The hads was administered to 521 participants 275 controls and 246 inpatients and outpatients of the internal medicine and surgical departments in attikon general hospital in athens. The hospital anxiety and depression scale hads was devised 30 years ago by zigmond and snaith 1 to measure anxiety and depression in a general medical population of patients. The hads is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. Hospital anxiety and depression scale occupational medicine. The hospital anxiety and depression scale hads was devised 30 years ago by zigmond and snaith 1 to measure anxiety and depression. Hospital anxiety and depression scale hads spinal cord. Anxiety depression summary the hospital anxiety and depression scale hads assesses anxiety and depression in a nonpsychiatric population through selfreporting. The hospital anxiety and depression scale hads is a questionnaire widely used for detecting anxiety and depressive disorders. Clinicians are aware that emotions play an important part in most illnesses. Validity of the hospital anxiety and depression scale and.
A validation study of the hospital anxiety and depression. One such instrument is the hospital anxiety and depression scale hads 4. Hospital anxiety and depression scale hads instructions. The hospital anxiety and depression scale hads is dead. The hads was originally developed by zigmond and snaith as a screening tool to capture clinically significant states of anxiety and depression in a nonpsychiatric hospital.
The validity of the hospital anxiety and depression scale. Depression is common but frequently undetected in patients with coronary artery disease cad. Scores of 07 in respective subscales are considered normal, with 810 borderline and 11 or over indicating clinical caseness. Many existing hadsd studies have used exploratory methods to select optimal cutoffs. Pdf measurement of change with the hospital anxiety and. The hospital anxiety and depression scale article, 1983. Studied the validity of the portuguese version of the hospital anxiety and depression scale a. Hospital anxiety and depression scale occupational. Hospital anxiety and depression scale hads tick the box beside the reply that is closest to how you have been feeling in the past week. It is used extensively in france, but has never been the subject of a full study in a population at work.
Hospital anxiety and depression scale hads is commonly used by doctors to determine the levels of anxiety and depression that a patient is experiencing. Doctors are aware that emotions play an important part in most illnesses. Factor structure, item analyses and internal consistency in a large population. It is a fourteen item selfassessment scale, with seven items related to anxiety and seven to depression. However, formatting rules can vary widely between applications and fields of interest or study. Agreement between hads classifications and singleitem.
We also explored whether anxiety and depression assessment by i single selfreport items or ii the hads was most strongly associated with a preference to be. Normative data for the hospital anxiety and depression scale core. The 15th and 16th items represent the total anxiety and depression score of the questionnaire. Selfreport screening instruments for assessing depression such as the hospital anxiety and depression scale hads and the patient health questionnaire9 phq9 are available but their validity is typically determined in depressed patients without comorbid somatic illness. Hospital anxiety and depression scale for use with adolescents. James university hospital, leeds, yorkshire, england abstract a selfassessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxi ety in the setting of an. Diagnostic accuracy of the depression subscale of the. It is suggested that the introduction of the scales into general hospital practice would. We assessed agreement between reported anxiety and depression levels of cancer patients using i single selfreport items and ii the hospital anxiety and depression scale hads. The hospital anxiety and depression scale hads is frequently used to measure symptoms of anxiety and depression.
It has become a popular tool, for clinical practice and research. James university hospital, leeds, yorkshire, england abstract a selfassessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxi. The hospital anxiety and depression scale hads, a selfassessment scale, was developed to detect states of depression, anxiety and emotional distress amongst. If your doctor knows about these feelings he or she will be able to help you more. Reliability and validity of the hospital anxiety and. Hads officially distributed by mapi research trust eprovide. The hospital anxiety and depression scale hads is a valid and reliable selfrating scale that measures anxiety and depression in both hospital and community settings. Perhaps, as zigmond and snaith 3 apparently intended, the alert. The term hospital in its title suggests that it is only valid in such a setting but many studies conducted throughout the world have confirmed that it is valid when used in community settings and primary care. Links to pubmed are also available for selected references. The aim, therefore, was to evaluate the psychometric properties of hads in a large sample of danish patients. Problems in crosscultural use of the hospital anxiety and. Feb 01, 1986 full text is available as a scanned copy of the original print version. Hospital anxiety depression hads 2019 natural remedy for.
The hospital anxiety and depression scale hads is a bidirectional selfassessment scale used to screen for clinical depression and anxiety in hospital outpatient medical clinics. This article examines whether these problems could be due to the construction of the. The depression items tend to focus on the anhedonic symptoms of depression. Normative data for the hospital anxiety and depression scale. Aug 01, 2003 the hospital anxiety and depression scale, or hads, was designed to provide a simple yet reliable tool for use in medical practice. Hospital anxiety and depression scale, deutsche version hads. The had scale is a questionnaire, which has been developed to detect the overall state and severity of anxiety and depression zigmond and snaith, 1983. Hospital anxiety and depression scale scoring sheet. Originally developed by zigmond and snaith 1983 and is commonly used to determine the levels of anxiety and depression that a patient is experiencing.
Assesses anxiety and depression in a nonpsychiatric population. Therefore, valid instruments and screening methods for psychological disorders are of great significance. Using the hospital anxiety and depression scale hads, these approaches are demonstrated and compared for 2 subject samples, comprising 901 oncologic patients and 2 695 cardiac patients. The objectives of this study were to present some psychometric properties of the hads on a large sample of french employees. Pdf the hospital anxiety and depression scale researchgate. The hospital anxiety and depression scale health and quality of. Originally developed by zigmond and snaith 1983 and is commonly used to determine the levels of anxiety and depression that a. Objective the hospital anxiety and depression scale hads is widely used to screen for anxiety and depression. Is the hospital anxiety and depression scale hads useful in. The hospital anxiety and depression scale, or hads, was designed to provide a simple yet reliable tool for use in medical practice. Hads hospital anxiety and depression scale scores and va visual analogue scales for anxiety scores were all used to assess the preoperative anxiety in the a, b, ab, and o groups. Hospital anxiety and depression scale scoring sheet yes definitely yes sometimes no, not much no, not at all 1.
The beauty of the hads score is its simplicity, speed and ease. Hospital anxiety and depression scale manual 2019 natural. Assessment of anxiety in hospital patients assessment of anxiety in hospital patients shuldham, c m. Background the hospital anxiety and depression scale hads is a widely used instrument for evaluating psychological distress from anxiety and depression. The depressive and anxiety subscales are used to measure the severity of each disorder, with each containing seven questions. One way to measure symptoms of anxiety and depression and their severity is the use of the hospital anxiety and depression scale had scale. Numerous studies examining its construct validity using exploratory efa and confirmatory cfa factor analysis and item response theory irt methods in clinical and nonclinical populations have been published. The hads was originally developed by zigmond and snaith as a screening tool to capture clinically significant states of anxiety and depression in a non. Assessment of anxiety in hospital patients, journal of.
The hospital anxiety and depression scale hads was developed by zigmond and snaith in 1983. Downloaded from the university of groningenumcg research database pure. The hospital anxiety and depression scale, german version hads 20 is a widely used 14item selfreport measure comprising 7 anxiety items and 7 depression items that yield separate anxiety and. Pdf there is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of suffering. Reliability and validity of the ethiopian version of the. The hospital anxiety and depression scale health and. Validation of the hospital anxiety and depression scale for. May 16, 2019 the population of people living with hiv plwh is growing in number and usually results in mental health problems that impact their quality of life. The hospital anxiety and depression scale hads has been used in several languages to assess anxiety and depression in general hospital patients with good results. A large literature is citable in support of its validity, but difficulties are increasingly being identified, such as inexplicably discrepant optimal cutpoints and inconsistent factorstructures. The hospital anxiety and depression scale hads is a brief, validated instrument that screens for both depression and anxiety bjelland et al. Get a printable copy pdf file of the complete article 314k, or click on a page image below to browse page by page.
Often, these studies report results from a small range of cutoff thresholds. Hads gives clinically meaningful results as a psychological screening tool and can assess the symptom severity and caseness of anxiety disorders and depression in patients with. The 15th and 16th items represent the total anxiety and depression score of. This questionnaire is designed to help your clinician to know how you feel. Validation of the hospital anxiety and depression scale. The hospital anxiety and depression scale hads reveals good psychometric properties, but shows ambiguous results in factor structure. Its purpose is to provide clinicians with an acceptable, reliable, valid and easy to use practical tool for identifying and quantifying depression and anxiety. Seven of the items relate to anxiety and seven relate to depression. Hospital anxiety and depression scale data share 2. Hospital anxiety and depression scale hads was originally developed by zigmond and snaith 1983 and is commonly used by doctors to determine the levels of anxiety and depression that a person is experiencing. The hospital anxiety and depression scale hads is a widely used measure of psychological distress designed for use in nonpsychiatric patient populations.
The hospital anxiety and depression scale hads has been used widely with cardiovascular. The findings of this study were published by zigmond and snaith 19831. Hospital anxiety and depression scale hads springerlink. If your clinician knows about these feelings he or she will be able to help you more.
Hads consists of two subscales anxiety and depression scored separately, with seven items each. The hads hospital anxiety and depression scale aims to measure symptoms of anxiety hads anxiety and depression hads depression. The norms below will give you an idea of the level of anxiety and depression. The depression subscale of the hospital anxiety and depression scale hadsd is the most commonly used screening tool in medically ill patients.
Is the hospital anxiety and depression scale hads useful. Depression and anxiety are prevalent psychiatric comorbidities that are known to have a negative impact on a patients general prognosis. The aim of this study was to evaluate the reliability and validity of the amharic ethiopian language version of hads among hiv infected patients. This is a sample version of the hospital anxiety and. The hospital anxiety and depression scale zigmond 1983. Full text the hospital anxiety and depression scale, in patients with. Hospital anxiety and depression scale, hds page 2 of 4 4 i can laugh and see the funny side of things as much as i always could 0 not quite so much now 1 definitely not so much now 2 not at all 3 5 worrying thoughts go through my mind a great deal of the time 3 a lot of the time 2 not too often 1 very little 0 6 i feel cheerful never 3 not. A selfassessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the. Is the hospital anxiety and depression scale hads a. Introduction the depression subscale of the hospital anxiety and depression scale hadsd has been recommended for depression screening in medically ill patients.
Hads is comprised of 14 questions which assess levels of depression and anxiety. Wed like to understand how you use our websites in order to improve them. The hospital anxiety and depression scale hads has been. Frontiers psychometric properties and factor structure of. I wake early and then sleep badly for the rest of the night. Other than physically ill individuals, the hads is also used with community samplespopulations. Hads is a selfreport questionnaire consisting of 16 items, the first 14 of which are scored. But screening for these potential comorbidities in a hospital s accident and emergency department has seldom been undertaken, particularly in saudi arabia and elsewhere in the middle east. The hospital anxiety and depression scale hads rug. Psychometric properties of the danish hospital anxiety and. Anxiety and depression symptoms are common among cardiac patients.
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