Internal consistency of the anxiety subscale of the hads is high cronbachs a0. Levels and predictors of anxiety, depression and health. The hospital anxiety and depression scale hads is dead, but. Adapted from the hospital anxiety and depression scale 1 zigmond and snaith, acta psychiatr. Anxiety depression summary the hospital anxiety and depression scale hads assesses anxiety and depression in a nonpsychiatric population through selfreporting. Seven of the items relate to anxiety and seven relate to depression. The hospital anxiety and depression scale hads was devised 30 years ago by zigmond and snaith to measure anxiety and depression in a general medical population of patients. Senior lecturer in psychiatry, university of leeds, 21 gledhow wood road leeds ls8 4bw, uk email.
The hospital anxiety and depression scale hads introduction. It is a fourteen item selfassessment scale, with seven items related to anxiety and seven to depression. The hospital anxiety and depression scale hads was administered to 50 1665 yr old medical patients and found to be a reliable instrument for detecting states of depression and anxiety. Managing chronic pain through selfhelp full text view.
It consists of 14 questions, each of which is scored 03. 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. Hads officially distributed by mapi research trust. Hospital anxiety and depression scale data share 2. The findings of this study were published by zigmond and snaith 19831. 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 findings of this study were published by zigmond and snaith 1983 1. Psychometric evidence of the brief resilience scale brs. Psychometric properties of the coping inventory for. Items are related to symptoms experienced in the past. Hospital anxiety and depression scale the british journal of. Effectiveness of a pilot schoolbased intervention on.
Pdf the hospital anxiety and depression scale researchgate. 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 h. Which questionnaire should i use to measure distress. A validation study of the hospital anxiety and depression. The hospital anxiety and depression scale hads assessment overview assessment area icf domain. Uitgebreide toelichting van het meetinstrument meetinstrumenten. Astudycomparingvariousdepression scales has been carried out in depressed patients admitted to a psychiatric hospital kearns et al. Review of the psychometric evidence of the perceived. Psychologicalfactorsandsubjectivecognitivecomplaints after. There is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of suffering in the setting of medical practice. Zigmond and snaith 1983 hospital anxiety and depression scale cohran and ganong 1989 intensive care unit environmental stressor scale icuess baron 1997 emotional quotient inventory eqi.
Snaith there was a need for the development of a selfassessment mood scale specifically designed for use in nonpsychiatric hos pital departments. The differentiation of anxiety and depression by rating scales. Hospital anxiety and depression scale hads is commonly used by doctors to determine the levels of anxiety and depression that a patient is experiencing. Perhaps, as zigmond and snaith 3 apparently intended, the alert anxious or depressed patient.
Anxiety and depression are each measured using seven items from the questionnaire, yielding scores from 0 to 21 for each scale. Hads is a selfreport scale developed by zigmond and snaith 1983 which is used to determine anxiety and depression levels. International journal of geriatric psychiatry, 20, 344 349. The validity and clinical utility of the hospital anxiety and. Hads is comprised of 14 questions which assess levels of depression and anxiety. One such instrument is the hospital anxiety and depression scale hads 4. Each item is rated on a fourpoint scale, ranging from 0 to 3, with 3 indicating higher symptom frequency. 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. The pps items evaluate the degree to which individuals believe their life has been. A validation of the hospital anxiety and depression scale hads in different groups of dutch subjects article pdf available in psychological medicine 272.
Hospital anxiety and depression scale occupational medicine. 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. Record form items originally published in acta psychiatrica scandinavica 67, 36170. Hospital anxiety and depression scale hads springerlink. The total score for both subscales ranges between 0 and 21, with higher scores indicating more symptoms of depression or anxiety. The hospital anxiety and depression scale zigmond 1983. The hads was originally developed for hospital outpatients with ages between 16 and 65yearsold and the authors did recommend.
Using these cutoffs, table 2 shows the distribution of scores for all four groups, and mean scores by group and gender. Development of the coping strategies questionnaire 24, a. The aim of the authors was to develop a scale with the following characteristics. Design and procedure data collection occurred within the hospitals outpatient department. The validity of the hospital anxiety and depression scale.
Screening measures such as the 15item geriatric depression scale gds15 sheikh and yesavage, 1986 and the hospital anxiety and depression scale hads zigmond and snaith, 1983 are important tools in the recognition of depressive symptoms in older people. 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. Hospital anxiety and depression scale occupational. The lowest possible scores for depression and anxiety are 0, and the highest possible scores are 21. 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 was developed from a study conducted in the outpatient clinic of a general medical hospital. A twofactor analysis of variance indicates the presence of highly significant differ ences between the groups f3j,26. Normative data for the hospital anxiety and depression scale. The beauty of the hads score is its simplicity, speed and ease. Normative data for the hospital anxiety and depression scale core.
Anxiety and depression are evaluated with seven questions each. Pdf there is a need to assess the contribution of mood disorder, especially anxiety and depression, in order to understand the experience of. 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 setting 4. Inaddition,therelationshipofhadsanxiety and depression scores with age awaits empirical study. Hospital anxiety and depression scale hads bmj open. The factor structure of the hospital anxiety and depression scale in older individuals with acquired amputations. The hads is composed of 14 items divided into two subscales with 7 items each, evaluating anxiety hadsa and depression hadsd, respectively. The hospital anxiety and depression scale hads is a widely used screening measure of anxiety and depression symptoms. The hospital anxiety and depression scale hads rug. Sep 07, 2016 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 patient is experiencing. Scores of 07 in respective subscales are considered normal, with 810 borderline and 11 or over indicating clinical caseness.
I feel tense or wound up 3 most of the time 2 a lot of the time 1 from time to time occasionally 0 not at all d q2. It is a selfreported questionnaire that was designed to measure the degree to which individuals appraise situations in their lives as stressful cohen et al. Originally developed by zigmond and snaith 1983, it has been found to be a reliable instrument for detecting states of depression and anxiety in the setting of a medical outpatient clinic. The anxiety and depression subscales were also valid measures of severity of the emotional disorder. Hospital anxiety and depression scale anxiety subscale. The hospital anxiety and depression scale zigmond 1983 acta. Two of our selfassessment scales, the wakefield depression inventory andthe leedsscales for depression and anxiety are now redundant but the two mostrecent scales, the irritabilitydepressionanxiety ida scale snaith et al. The hospital anxiety and depression scale health and. Pdf a validation of the hospital anxiety and depression. Zigmond and snaith 1983 1 i feel tense or wound up most of the time 3 a lot of the time 2 from time to time occasionally 1 not at all 0. Additionally, the hospital anxiety and depression scale had. Hospital anxiety and depression scale hads spinal cord. It is suggested that the introduction of the hads into general hospital practice would facilitate.
The hospital anxiety and depression scale, or hads, was. 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. Since patients would be expected to complete the questionnaire in a short space of time, perhaps whilst waiting to. Pdf spanish society of rheumatology ser rivera et al. The depression items tend to focus on the anhedonic symptoms of depression. Health and quality of life outcomes commentary open access the hospital anxiety and depression scale r philip snaith address. It is suggested that the introduction of the scales into general hospital practice would.
The efficacy of relaxation training in treating anxiety pagnini francesco ms, manzoni gian mauro psy. It was divided into an anxiety subscale hadsa and a depression subscale hadsd both containing seven intermingled items. The hospital anxiety and depression scale hads is dead. Psychometric properties of a european spanish version of. The anxiety and depressive subscales are also valid measures of severity of the emotional disorder. Most physicians are aware of this aspect of the illness of their patients but many feel incompetent to provide the patient with reliable information. Validation of the hospital anxiety and depression scale for. Examining the stability of the hospital anxiety and. Psychometric properties of the coping inventory for stressful situations ciss in patients with acquired brain injury. Hospital anxiety and depression scale hads ild care foundation. It has become a popular tool, for clinical practice and research. Two calculations were undertaken for each original study.
1000 905 1061 1413 1564 1346 733 1522 415 942 1450 826 1165 1312 1114 1447 739 160 939 1542 24 1320 765 831 448 1446 647 910 1195 923 1