Frontiers symptoms of anxiety and depression in young. Seven of the items relate to anxiety and seven relate to depression. Read article for free, from open access legal sources, via unpaywall. Hads is a brief selfreport measure of anxiety and depres sion symptoms. Its purpose is to provide clinicians with an acceptable, reliable, valid and easy to use practical tool for identifying and quantifying depression and anxiety. Depression and anxiety in patients with rheumatoid. 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 depressive and anxiety subscales are used to measure the severity of each disorder, with each containing seven questions. 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. It is composed of two 7item subscales hadsd and hadsa for depression and anxiety, resp. Often, these studies report results from a small range of cutoff thresholds. Subjects rate the 14 items on a fivepoint scale 04. Hospital anxiety and depression scale for use with adolescents. A 14item scale divided into two subscales, anxiety and depression, each one comprising 7 items depression for even items and anxiety for odd ones.
The hads is a 14item, 4point selfreport likert scale assessing anxiety and depression symptoms. The hospital anxiety and depression scale article, 1983. Get a printable copy pdf file of the complete article 314k, or click on a page image below to browse page by page. 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. Hospital anxiety and depression scale for use among. 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 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. Hospital anxiety and depression scale occupational medicine. Pdf validity and reliability of turkish version of. Patients free of anxiety or depressive disorder were randomised to receive. The hospital anxiety and depression scale hads was developed by zigmond and snaith in 1983.
The hospital anxiety and depression scale hads is a widely used questionnaire in health research. The hospital anxiety and depression scale health and quality of life outcomes. Encouragingly, our findings suggest that hads provides a reliable and valid assessment of anxiety and depression in asd. The hospital anxiety and depression scale hads is a brief, validated instrument that screens for both depression and anxiety bjelland et al. To reduce the risk of a false positive bias, the scale does not assess symptoms of anxiety and depression related to. Tick the box beside the reply that is closest to how you have been feeling in the past week. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. Hads is a selfreport questionnaire consisting of 16 items, the first 14 of which are scored. The total score for each subscale ranges from 0 to 21. Hospital anxiety and depression scale, deutsche version hads. A positive score is an anxiety or depression rating of 8 or more.
There are 7 questions related to anxiety, therefore, 7 numbers to add. Scores of 07 in respective subscales are considered normal, with 810 borderline and 11 or over indicating clinical caseness. Assessing psychological distress in patients with facial. 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.
Can a brief psychological intervention prevent anxiety or depressive. To adapt the scale for chilean cancer patients, we used the spanish version 31 of the original scale 27. Handling missing items in the hospital anxiety and depression. Introduction the depression subscale of the hospital anxiety and depression scale hadsd has been recommended for depression screening in medically ill patients. 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. Pdf reliability and validity of the hospital anxiety and.
Handling missing items in the hospital anxiety and. 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. 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. Hospital anxiety and depression scale scoring sheet yes definitely yes sometimes no, not much no, not at all 1. Factor analyses of the hospital anxiety and depression scale. Acta psychiatrica scandinavica wiley online library. Primed tat 017 1 adapted from the hospital anxiety and depression scale 1 zigmond. Thevalidityandclinicalutilityofthehospitalanxietyand. The hads hospital anxiety and depression scale aims to measure symptoms of anxiety hads anxiety and depression hads depression. Hospital anxiety and depression scale hads spinal cord. However, formatting rules can vary widely between applications and fields of interest or study. An overview of the twinsuk cohorts anxiety and depression.
I get very frightened or have panic feelings for apparently no reason at all. 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 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. The 15th and 16th items represent the total anxiety and depression score of. Originally developed by zigmond and snaith 1983 and is commonly used to determine the levels of anxiety and depression that a patient is experiencing. Feb 01, 1986 channer ks, papouchado m, james ma, rees jr. 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. Responses are based on the relative frequency of symptoms over the past week. Hospital anxiety and depression scale in adolescents twa i depression sub scale. Factor structure, item analyses and internal consistency in a large population.
Hospital anxiety and depression scale hads the hospital anxiety and depression scale hads. Hads questionnaires completed by the twins in the twinsuk registry. Items referring to symptoms that may have a physical cause e. It is suggested that the introduction of the scales into general hospital practice. Hospital anxiety and depression scale hads please check you. Hads officially distributed by mapi research trust eprovide. Links to pubmed are also available for selected references.
It is suggested that the introduction of the scales into general hospital practice would. The prevalence of anxiety and depressive disorders in patients with chest pain were determined by using the hospital anxiety and depression scale. Hospital anxiety and depression scale hads was originally developed by zigmond and snaith 1983 and is commonly used by doctors to determine the. The beauty of the hads score is its simplicity, speed and ease. 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.
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 15th and 16th items represent the total anxiety and depression score of the questionnaire. European health psychology society annual conference. 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. 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. The validity of the hospital anxiety and depression scale. 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 scoring sheet. The hospital anxiety and depression scale directory of open. 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 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. An author webinar on the hospital anxiety and depression scale recorded session available here.
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 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. 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. I wake early and then sleep badly for the rest of the night. Relationships between boredom proneness, mindfulness. Examining the stability of the hospital anxiety and. Pdf is the hospital anxiety and depression scale hads a valid.
Regarding the analysis of age on the anxiety and depression subscales, age groups were classified as follows. Dr philip spinhoven, po box 1251, 2340 bg oegstgeest, the netherlands. 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. There is also a lack of psychometric evaluations of the hads in nonclinical samples of older people. Many existing hadsd studies have used exploratory methods to select optimal cutoffs. The depression items tend to focus on the anhedonic symptoms of depression. Other than physically ill individuals, the hads is also used with community samplespopulations. The anxiety and depressive subscales are also valid. Is the hospital anxiety and depression scale hads a. Each of the three scales contains 14 items, divided into subscales of 25 items with similar content. Validation of the hospital anxiety and depression scale in. The hospital anxiety and depression scale zigmond 1983. Adolescence is a developmental transition from childhood to adulthood, with substantial physical and.
The hospital anxiety and depression scale health and. Screening for psychiatric illness in palliative care inpatient setting. It has become a popular tool, for clinical practice and research. 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. Is the hospital anxiety and depression scale hads a valid. Assessment of the hospital anxiety and depression scale. 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 is a widely used screening measure of anxiety and depression symptoms.
Reliability and factor structure of the hospital anxiety and. Participants completed hads and a range of mental health and well. This questionnaire is designed to help your clinician to know how you feel. The hads is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms. Assesses anxiety and depression in a nonpsychiatric population. It is a fourteen item selfassessment scale, with seven items related to anxiety and seven to depression. The hospital anxiety and depression scale hads is a questionnaire widely used for detecting anxiety and depressive disorders. Diagnostic accuracy of the depression subscale of the. This is a sample version of the hospital anxiety and.
The tool includes 14 items, seven related to anxiety hadsa and seven related to depression hadsd, each scored. 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. Pdf the hospital anxiety and depression scale milly. Accuracy of the hospital anxiety and depression scale for. Hospital anxiety and depression scale hads instructions. Hospital anxiety and depression scale hads springerlink. Normative data for the hads from a large nona wiley online library. Validation of the hospital anxiety and depression scale. This scale was developed by zigmond and snaith 1983 16 and adapted to turkish by aydemir et al. If your clinician knows about these feelings he or she will be able to help you more. The hospital anxiety and depression scale hads and the 9. Use of the hospital anxiety and depression scale hads in a. The hospital anxiety and depression scale, factor analysis, and why health psychologists shouldnt care anymore january 20 conference.
Patients with 8 or more points in the scale were considered probable case of anxiety or depression. Is the hospital anxiety and depression scale hads useful. To provide normative data for the hospital anxiety depression scale. 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 hospital anxiety and depression scale hads is a widely used questionnaire in health research, but there is.
Doctors are aware that emotions play an important part in most illnesses. 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 valid and reliable selfrating scale that measures anxiety and depression in both hospital and community settings. 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. Results show that boredom proneness correlated positively with anxiety, depression, and substance use, and. Any potential participants who scored a total of 16 or over on the hads 22x22. 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. The objectives of this study were to present some psychometric properties of the hads on a large sample of french employees. If your doctor knows about these feelings he or she will be able to help you more. This questionnaire is designed to help your doctor know how you feel. Hospital anxiety and depression scale data share 2. A validation study of the hospital anxiety and 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. It was divided into an anxiety subscale hadsa and a depression subscale hadsd both containing seven intermingled items. Hospital anxiety and depression scale hads hospital anxiety and depression scale hads detects states of anxiety and depression in an adult population. Anxiety and depression in patients with chest pain referred for exercise testing. Pdf the hospital anxiety and depression scale, factor. The hospital anxiety and depression scale, or hads, was designed to provide a simple yet reliable tool for use in medical practice.