ageing (TILDA). International Journal of Epidemiology, 47(5): 1443–1453. https://doi.org/10.1093/ije/dyy141

Code

  • Stata
  • R
  • SPSS
gen gad_1 = (mh301==1|mh302==1) & (mh304m>=6|mh304y>=1|mh305m>=6|mh305y>=1|mh304==3|mh305==3)
label variable gad_1 "period of worry lasting at least 6 months"

gen gad_a = mh306==1 & mh307==1 & (mh308==5|mh310==1)
label variable gad_a "severe worry"

gen gad_b = mh309==1 | mh311==1 |mh312==1
label variable gad_b "difficult to control worry"

egen gad_c = anycount (mh314 mh315 mh316 mh317 mh318 mh319 mh320), values (1)
label variable gad_c "number of additional anxiety symptoms"


gen gad_diagnosis = (gad_1) & (gad_a) & (gad_b) & (gad_c>=3)
replace gad_diagnosis =. if (mh301==-1)|(mh301>=98&mh302!=1)|mh302>=98|mh303>=99|mh304>=98|mh305>=98
replace gad_diagnosis =. if mh306>=98|mh307>=98|(mh308>=98&mh310>=98)
replace gad_diagnosis =. if mh309>=98&mh311>=98&mh312>=98


label variable gad_diagnosis "Fulfills criteria for Generalised Anxiety Disorder in the last 12 months"


drop gad_1 gad_a gad_b gad_c


rename gad_diagnosis MHcidi_anxiety
label def MHcidi_anxiety 0 "No" 1 "Yes"
label val MHcidi_anxiety MHcidi_anxiety 

notes MHcidi_anxiety : fulfills DSM criteria for Generalised Anxiety Disorder based on an episode lasting at least 6 months
notes MHcidi_anxiety : This scale is designed to detect clinially significant cases of Generalized Anxiety Disorder, it is not necessarily ///
sensitive to other types of anxiety disorder
notes MHcidi_anxiety : Proxies or individuals who answer DK/RF to the early questions in the scale are routed past the additional questions required ///
to fulfill criteria for GAD and are subsequently coded as missing

Download Stata .do file

data$gad_1 <- (
  (data$mh301 == 1 | data$mh302 == 1) &
  (
    data$mh304m >= 6 | data$mh304y >= 1 |
    data$mh305m >= 6 | data$mh305y >= 1 |
    data$mh304 == 3 | data$mh305 == 3
  )
)
attr(data$gad_1, "label") <- "period of worry lasting at least 6 months"

data$gad_a <- data$mh306 == 1 & data$mh307 == 1 &
              (data$mh308 == 5 | data$mh310 == 1)
attr(data$gad_a, "label") <- "severe worry"

data$gad_b <- data$mh309 == 1 | data$mh311 == 1 | data$mh312 == 1
attr(data$gad_b, "label") <- "difficult to control worry"

gad_c_items <- paste0("mh", 314:320)
data$gad_c <- rowSums(
  sapply(gad_c_items, function(v) data[[v]] == 1),
  na.rm = TRUE
)
attr(data$gad_c, "label") <- "number of additional anxiety symptoms"

data$gad_diagnosis <- as.numeric(
  data$gad_1 & data$gad_a & data$gad_b & data$gad_c >= 3
)

# Missing rules from the Stata source.
c1 <- (data$mh301 == -1) |
      ((is.na(data$mh301) | data$mh301 >= 98) &
       (is.na(data$mh302) | data$mh302 != 1)) |
      (is.na(data$mh302) | data$mh302 >= 98) |
      (is.na(data$mh303) | data$mh303 >= 99) |
      (is.na(data$mh304) | data$mh304 >= 98) |
      (is.na(data$mh305) | data$mh305 >= 98)

c2 <- (is.na(data$mh306) | data$mh306 >= 98) |
      (is.na(data$mh307) | data$mh307 >= 98) |
      ((is.na(data$mh308) | data$mh308 >= 98) &
       (is.na(data$mh310) | data$mh310 >= 98))

c3 <- (is.na(data$mh309) | data$mh309 >= 98) &
      (is.na(data$mh311) | data$mh311 >= 98) &
      (is.na(data$mh312) | data$mh312 >= 98)

data$gad_diagnosis[c1 %in% TRUE | c2 %in% TRUE | c3 %in% TRUE] <- NA_real_

attr(data$gad_diagnosis, "label") <-
  "Fulfills criteria for Generalised Anxiety Disorder in the last 12 months"

data$gad_1 <- NULL
data$gad_a <- NULL
data$gad_b <- NULL
data$gad_c <- NULL

names(data)[names(data) == "gad_diagnosis"] <- "MHcidi_anxiety"

attr(data$MHcidi_anxiety, "labels") <- c("No" = 0, "Yes" = 1)
attr(data$MHcidi_anxiety, "note") <- paste(
  "fulfills DSM criteria for Generalised Anxiety Disorder based on an episode lasting at least 6 months.",
  "This scale is designed to detect clinically significant cases of Generalized Anxiety Disorder;",
  "it is not necessarily sensitive to other types of anxiety disorder.",
  "Proxies or individuals who answer DK/RF to early questions are routed past additional questions",
  "required to fulfill criteria for GAD and are subsequently coded as missing."
)

Download R file

COMPUTE gad_1 =
  (mh301 = 1 OR mh302 = 1) AND
  (mh304m >= 6 OR mh304y >= 1 OR mh305m >= 6 OR mh305y >= 1
   OR mh304 = 3 OR mh305 = 3).
VARIABLE LABELS gad_1 "period of worry lasting at least 6 months".

COMPUTE gad_a = mh306 = 1 AND mh307 = 1 AND (mh308 = 5 OR mh310 = 1).
VARIABLE LABELS gad_a "severe worry".

COMPUTE gad_b = mh309 = 1 OR mh311 = 1 OR mh312 = 1.
VARIABLE LABELS gad_b "difficult to control worry".

COUNT gad_c = mh314 mh315 mh316 mh317 mh318 mh319 mh320 (1).
VARIABLE LABELS gad_c "number of additional anxiety symptoms".

COMPUTE gad_diagnosis = gad_1 AND gad_a AND gad_b AND gad_c >= 3.

IF (
  mh301 = -1 OR
  ((MISSING(mh301) OR mh301 >= 98) AND (MISSING(mh302) OR mh302 <> 1)) OR
  MISSING(mh302) OR mh302 >= 98 OR
  MISSING(mh303) OR mh303 >= 99 OR
  MISSING(mh304) OR mh304 >= 98 OR
  MISSING(mh305) OR mh305 >= 98
) gad_diagnosis = $SYSMIS.

IF (
  MISSING(mh306) OR mh306 >= 98 OR
  MISSING(mh307) OR mh307 >= 98 OR
  ((MISSING(mh308) OR mh308 >= 98) AND (MISSING(mh310) OR mh310 >= 98))
) gad_diagnosis = $SYSMIS.

IF (
  (MISSING(mh309) OR mh309 >= 98) AND
  (MISSING(mh311) OR mh311 >= 98) AND
  (MISSING(mh312) OR mh312 >= 98)
) gad_diagnosis = $SYSMIS.

VARIABLE LABELS gad_diagnosis
  "Fulfills criteria for Generalised Anxiety Disorder in the last 12 months".

DELETE VARIABLES gad_1 gad_a gad_b gad_c.
RENAME VARIABLES (gad_diagnosis = MHcidi_anxiety).

VALUE LABELS MHcidi_anxiety 0 "No" 1 "Yes".

* Notes from the Stata source:
* Fulfills DSM criteria for Generalised Anxiety Disorder based on an episode
* lasting at least 6 months.
* Designed to detect clinically significant cases of GAD; not necessarily
* sensitive to other anxiety disorders.
* Proxies/DK/RF routed past additional questions are subsequently missing.

EXECUTE.

Download SPSS .sps file

CESD-8
CIDI-SF-Depression

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