Assessing Anxiety and Depression: A Comparison of National Health Interview Survey Measures

Abstract

Objective―This report examines differences across two different sets of measures used to assess anxiety and depression in the National Health Interview Survey (NHIS). Methods―Data from the 2019 NHIS were used to examine agreement between the seven-item Generalized Anxiety Disorder scale (GAD–7) and the eight-item Patient Health Questionnaire depression scale (PHQ–8) with questions developed by the Washington Group on Disability Statistics (WG) to assess symptoms or feelings of anxiety (WG–ANX) and depression (WG–DEP), respectively, on a sample of adults who responded to both sets of questions. Categorical variables for anxiety and depression were created for each question set using recommended cutoffs. Prevalence estimates of anxiety and depression using the different question sets, the relationship between the different questions, and how the different question sets relate to sociodemographic characteristics and mental health treatment are presented. Results―A high level of agreement was observed for both the anxiety and depression measures (about 90% each), in part reflecting the large percentage of adults being categorized into the lowest categories for all measures. When differences occurred, a larger percentage of adults were categorized higher on WG–ANX than GAD–7, and a larger percentage of adults were categorized higher on PHQ–8 than WG–DEP. Relationships between sociodemographic characteristics and categorizations of anxiety and depression were generally consistent across the two measures. Receipt of mental health treatment was more common as the severity of symptoms or level of anxiety or depression increased in both sets of measures. Conclusion―This report examined adults’ responses to two different sets of measures for both anxiety and depression, with comparable findings across assessment approaches.