BACKGROUND Zung's Self-rating Anxiety Scale (SAS) is a norm-referenced scale which enjoys widespread use a screener for anxiety disorders. However, recent research (Dunstan DA and Scott N, Depress Res Treat 2018:9250972, 2018) has questioned whether the existing cut-off for identifying the presence of a disorder might be lower than ideal. METHOD The current study explored this issue by examining sensitivity and specificity figures against diagnoses made on the basis of the Patient Health Questionnaire (PHQ) in clinical and community samples. The community sample consisted of 210 participants recruited to be representative of the Australian adult population. The clinical sample consisted of a further 141 adults receiving treatment from a mental health professional for some form of anxiety disorder. RESULTS Mathematical formulas, including Youden's Index and the Receiver Operating Characteristics Curve, applied to positive PHQ diagnoses (presence of a disorder) from the clinical sample and negative PHQ diagnoses (absence of a disorder) from the community sample suggested that the ideal cut-off point lies between the current and original points recommended by Zung. CONCLUSIONS Consideration of prevalence rates and of the potential costs of false negative and false positive diagnoses, suggests that, while the current cut-off of 36 might be appropriate in the context of clinical screening, the original raw score cut-off of 40 would be most appropriate when the SAS is used in research.

中文翻译：

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Zung的自评焦虑量表规范。

背景技术Zung的自评焦虑量表（SAS）是一种规范参考的量表，在焦虑症筛查中得到了广泛的应用。但是，最近的研究（Dunstan DA和Scott N，Depress Res Treat 2018：9250972,2018）质疑用于识别疾病是否存在的现有临界值是否可能低于理想水平。方法本研究通过检查针对临床和社区样本中基于患者健康问卷（PHQ）做出的诊断的敏感性和特异性，探讨了这个问题。社区样本包括210名被招募代表澳大利亚成年人口的参与者。临床样本包括另外141名成年人，他们接受了心理健康专家的某种形式的焦虑症治疗。结果数学公式，包括Youden指数和接收者操作特征曲线在内，适用于临床样本的阳性PHQ诊断（疾病的存在）和社区样本的阴性PHQ诊断（疾病的存在）表明，理想的临界点介于两者之间。 Zung推荐的当前观点和原始观点。结论考虑流行率以及假阴性和假阳性诊断的潜在成本，这表明，尽管目前的36分界值在临床筛查中可能是适当的，但原始的原始分界值40分应为在研究中使用SAS时最合适。应用于临床样本的阳性PHQ诊断（疾病的存在）和社区样本的阴性PHQ诊断（疾病的存在）表明，理想的分界点在Zung建议的当前值与原始值之间。结论考虑流行率以及假阴性和假阳性诊断的潜在成本，这表明，尽管目前的36分界值在临床筛查中可能是适当的，但原始的原始分界值40分应为在研究中使用SAS时最合适。应用于临床样本的阳性PHQ诊断（疾病的存在）和社区样本的阴性PHQ诊断（疾病的存在）表明，理想的分界点在Zung建议的当前值与原始值之间。结论考虑流行率以及假阴性和假阳性诊断的潜在成本，这表明，尽管目前的36分界值在临床筛查中可能是适当的，但原始的原始分界值40分应为在研究中使用SAS时最合适。