Validity and reliability of Hospital Anxiety and Depression Scale in cancer patients in Peru

Abstract The Hospital Anxiety and Depression Scale (HADS) despite being widely studied in various populations, there is still no consensus on its factor structure. Our study aims to evaluate the psychometric properties of HADS in people with cancer. It involved 467 patients-diagnosed with cancer, who could read and write and were treated in a public institution specialized in cancer. It was found that HADS is best suited to a bifactorial structure where there is one general factor (emotional distress) and two specific factors (anxiety and depression). HADS proves to be invariant according to sex and years of education. It is moderately related to Beck's anxiety and depression inventory. Also, it presents acceptable levels of reliability and relationship with instruments used in the diagnosis of anxiety and depression. Its brevity, versatility, hospital-focused design, and extensive study make HADS a very important instrument in the detection of anxiety and depression in cancer patients.

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The Factor Structure and Factor Stability of the Hospital Anxiety and Depression Scale in Patients with Cancer

The British Journal of Psychiatry ◽

10.1192/bjp.158.2.255 ◽

1991 ◽

Vol 158 (2) ◽

pp. 255-259 ◽

Cited By ~ 416

Author(s):

Stirling Moorey ◽

Steven Greer ◽

Maggie Watson ◽

Christine Gorman ◽

Linda Rowden ◽

...

Keyword(s):

Factor Analysis ◽

Cancer Patients ◽

Emotional Disturbance ◽

Factor Structure ◽

Depression Scale ◽

Total Sample ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Patients With Cancer ◽

Correlated Factors

An exploratory factor analysis of the HAD was carried out in 568 cancer patients. Two distinct, but correlated, factors emerged which corresponded to the questionnaire's anxiety and depression subscales. The factor structure proved stable when subsamples of the total sample were investigated. The internal consistency of the two subscales was also high. These results provide support for the use of the separate subscales of the HAD in studies of emotional disturbance in cancer patients.

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Performance of the Hospital Anxiety and Depression Scale as a screening tool for major depressive disorder in cancer patients

Journal of Psychosomatic Research ◽

10.1016/j.jpsychores.2007.01.009 ◽

2007 ◽

Vol 63 (1) ◽

pp. 83-91 ◽

Cited By ~ 93

Author(s):

Jane Walker ◽

Kirstine Postma ◽

Gillian S. McHugh ◽

Robert Rush ◽

Brian Coyle ◽

...

Keyword(s):

Major Depressive Disorder ◽

Depressive Disorder ◽

Cancer Patients ◽

Screening Tool ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Major Depressive

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A study of the validity and the reliability of the Geriatric Anxiety Inventory in screening for anxiety after stroke in older inpatients

Clinical Rehabilitation ◽

10.1177/0269215515619661 ◽

2016 ◽

Vol 30 (12) ◽

pp. 1220-1228 ◽

Cited By ~ 9

Author(s):

Ian I Kneebone ◽

Chris Fife-Schaw ◽

Nadina B Lincoln ◽

Helena Harder

Keyword(s):

Phase 1 ◽

Depression Scale ◽

Clinical Interview ◽

Anxiety And Depression ◽

Validity And Reliability ◽

Operating Characteristics ◽

Hospital Anxiety ◽

Internal Reliability ◽

Older Inpatients ◽

Anxiety Subscale

Objectives: To investigate the validity and reliability of the Geriatric Anxiety Inventory in screening for anxiety in older inpatients post-stroke. Design: Longitudinal. Subjects: A total of 81 inpatients with stroke aged 65 years or older were recruited at four centres in England. Main measures: At phase 1 the Geriatric Anxiety Inventory and the Hospital Anxiety and Depression Scale were administered and then the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders 4th edition (phase 2). The Geriatric Anxiety Inventory was repeated a median of seven days later (phase 3). Results: Internal reliability of the Geriatric Anxiety Inventory was high (α = 0.95) and test–retest reliability acceptable ( τB = 0.53). Construct validity was evident relative to the Hospital Anxiety and Depression Scale – Anxiety subscale ( τB = 0.61). At a cut off of 6/7, sensitivity of the Geriatric Anxiety Inventory was 0.88, specificity 0.84, with respect to the Structured Clinical Interview anxiety diagnosis. Hospital Anxiety and Depressions Scale – Anxiety subscale sensitivity was 0.88, specificity 0.54 at the optimum cut off of 5/6. A comparison of the areas under the curve of the Receiver Operating Characteristics for the two instruments indicated that the area under the curve of the Geriatric Anxiety Inventory was significantly larger than that of the Hospital Anxiety and Depressions Scale – Anxiety subscale, supporting its superiority. Conclusions: The Geriatric Anxiety Inventory is an internally consistent, reliable (stable) and valid instrument with acceptable sensitivity and specificity to screen for anxiety in older inpatients with stroke.

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Psychometric properties of the Danish Hospital Anxiety and Depression Scale in patients with cardiac disease: results from the DenHeart survey

Health and Quality of Life Outcomes ◽

10.1186/s12955-019-1264-0 ◽

2020 ◽

Vol 18 (1) ◽

Cited By ~ 7

Author(s):

Anne Vinggaard Christensen ◽

Jane K. Dixon ◽

Knud Juel ◽

Ola Ekholm ◽

Trine Bernholdt Rasmussen ◽

...

Keyword(s):

Factor Analysis ◽

Factor Structure ◽

Internal Consistency ◽

Convergent Validity ◽

Depression Scale ◽

Anxiety And Depression ◽

Divergent Validity ◽

Hospital Anxiety ◽

Item Functioning ◽

Confirmatory Factor

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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