The hospital anxiety and depression scale hads was developed by zigmond and snaith in 1983 to identify caseness possible and probable of anxiety disorders and depression among patients in nonpsychiatric hospital clinics. The hospital anxiety and depression scale hads is a questionnaire widely used for detecting anxiety and depressive disorders. Normative data for the hads from a large nona wiley online library. The hospital anxiety and depression scale hads is a brief, validated instrument that screens for both depression and anxiety bjelland et al. Patients were assessed by the hospital anxiety and depression scale as a screening instrument wile following a systematized protocol to rule out the diagnosis of acute coronary syndrome and other potentially fatal diseases. The hads hospital anxiety and depression scale aims to measure symptoms of anxiety hads anxiety and depression hads depression. The hospital anxiety and depression scale hads, zigmond and snaith, 1983 is a selfreport instrument for assessing states of depression and anxiety suitable for use among both medical patients and general population in the community. For accepted manuscripts, the time from acceptance to publication is on average 1 month for early view publication online and 3 months for hard copy publication.
Any potential participants who scored a total of 16 or over on the hads 22x22. This paper addresses three questions about the validity of the hads concerning its independence of physical symptoms, the extent to which its items robustly measure the identified. The aim of this study was to explore the properties of the hospital anxiety and depression scale hads in a sample of 151 young people with asd. 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. Acta psychiatrica scandinavica wiley online library. The hospital anxiety and depression scale directory of open. Other than physically ill individuals, the hads is also used with community samplespopulations. There is also a lack of psychometric evaluations of the hads in nonclinical samples of older people. The objectives of this study were to present some psychometric properties of the hads on a large sample of french employees. Examining the stability of the hospital anxiety and.
The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows. Reliability and factor structure of the hospital anxiety and. Hospital anxiety and depression scale hads please check you. To reduce the risk of a false positive bias, the scale does not assess symptoms of anxiety and depression related to. Hospital anxiety and depression scale in adolescents twa i depression sub scale. Primed tat 017 1 adapted from the hospital anxiety and depression scale 1 zigmond. Accuracy of the hospital anxiety and depression scale for. A 14item questionnaire with two subscales, researchers have used the sub scales separately, or as a composite score to measure or screen for distress, in various fields including oncology, cardiology, psychology and psychiatry, both in research and clinical capacities. An author webinar on the hospital anxiety and depression scale recorded session available here. However, prior analyses of the measure have found heterogeneous factor structures and called into question its ability to differentiate between symptoms of anxiety and depression.
The hospital anxiety and depression scale, factor analysis, and why health psychologists shouldnt care anymore january 20 conference. Depression anxiety and stress scale dass the dass is a 42item questionnaire which includes three selfreport scales designed to measure the negative emotional states of depression, anxiety and stress. However, formatting rules can vary widely between applications and fields of interest or study. A selfassessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic. Pdf reliability and validity of the hospital anxiety and. Is the hospital anxiety and depression scale hads a. 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. I wake early and then sleep badly for the rest of the night. Handling missing items in the hospital anxiety and depression. Hospital anxiety and depression scale scoring sheet. There are 7 questions related to anxiety, therefore, 7 numbers to add. A validation study of the hospital anxiety and depression. Read article for free, from open access legal sources, via unpaywall. The hospital anxiety and depression scale health and quality of life outcomes.
Assessment of the hospital anxiety and depression scale. The hospital anxiety and depression scale hads was originally designed by zigmond and snaith in 1983 as a short, easytouse, 14item screening tool for depression and anxiety symptoms in the hospital outpatient setting. The tool includes 14 items, seven related to anxiety hadsa and seven related to depression hadsd, each scored. Many existing hadsd studies have used exploratory methods to select optimal cutoffs. Responses are based on the relative frequency of symptoms over the past week. 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 bidirectional selfassessment scale used to screen for clinical depression and anxiety in hospital outpatient medical clinics. The beauty of the hads score is its simplicity, speed and ease. The total score for each subscale ranges from 0 to 21. Hads is a selfreport questionnaire consisting of 16 items, the first 14 of which are scored. This scale was developed by zigmond and snaith 1983 16 and adapted to turkish by aydemir et al.
Adolescence is a developmental transition from childhood to adulthood, with substantial physical and. Originally developed by zigmond and snaith 1983 and is commonly used to determine the levels of anxiety and depression that a patient is experiencing. An overview of the twinsuk cohorts anxiety and depression. Doctors are aware that emotions play an important part in most illnesses. The hospital anxiety and depression scale hads is a widely used screening measure of anxiety and depression symptoms. Pdf validity and reliability of turkish version of. Can a brief psychological intervention prevent anxiety or depressive. It is suggested that the introduction of the scales into general hospital practice. The hospital anxiety and depression scale, or hads, was designed to provide a simple yet reliable tool for use in medical practice. Its purpose is to provide clinicians with an acceptable, reliable, valid and easy to use practical tool for identifying and quantifying depression and anxiety. Frontiers symptoms of anxiety and depression in young.
The depression items tend to focus on the anhedonic symptoms of depression. 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. A 14item scale divided into two subscales, anxiety and depression, each one comprising 7 items depression for even items and anxiety for odd ones. Validation of the hospital anxiety and depression scale in. Validation of the hospital anxiety and depression scale. The hospital anxiety and depression scale hads can be used as a diagnostic aid with adolescents, with modifications to the cutoffs reflecting lower rates of depression among adolescents than among adults and higher rates of anxiety. It is composed of two 7item subscales hadsd and hadsa for depression and anxiety, resp. 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. Hospital anxiety and depression scale hads was originally developed by zigmond and snaith 1983 and is commonly used by doctors to determine the. Depression and anxiety in patients with rheumatoid. The hads is a 14item, 4point selfreport likert scale assessing anxiety and depression symptoms. It was divided into an anxiety subscale hadsa and a depression subscale hadsd both containing seven intermingled items. Introduction the depression subscale of the hospital anxiety and depression scale hadsd has been recommended for depression screening in medically ill patients. Abstract a selfassessment scale has been developed and found to be a reliable instrument for detecting states of depression and anxiety in the setting of an hospital medical outpatient clinic.
Hads officially distributed by mapi research trust eprovide. The hospital anxiety and depression scale hads was developed by zigmond and snaith in 1983, to identify caseness possible and probable of anxiety disorders and depression among patients in nonpsychiatric hospital clinics. Clinicians are aware that emotions play an important part in most illnesses. This questionnaire is designed to help your doctor know how you feel. It is used extensively in france, but has never been the subject of a full study in a population at work. Diagnostic accuracy of the depression subscale of the. I get very frightened or have panic feelings for apparently no reason at all. Assessing psychological distress in patients with facial. For the twofactor model proposed by zigmond and snaith 1, satisfactory levels of cronbachs alphas were found for anxiety and depression factors in the community a. The validity of the hospital anxiety and depression scale. The hospital anxiety and depression scale hads is a widely used questionnaire in health research.
Feb 01, 1986 channer ks, papouchado m, james ma, rees jr. Patients with 8 or more points in the scale were considered probable case of anxiety or depression. Each subscale comprises seven items which are rated on a fourpoint scale and scored from 03 with total scores therefore ranging from 021 for each subscale. Hospital anxiety and depression scale hads instructions. Links to pubmed are also available for selected references. Subjects rate the 14 items on a fivepoint scale 04. Hospital anxiety and depression scale, deutsche version hads. Encouragingly, our findings suggest that hads provides a reliable and valid assessment of anxiety and depression in asd. It is a fourteen item selfassessment scale, with seven items related to anxiety and seven to depression. Thevalidityandclinicalutilityofthehospitalanxietyand. This questionnaire is designed to help your clinician to know how you feel. Anxiety depression summary the hospital anxiety and depression scale hads assesses anxiety and depression in a nonpsychiatric population through selfreporting.
Hospital anxiety and depression scale for use with adolescents. Assesses anxiety and depression in a nonpsychiatric population. The hospital anxiety and depression scale zigmond 1983. Hads questionnaires completed by the twins in the twinsuk registry. Handling missing items in the hospital anxiety and. Items referring to symptoms that may have a physical cause e. It is suggested that the introduction of the scales into general hospital practice would. Get a printable copy pdf file of the complete article 314k, or click on a page image below to browse page by page.
Hospital anxiety and depression scale occupational medicine. To adapt the scale for chilean cancer patients, we used the spanish version 31 of the original scale 27. The prevalence of anxiety and depressive disorders in patients with chest pain were determined by using the hospital anxiety and depression scale. Results show that boredom proneness correlated positively with anxiety, depression, and substance use, and. Pdf is the hospital anxiety and depression scale hads a valid.
The depressive and anxiety subscales are used to measure the severity of each disorder, with each containing seven questions. Is the hospital anxiety and depression scale hads a valid. The 15th and 16th items represent the total anxiety and depression score of the questionnaire. Often, these studies report results from a small range of cutoff thresholds. Hospital anxiety and depression scale hads spinal cord. 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.
European health psychology society annual conference. Relationships between boredom proneness, mindfulness. The hospital anxiety and depression scale hads was developed by zigmond and snaith in 1983. A positive score is an anxiety or depression rating of 8 or more. Factor structure, item analyses and internal consistency in a large population. Pdf the hospital anxiety and depression scale milly. Hospital anxiety and depression scale hads the hospital anxiety and depression scale hads. Anxiety and depression in patients with chest pain referred for exercise testing. It has become a popular tool, for clinical practice and research. Tick the box beside the reply that is closest to how you have been feeling in the past week. Hospital anxiety and depression scale hads is commonly used by doctors to determine the levels of anxiety and depression that a patient is experiencing.
Hospital anxiety and depression scale for use among. The hospital anxiety and depression scale hads is a widely used questionnaire in health research, but there is. 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. Dr philip spinhoven, po box 1251, 2340 bg oegstgeest, the netherlands. Patients free of anxiety or depressive disorder were randomised to receive. To provide normative data for the hospital anxiety depression scale. Hads is a brief selfreport measure of anxiety and depres sion symptoms. Hospital anxiety and depression scale scoring sheet yes definitely yes sometimes no, not much no, not at all 1. If your doctor knows about these feelings he or she will be able to help you more. Hospital anxiety and depression scale hads springerlink. Hospital anxiety and depression scale hads hospital anxiety and depression scale hads detects states of anxiety and depression in an adult population. Hospital anxiety and depression scale hads doctors are aware that emotions play an important part in most illnesses. 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. Seven of the items relate to anxiety and seven relate to depression.
Each of the three scales contains 14 items, divided into subscales of 25 items with similar content. Pdf background the hads hospital anxiety and depression scale aims to measure symptoms of. Screening for psychiatric illness in palliative care inpatient setting. The hospital anxiety and depression scale hads and the 9. 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. This is a sample version of the hospital anxiety and. Factor analyses of the hospital anxiety and depression scale. The 15th and 16th items represent the total anxiety and depression score of. The anxiety and depressive subscales are also valid.
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. Use of the hospital anxiety and depression scale hads in a. Hospital anxiety and depression scale the hads is a selfadministered scale consisting of 14 items split across anxiety and depression subscales, each with a fourpoint ordinal response format. Participants completed hads and a range of mental health and well. The hospital anxiety and depression scale health and. The hospital anxiety and depression scale article, 1983. 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. The hads is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms.
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