Internal consistency and validity of the Hospital Anxiety and Depression Scale (HADS) in women with abnormal Pap smear in Serbia

Abstract Background Anxiety and depression symptoms are common among cardiac patients. The Hospital Anxiety and Depression Scale (HADS) is frequently used to measure symptoms of anxiety and depression; however, no study on the validity and reliability of the scale in Danish cardiac patients has been done. The aim, therefore, was to evaluate the psychometric properties of HADS in a large sample of Danish patients with the four most common cardiac diagnoses: ischemic heart disease, arrhythmias, heart failure and heart valve disease. Methods The DenHeart study was designed as a national cross-sectional survey including the HADS, SF-12 and HeartQoL and combined with data from national registers. Psychometric evaluation included analyses of floor and ceiling effects, structural validity using both exploratory and confirmatory factor analysis and hypotheses testing of convergent and divergent validity by relating the HADS scores to the SF-12 and HeartQoL. Internal consistency reliability was evaluated by Cronbach’s alpha, and differential item functioning by gender was examined using ordinal logistic regression. Results A total of 12,806 patients (response rate 51%) answered the HADS. Exploratory factor analysis supported the original two-factor structure of the HADS, while confirmatory factor analysis supported a three-factor structure consisting of the original depression subscale and two anxiety subscales as suggested in a previous study. There were floor effects on all items and ceiling effect on item 8. The hypotheses regarding convergent validity were confirmed but those regarding divergent validity for HADS-D were not. Internal consistency was good with a Cronbach’s alpha of 0.87 for HADS-A and 0.82 for HADS-D. There were no indications of noticeable differential item functioning by gender for any items. Conclusions The present study supported the evidence of convergent validity and high internal consistency for both HADS outcomes in a large sample of Danish patients with cardiac disease. There are, however, conflicting results regarding the factor structure of the scale consistent with previous research. Trial registration ClinicalTrials.gov: NCT01926145.

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Adaptation to Portuguese of the Depression, Anxiety and Stress Scales (DASS)

Revista Latino-Americana de Enfermagem ◽

10.1590/s0104-11692006000600006 ◽

2006 ◽

Vol 14 (6) ◽

pp. 863-871 ◽

Cited By ~ 26

Author(s):

João Luís Alves Apóstolo ◽

Aida Cruz Mendes ◽

Zaida Aguiar Azeredo

Keyword(s):

Factor Structure ◽

Internal Consistency ◽

Concurrent Validity ◽

Depression Scale ◽

Anxiety And Depression ◽

Strong Positive Correlation ◽

Emotional States ◽

Hospital Anxiety ◽

Back Translation ◽

Good Internal Consistency

Objective: to adapt to Portuguese, of Portugal, the Depression, Anxiety and Stress Scales, a 21-item short scale (DASS 21), designed to measure depression, anxiety and stress. Method: After translation and back-translation with the help of experts, the DASS 21 was administered to patients in external psychiatry consults (N=101), and its internal consistency, construct validity and concurrent validity were measured. Results: The DASS 21 properties certify its quality to measure emotional states. The instrument reveals good internal consistency. Factorial analysis shows that the two-factor structure is more adequate. The first factor groups most of the items that theoretically assess anxiety and stress, and the second groups most of the items that assess depression, explaining, on the whole, 58.54% of total variance. The strong positive correlation between the DASS 21 and the Hospital Anxiety and Depression scale (HAD) confirms the hypothesis regarding the criterion validity, however, revealing fragilities as to the divergence between theoretically different constructs.

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A validation study of the Hospital Anxiety and Depression Scale (HADS) in WLHIV

10.21203/rs.3.rs-34238/v1 ◽

2020 ◽

Author(s):

Abdilahi Yousuf ◽

Ramli Musa ◽

Muhammad Lokman Md. ◽

Siti Roshaidai Mohd Arifin

Keyword(s):

Internal Consistency ◽

Validation Study ◽

Assessment Tool ◽

Depression Scale ◽

Anxiety And Depression ◽

People Living With Hiv ◽

Validity And Reliability ◽

Hospital Anxiety ◽

Eastern Ethiopia ◽

Living With Hiv

Abstract Background Hospital Anxiety and Depression Scale (HADS) is a self-assessment tool that measures anxiety and depression and is mostly used in hospital settings. The purpose of this study is to test the validity and reliability of the Somali version of HADS in selected two hospitals in eastern Ethiopia. Method: From the WLHIV who attend the ART service, 357 women were included in the study and assessed with this tool. The English language of HADS was translated into the Somali version and used for this study. Statistical analysis was computed to examine the validity and measure the reliability of the study. Result This version of HADS was found to be acceptable for people living with HIV. To test the reliability, the internal consistency was found to be 0.83 for the anxiety sub-scale and 0.84 for the depression sub-scale. The Somali version of HADS has shown good internal consistency with its metric properties similar to international literature. By two-factor analysis, the Varimax rotation has shown high factor loading in both sub-scales (Anxiety and depression). Conclusion Therefore, this version can be used to screen the anxiety and depression of patients living with HIV. Therefore, the findings of this validation study show that the Somali version of the HADS is a valid and reliable tool to measure depression and anxiety and can be used to screen people living with HIV.

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Validation of the Malay Version of the Hospital Anxiety and Depression Scale among Patients with Traumatic Brain Injury

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v18i2.103 ◽

2020 ◽

Vol 18 (2) ◽

Author(s):

Leong Abdullah MFI ◽

Sidi H ◽

Ng YP

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Positive Predictive Value ◽

Internal Consistency ◽

Predictive Value ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Hospital Anxiety ◽

Anxiety Subscale

Introduction: Depression and anxiety are common complications associated with traumatic brain injury (TBI) patients but screening tools which are validated to assess these complications in the TBI population are scarce. This study investigated the validity of the Malay version of Hospital Anxiety and Depression Scale (HADS) to screen for depression and anxiety among Malaysian TBI patients. Materials and Methods: This cross -sectional study recruited 101 TBI patients in which they were administered the Malay version of HADS and the Structured Clinical Interview for Diagnostic and Statistical Manual for Mental Disorder 4th Edition (DSM-IV) for Axis I Disorders (SCID-I) (as comparison tool). Internal consistency (Cronbach’s α) and concurrent validity (using receiver operating characteristics) of the Malay version of HADS were evaluated. Results: The total Malay version of HADS score and its anxiety subscale exhibited good internal consistency of 0.80 and 0.78 respectively, but the internal consistency of its depressive subscale was low at 0.57. The depressive subscale of the Malay version of HADS exhibited high area under the curve (AUC) of 0.86, specificity of 82%, sensitivity of 76% and negative predictive value of 91% but its positive predictive value was 58%, at cut-off point of 8/9. While the anxiety subscale also demonstrated high AUC of 0.88, specificity of 71%, sensitivity of 93% and negative predictive value of 98% its positive predictive value was only 34%. Conclusion: The Malay version of HADS is a valid screening tool for depression and anxiety among Malaysian TBI population.

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Hospital Anxiety and Depression Scale: Factor Structure, Internal Consistency and Convergent Validity in Patients with Dizziness

Audiology and Neurotology ◽

10.1159/000438740 ◽

2015 ◽

Vol 20 (6) ◽

pp. 394-399 ◽

Cited By ~ 10

Author(s):

Erin G. Piker ◽

David M. Kaylie ◽

Douglas Garrison ◽

Debara L. Tucci

Keyword(s):

Factor Structure ◽

Internal Consistency ◽

Convergent Validity ◽

Depression Scale ◽

Self Report ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Dizziness Handicap Inventory ◽

Unselected Group ◽

Outpatient Settings

Psychiatric comorbidities, particularly anxiety-related pathologies, are often observed in dizzy patients. The Hospital Anxiety and Depression Scale (HADS) is a widely used self-report instrument used to screen for anxiety and depression in medical outpatient settings. The purpose of this study was to assess the factor structure, internal consistency and convergent validity of the HADS in an unselected group of patients with dizziness. The HADS and the Dizziness Handicap Inventory (DHI) were administered to 205 dizzy patients. An exploratory factor analysis was conducted and indicated a 3-factor structure, inconsistent with the 2-subscale structure (i.e. anxiety and depression) of the HADS. The total scale was found to be internally consistent, and convergent validity, as assessed using the DHI, was acceptable. Overall findings suggest that the HADS should not be used as a tool for psychiatric differential diagnosis, but rather as a helpful screener for general psychiatric distress in the two domains of psychiatric illness most germane in dizzy patients.

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Evaluating the factor structure, item analyses, and internal consistency of hospital anxiety and depression scale in Iranian infertile patients

International Journal of Reproductive BioMedicine ◽

10.29252/ijrm.15.5.287 ◽

2017 ◽

Vol 15 (5) ◽

pp. 287-296 ◽

Cited By ~ 14

Author(s):

Payam Amini ◽

Saman Maroufizadeh ◽

Reza Omani Samani ◽

◽

...

Keyword(s):

Factor Structure ◽

Internal Consistency ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Infertile Patients

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Stehen kognitive Funktionen im Zusammenhang mit Angst, Depression und Posttraumatischer Belastungsstörung bei Brustkrebspatientinnen nach onkologischer Behandlung?

Zeitschrift für Psychiatrie Psychologie und Psychotherapie ◽

10.1024/1661-4747.57.1.33 ◽

2009 ◽

Vol 57 (1) ◽

pp. 33-42 ◽

Cited By ~ 1

Author(s):

Lena Schirmer ◽

Anja Mehnert ◽

Angela Scherwath ◽

Barbara Schleimer ◽

Frank Schulz-Kindermann ◽

...

Keyword(s):

Posttraumatic Stress Disorder ◽

Posttraumatic Stress ◽

Stress Disorder ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Kognitive Funktionen

Die in mehreren Studien gefundenen kognitiven Störungen bei Tumorpatienten nach Chemotherapie werden zumeist mit der Zytostatikaneurotoxizität assoziiert. In der vorliegenden Arbeit wird der Zusammenhang von Angst, Depression und Posttraumatischer Belastungsstörung mit der kognitiven Leistungsfähigkeit bei Frauen mit Mammakarzinom untersucht. Insgesamt wurden 76 Brustkrebspatientinnen fünf Jahre nach Abschluss der onkologischen Behandlung mit neuropsychologischen Testverfahren sowie mit der Hospital Anxiety and Depression Scale – Deutsche Version (HADS-D) und der Posttraumatic Stress Disorder Checklist – Civilian Version (PCL-C) untersucht: 23 nach Standard- und 24 nach Hochdosistherapie sowie 29 nach Brustoperation und Strahlentherapie als Vergleichsgruppe. Signifikante Zusammenhänge sind vor allem zwischen kognitiven Funktionen und Intrusionssymptomen einer Posttraumatischen Belastungsstörung (PTBS) festzustellen. Bei Patientinnen nach Standardtherapie weisen Intrusionen der PTBS einen moderaten Zusammenhang mit der globalen kognitiven Beeinträchtigung auf. Die Ergebnisse der Studie deuten auf multidimensionale Einfluss- und moderierende Faktoren bei der Entwicklung kognitiver Defizite bei Brustkrebspatientinnen nach onkologischer Therapie hin.

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Hypochondrie in der Allgemeinbevölkerung:

Diagnostica ◽

10.1026//0012-1924.49.1.34 ◽

2003 ◽

Vol 49 (1) ◽

pp. 34-42 ◽

Cited By ~ 38

Author(s):

Andreas Hinz ◽

Winfried Rief ◽

Elmar Brähler

Keyword(s):

Nottingham Health Profile ◽

Depression Scale ◽

Somatoforme Störungen ◽

Anxiety And Depression ◽

Multidimensional Fatigue Inventory ◽

Health Profile ◽

Hospital Anxiety ◽

Gießener Beschwerdebogen

Zusammenfassung. Der Whiteley-Index ist ein Instrument zur Erfassung von Hypochondrie. Für diesen Fragebogen wurde eine Normierungs- und Validierungsstudie anhand einer bevölkerungsrepräsentativen Stichprobe (n = 1996) durchgeführt. Hypochondrie zeigt eine etwa lineare Altersabhängigkeit (r = .24). Frauen haben in allen Altersstufen höhere Hypochondrie-Ausprägungen als Männer. Für verschiedene Alters- und Geschlechtsgruppen werden Normwerte bereit gestellt. Die in der Literatur beschriebene dreidimensionale Struktur des Whiteley-Index (Krankheitsängste, somatische Beschwerden und Krankheitsüberzeugung) konnte mit gewissen Einschränkungen bestätigt werden. Validierungsuntersuchungen mit anderen Instrumenten (Hospital Anxiety and Depression Scale, Multidimensional Fatigue Inventory, Gießener Beschwerdebogen, Screening für Somatoforme Störungen und Nottingham Health Profile) zeigten, dass eine auf sieben Items reduzierte Kurzskala der Gesamtskala mit 14 Items ebenbürtig ist. Für differenzierte Analysen wird jedoch die Originalskala empfohlen. Durch die angegebenen Normwerte ist es künftig besser möglich, Patientengruppen verschiedener Alters- und Geschlechtsverteilungen untereinander oder auch mit Stichproben der Normalbevölkerung zu vergleichen.

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