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

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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Validity of the Hospital Anxiety and Depression Scale to assess depression and anxiety following traumatic brain injury as compared with the Structured Clinical Interview for DSM-IV

Journal of Affective Disorders ◽

10.1016/j.jad.2008.06.007 ◽

2009 ◽

Vol 114 (1-3) ◽

pp. 94-102 ◽

Cited By ~ 134

Author(s):

Rochelle Whelan-Goodinson ◽

Jennie Ponsford ◽

Michael Schönberger

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Depression Scale ◽

Clinical Interview ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Hospital Anxiety ◽

Dsm Iv

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Clinical utility and measurement characteristics of the Hospital Anxiety and Depression Scale for individuals with traumatic brain injury.

Rehabilitation Psychology ◽

10.1037/rep0000079 ◽

2016 ◽

Vol 61 (1) ◽

pp. 112-113 ◽

Cited By ~ 5

Author(s):

Lucas D. Driskell ◽

Amy J. Starosta ◽

Lisa A. Brenner

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Clinical Utility ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety

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Key Hospital Anxiety and Depression Scale (HADS) items associated with DSM-IV depressive and anxiety disorder 12-months post traumatic brain injury

Journal of Affective Disorders ◽

10.1016/j.jad.2018.04.092 ◽

2018 ◽

Vol 236 ◽

pp. 164-171 ◽

Cited By ~ 2

Author(s):

Dean P. McKenzie ◽

Marina G. Downing ◽

Jennie L. Ponsford

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Anxiety Disorder ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety ◽

Post Traumatic ◽

Dsm Iv

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Validation of Mood Measures for People with Multiple Sclerosis

International Journal of MS Care ◽

10.7224/1537-2073.2013-013 ◽

2014 ◽

Vol 16 (2) ◽

pp. 105-109 ◽

Cited By ~ 36

Author(s):

Tessa M. Watson ◽

Emma Ford ◽

Esme Worthington ◽

Nadina B. Lincoln

Keyword(s):

Multiple Sclerosis ◽

Depression Scale ◽

High Sensitivity ◽

High Specificity ◽

Anxiety And Depression ◽

Cutoff Score ◽

Depression And Anxiety ◽

Hospital Anxiety ◽

Depression Subscale ◽

Anxiety Subscale

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.

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The factor structure of the Hospital Anxiety and Depression Scale in individuals with traumatic brain injury

Psychiatry Research ◽

10.1016/j.psychres.2009.07.003 ◽

2010 ◽

Vol 179 (3) ◽

pp. 342-349 ◽

Cited By ~ 58

Author(s):

Michael Schönberger ◽

Jennie Ponsford

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Factor Structure ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety

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

Women & Health ◽

10.1080/03630242.2021.1893244 ◽

2021 ◽

Vol 61 (4) ◽

pp. 363-371

Author(s):

Irena Ilic ◽

Goran Babic ◽

Aleksandra Dimitrijevic ◽

Milena Ilic ◽

Sandra Sipetic Grujicic

Keyword(s):

Internal Consistency ◽

Pap Smear ◽

Depression Scale ◽

Anxiety And Depression ◽

Hospital Anxiety

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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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A-121 Functional Outcomes in Bilingual Persons with Traumatic Brain: The Role of Mood

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.139 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1171-1171

Author(s):

Winter Olmos ◽

Daniel W Lopez-Hernandez ◽

Isabel Munoz ◽

Laura Schierholz ◽

Rachel A Rugh-Fraser ◽

...

Keyword(s):

Depressive Symptoms ◽

Functional Outcomes ◽

Depression Scale ◽

Anxiety And Depression ◽

Depression And Anxiety ◽

Hospital Anxiety ◽

Anxiety Levels ◽

The Relationship ◽

Pearson Correlations

Abstract Introduction We examined the relationship between depression and anxiety, language, and functional outcomes in persons with traumatic brain injury (TBI). Methods The sample consisted of 48 acute TBI (ATBI: 23 Spanish-English Bilinguals; 25 English monolinguals), 30 chronic TBI (CTBI: 17 Spanish English Bilinguals; 12 English monolinguals), and 47 healthy comparison (HC: 29 Spanish-English Bilinguals; 18 English monolinguals) participants. The Hospital Anxiety and Depression Scale was used to measure depression (HADS-D) and anxiety (HADS-A). The Mayo Portland Adaptability Inventory-4 (MPAI-4) was used to measure functional outcomes (ability, adjustment, participation). Results An ANCOVA, controlling for age, revealed the ATBI group reported lower anxiety levels compared to the CTBI group, p = 0.034 np2 = 0.06. HC participants demonstrated significantly higher functional ability compared to both TBI groups, p < 0.05, np2 = 0.08–0.19. The ATBI group demonstrated worse participation scores compared to the CTBI and HC groups, p = 0.001, np2 = 0.11. Pearson correlations revealed mood was related to functional status in ATBI monolinguals (HADS-A: r = 0.29–0.64; HADS-D, r = 0.49–0.62). Monolingual participants with ATBI demonstrated correlations between depressive symptoms and functional adjustment (r = 0.57, p = 0.005) and ability (r = 0.44, p = 0.034). For monolinguals with CTBI, HADS-A correlated with functional outcomes, r = 0.60–0.66, p < 0.05. For bilinguals with CTBI, functional outcomes correlated with HADS-A, r = 0.53–0.66, p < 0.05, and HADS-D, r = 0.54–0.66, p < 0.05. For HC monolinguals, functional outcomes correlated with HADS-A, r = 0.53–0.70, p < 0.05, and HADS-D, r = 0.50–0.72, p < 0.05. Finally, for HC bilinguals, functional outcomes correlated with HADS-A, r = 0.59–0.68, p < 0.05. Conclusion Our results suggest that a relationship between anxiety and depressive symptoms is related more to functional outcomes in monolingual TBI survivors compared to bilingual TBI survivors.

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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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