Open Access Highly Accessed Research article

Is the beck anxiety inventory a good tool to assess the severity of anxiety? A primary care study in The Netherlands study of depression and anxiety (NESDA)

Anna DT Muntingh1234*, Christina M van der Feltz-Cornelis145, Harm WJ van Marwijk23, Philip Spinhoven67, Brenda WJH Penninx2789 and Anton JLM van Balkom28

Author Affiliations

1 Netherlands Institute of Mental Health and Addiction (Trimbos Institute), PO Box 725, Utrecht, 3500 AS, The Netherlands

2 EMGO Institute for Health and Care Research (EMGO+), PO Box 7057, Amsterdam, 1007 MB, The Netherlands

3 Department of General Practice, VU University Medical Centre, Van der Boechorststraat 7, Amsterdam, 1081 BT, The Netherlands

4 Department of Developmental, Clinical and Cross-cultural Psychology, Tilburg University, PO Box 90153, Tilburg, 5000 LE, The Netherlands

5 Academic Psychiatry Department GGZ Breburg, Lage Witsiebaan 4, Tilburg, 5042 DA, The Netherlands

6 Institute of Psychology, Leiden University, PO Box 9555 Leiden, 2300 RB, The Netherlands

7 Department of Psychiatry, Leiden University Medical Centre, PO Box 9600, Leiden, 2300 RC, The Netherlands

8 Department of Psychiatry, VU University Medical Centre, A.J. Ernststraat 1187 Amsterdam, 1081 HL, The Netherlands

9 Department of Psychiatry, University Medical Centre Groningen, PO Box 30.001 Groningen, 9700 RB, The Netherlands

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BMC Family Practice 2011, 12:66  doi:10.1186/1471-2296-12-66

Published: 4 July 2011



Appropriate management of anxiety disorders in primary care requires clinical assessment and monitoring of the severity of the anxiety. This study focuses on the Beck Anxiety Inventory (BAI) as a severity indicator for anxiety in primary care patients with different anxiety disorders (social phobia, panic disorder with or without agoraphobia, agoraphobia or generalized anxiety disorder), depressive disorders or no disorder (controls).


Participants were 1601 primary care patients participating in the Netherlands Study of Depression and Anxiety (NESDA). Regression analyses were used to compare the mean BAI scores of the different diagnostic groups and to correct for age and gender.


Patients with any anxiety disorder had a significantly higher mean score than the controls. A significantly higher score was found for patients with panic disorder and agoraphobia compared to patients with agoraphobia only or social phobia only. BAI scores in patients with an anxiety disorder with a co-morbid anxiety disorder and in patients with an anxiety disorder with a co-morbid depressive disorder were significantly higher than BAI scores in patients with an anxiety disorder alone or patients with a depressive disorder alone. Depressed and anxious patients did not differ significantly in their mean scores.


The results suggest that the BAI may be used as a severity indicator of anxiety in primary care patients with different anxiety disorders. However, because the instrument seems to reflect the severity of depression as well, it is not a suitable instrument to discriminate between anxiety and depression in a primary care population.