A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

1997 ◽  
Vol 27 (2) ◽  
pp. 363-370 ◽  
Author(s):  
PH. SPINHOVEN ◽  
J. ORMEL ◽  
P. P. A. SLOEKERS ◽  
G. I. J. M. KEMPEN ◽  
A. E. M. SPECKENS ◽  
...  

Background. Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its efficacy in determining the presence of depression in different patient groups has been questioned.Methods. Psychometric properties of the HADS were assessed in six different groups of Dutch subjects (N = 6165): (1) a random sample of younger adults (age 18–65 years) (N = 199); (2) a random sample of elderly subjects of 57 to 65 years of age (N = 1901); (3) a random sample of elderly subjects of 66 years or older (N = 3293); (4) a sample of consecutive general practice patients (N = 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms (N = 169); and (6) a sample of consecutive psychiatric out-patients (N = 491).Results. Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test–retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8.Conclusions. The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a ‘case-identifier’ for psychiatric disorder or depression.

1990 ◽  
Vol 157 (6) ◽  
pp. 860-864 ◽  
Author(s):  
Glyn Lewis ◽  
Simon Wessely

The specificity and sensitivity of the HAD, 12-item GHQ and CIS were calculated by comparing the scores of dermatological patients on these tests with a criterion measure of disorder. Since psychiatry, along with many other branches of medicine, does not have an error-free criterion, it was assumed that the criterion was an underlying latent construct which was measured by all of the tests and could be derived by factor analysis from the scores on them. No differences were found between the two questionnaires (HAD and GHQ) in their ability to detect cases of minor psychiatric disorder although they were somewhat less reliable than the CIS.


2012 ◽  
Vol 70 (5) ◽  
pp. 352-356 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Orlando Righesso ◽  
Alisson Roberto Teles ◽  
Natália Baseggio ◽  
Maíra Cristina Velho ◽  
...  

OBJECTIVE: To evaluate the accuracy of the Depression Subscale of Hospital Anxiety and Depression Scale (HADS-D) in spine surgery, comparing it to Beck Depression Inventory (BDI). METHODS: In a cross-sectional study, the HADS-D and the BDI were applied to patients undergoing spine surgery for lumbar (n=139) or cervical spondylosis (n=17). Spearman correlation tests for HADS-D and BDI were applied. The internal consistency of HADS-D was estimated by Cronbach's alpha coefficient. RESULTS: According to the BDI, the prevalence of depression was of 28.8% (n=45). The Spearman r coefficient between HADS-D and BDI was 0.714 (p<0.001). Cronbach's alpha for HADS-D was 0.795. The area of the ROC curve was 0.845. Using a cutoff for HADS-D >10, there was a sensitivity of 71.1%, specificity of 95.4%, and positive likelihood-ratio of 15.78. CONCLUSIONS: HADS-D showed a strong correlation with BDI and good reliability. HADS-D is a good alternative for screening depression and assessing its severity.


2019 ◽  
Vol 27 (4) ◽  
pp. 381-390 ◽  
Author(s):  
Mechthild Westhoff-Bleck ◽  
Lotta Winter ◽  
Lukas Aguirre Davila ◽  
Christoph Herrmann-Lingen ◽  
Jens Treptau ◽  
...  

Objective The purpose of this study was the diagnostic evaluation of the hospital anxiety and depression scale total score, its depression subscale and the Beck depression inventory II in adults with congenital heart disease. Methods This cross-sectional study evaluated 206 patients with congenital heart disease (mean age 35.3 ± 11.7 years; 58.3% men). Major depressive disorder was diagnosed by a structured clinical interview for the Diagnostic and Statistical Manual of Mental Disorders IV and disease severity with the Montgomery–Åsberg depression rating scale. Receiver operating characteristics provided assessment of diagnostic accuracy. Youden’s J statistic identified optimal cut-off points. Results Fifty-three participants (25.7%) presented with major depressive disorder. Of these, 28 (52.8%) had mild and 25 (47.2%) had moderate to severe symptoms. In the total cohort, the optimal cut-off of values was >11 in the Beck depression inventory II, >11 in the hospital anxiety and depression scale and >5 in the depression subscale. Optimal cut-off points for moderate to severe major depressive disorder were similar. The cut-offs for mild major depressive disorder were lower (Beck depression inventory II >4; hospital anxiety and depression scale >8; >2 in its depression subscale). In the total cohort the calculated area under the curve varied between 0.906 (hospital anxiety and depression scale) and 0.93 (Beck depression inventory II). Detection of moderate to severe major depressive disorder (area under the curve 0.965–0.98) was excellent; detection of mild major depressive disorder (area under the curve 0.851–0.885) was limited. Patients with major depressive disorder had a significantly lower quality of life, even when they had mild symptoms. Conclusion All scales were excellent for detecting moderate to severe major depressive disorder. Classification of mild major depressive disorder, representing 50% of cases, was limited. Therapy necessitating loss of quality of life is already present in major depressive disorder with mild symptoms. Established cut-off points may still be too high to identify patients with major depressive disorder requiring therapy. External validation is needed to confirm our data.


2015 ◽  
Vol 27 (9) ◽  
pp. 1577-1578 ◽  
Author(s):  
Guy Campbell ◽  
Christina Bryant ◽  
Kathryn A. Ellis ◽  
Rachel Buckley ◽  
David Ames ◽  
...  

Screening measures such as the 15-item Geriatric Depression Scale (GDS-15) (Sheikh and Yesavage, 1986) and the Hospital Anxiety and Depression Scale (HADS) (Zigmond and Snaith, 1983) are important tools in the recognition of depressive symptoms in older people. While these measures are widely used, there is evidence of specific weaknesses in some cohorts and contexts, with the GDS-15 showing limitations in the context of cognitive impairment (Gilley and Wilson, 1997), and the depression subscale of the HADS (HADS-D) losing sensitivity in the context of older participants in hospital inpatient settings (Davies et al., 1993).


1991 ◽  
Vol 158 (6) ◽  
pp. 782-784 ◽  
Author(s):  
D. Hamer ◽  
D. Sanjeev ◽  
E. Butterworth ◽  
P. Barczak

In-patients referred to a deliberate self-harm team were asked to complete the HAD questionnaire and diagnoses were made using the SCID. The total prevalence of psychiatric disorder by DSM–III criteria was 54%. The HAD performed well as a screening instrument; a threshold score of eight gave a sensitivity of 88% and a positive predictive value of 80%; its use by non-psychiatrists to detect depressive disorder in patients presenting with deliberate self-harm is to be recommended.


2014 ◽  
Vol 16 (2) ◽  
pp. 105-109 ◽  
Author(s):  
Tessa M. Watson ◽  
Emma Ford ◽  
Esme Worthington ◽  
Nadina B. Lincoln

Background: Valid assessments are needed in order to identify anxiety and depression in people with multiple sclerosis (MS). The objective of this study was to assess the validity of questionnaire measures of mood in people with MS. Methods: People with MS were recruited from a clinic database and asked to complete and return a questionnaire containing the Beck Anxiety Inventory (BAI), Beck Depression Inventory–II (BDI-II), and Hospital Anxiety and Depression Scale (HADS). Those who returned the questionnaire were invited to complete a structured clinical interview, which was blind to the results of the questionnaire. Results: The BDI-II and HADS were both found to be valid measures to detect depression and anxiety in people with MS. An optimum cutoff score of 23 for the BDI-II yielded high sensitivity (85%) and high specificity (76%). An optimum cutoff score of 11 for the HADS demonstrated high sensitivity and specificity for both the Anxiety subscale (sensitivity 90%, specificity 92%) and the Depression subscale (sensitivity 77%, specificity 81%). The BAI had high sensitivity (80%) but poor specificity (46%) for detecting anxiety. Conclusion: The BDI-II and HADS can be used to identify mood disorders in people with MS.


2006 ◽  
Vol 15 (9) ◽  
pp. 817-827 ◽  
Author(s):  
A.B. Smith ◽  
E.P. Wright ◽  
R. Rush ◽  
D.P. Stark ◽  
G. Velikova ◽  
...  

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