The Spielberger State-Trait Anxiety Inventory (STAI): the state scale in detecting mental disorders in geriatric patients

Background In geriatric psychiatry assessment scales are often used in clinical praxis in the diagnostic work-up of mental disorders. Aim To assess whether the state part of the STAI is useful as a case-finding instrument of mental disorders. Materials and method Data came from 70 non demented geriatric in-patients in stable clinical condition. Mean age was 83.3 years (range 64-96), and 74.3% were women. The 20-item STAI state instrument was used to measure current anxiety symptoms. Without knowledge of the score on STAI state a psychiatrist examined all patients and set diagnosis according to DSM-IV-TR criteria, but hierarchical rules were not used. Sensitivity, specificity, Likelihood ratio and accuracy were calculated for different cut-points of the mean sumscore on the STAI state. Results 15.7% of the participants suffered from a mental disorder: GAD = 1, mixed anxiety-depression = 5, depression = 1, dystymic = 1, adjustment disorder (mixed anxiey-depression) = 1, and personality disorder = 1. The mean STAI sumscore in this group was 56.3 compared with 39.2 in the 59 patients without any psychiatric diagnosis. The optimal cut-off score on the STAI mean sumscore corresponding to the highest accuracy of 0.87 was 55/54 with sensitivity 0.82, specificity 0.88, and LR + 6.8. Conclusion The STAI state scale is a useful instrument for detecting a variety of mental disorders in older people. Further studies should be carried out in different populations. Copyright (c) 2005 John Wiley & Sons, Ltd.