Hospital Anxiety and Depression Scale - AbilityLab

The Hospital Anxiety and Depression Scale is a two dimension scale developed to identify ... 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PatientPortal Payabill LastUpdated April26,2012 Purpose Atwodimensionscaledevelopedtoidentifydepressionandanxiety amongphysicallyillpatients. LinktoInstrument instrumentdetails Acronym HADS   AreaofAssessment Depression MentalHealth AssessmentType PatientReportedOutcomes AdministrationMode Paper&Pencil Cost NotFree CostDescription Contactinformationandpermissiontouse: MAPIResearchTrust,Lyon,France: Email:[email protected] Internet:www.mapi-trust.org Diagnosis/Conditions Arthritis+JointConditions CardiacDysfunction Parkinson'sDisease&NeurologicRehabilitation SpinalCordInjury StrokeRecovery-Draft2 CardiovascularDisease Stroke SpinalInjuries Non-SpecificPatientPopulation TheHADSconsistsof14items,dividedintotwo7itemsubscales: Anxiety(HADS-A);itemsreflectastateofgeneralizedanxiety Depression(HADS-D);focusontheconceptofanhedonia(Robertsetal,2001;FlintandRifat,2002). Therespondentrateseachitemona4-pointscalerangingfrom0(absence)to3(extremepresence). Itemsdonotassesssomaticcomplaints. Fiveofthe14itemsarereversecoded. Thetotalscoreisoutof42,(21persubscale). Scoresarederivedbysummingresponsesforeachofthetwosubscalesorforthescaleasawhole Higherscoresindicategreaterlevelsofanxietyordepression. ThetotalHADSscoremayberegardedasaglobalmeasureofpsychologicaldistress(Robertsetal,2001;Johnstonetal,2000). NumberofItems 14 2-6 minutes RequiredTraining NoTraining Adolescent 13 - 17 years Adult 18 - 64 years ElderlyAdult 65 + years InstrumentReviewers InitiallyreviewedbyJasonRaad,MSandtheRehabilitationMeasuresTeam;UpdatedwithaCHDpopulationbyAvaniDesai,SPTand FleurLangner,SPT in2011 ICFDomain BodyFunction MeasurementDomain Emotion Considerations TheGHQ-28andtheGDSwerefoundtobebetterscreeninginstrumentsfordepressionthantheHADS-D(Johnsonetal,1995) Self-assessmentscalesareonlyvalidforscreeningpurposes The HADSmay performbetterinmale comparedto femaleacutestrokepatients(Aben,2002) Cognitiveimpairments,debilitatingcomorbidillnesses,andimpairedphysicalstatesallinterferewiththeefficiencyoftheHADStoidentifydepressionandanxietyinatargetpopulation(Robertsetal,2001). Doyouseeanerrororhaveasuggestionforthisinstrumentsummary?Please e-mailus! MinimalDetectableChange(MDC)   Cut-OffScores PrimaryCarePatients:(Wilkinson&Barczak,1988; n =100;meanage=37.4(17.4)years) > 8wasfoundtobeoptimal for detectingDSM-III-definedpsychiatricmorbidity   Meta-analysis:(Brennanetal.,2010;n=3244,median=108(69-1078)across16studies > 8indicatesdepression(sensitivity=0.72,specificity=0.86) Test/RetestReliability Test-retestreliability: (Herrmann,1996;meta-analyticresults) Excellent at0-2weeks(n=79;r=0.84-0.85) Adequate toExcellentat>2-6weeks(n=111;r=0.73-0.76) Adequate at>6weeks(n=901;r=0.70) InternalConsistency Meta-analyticEvidence:(Bjellandetal,2002;literaturereviewof747papers) AdequatetoExcellent (0.68to0.93) AdequatetoExcellent (0.67to0.90) CriterionValidity(Predictive/Concurrent) ConcurrentValidity:(Bjellandetal,2002)  CorrelationsbetweentheHADSandothermeasuresofdepressionandAnxiety:       Scale HADS-A HADS-D Study BDI .64* .71* Lisspersetal,1997 BDI .68* .70* Savardetal,1998 BDI .61* .73* Tedmanetal,1997 GHQ-28 .50 .50 Chandaranaetal,1987 CAS .69* .44 Snaith&Taylor,1985 MADRS .37 .81* Snaith&Taylor,1985 BDI=BeckDepressionInventory GHQ-28=GeneralHealthQuestionnaire28 CAS=ClinicalAnxietyScale MADRS=Montgomery-AsbergDepressionRatingScale *indicatesexcellentcorrelation       ConstructValidity Responsiveness Meta-analyticEvidence: (Bjellandetal,2002) Scoresof8onboththeHADS-AandHADS-Ddemonstratedanoptimalbalancebetweensensitivityandspecificity StandardErrorofMeasurement(SEM) CoronaryHeartDisease:(calculatedfromWang,2009) HADS-A=1.37 HADS-D=1.44 HADS-T=2.05 MinimalDetectableChange(MDC) CoronaryHeartDisease: (calculatedfromWang,2009) HADS-A=3.80 HADS-D=3.99 HADS-T=5.68 Cut-OffScores CoronaryHeartDiseasePatients: (Staffordetal,2007,n=193;meanage=64.14(10.37)years) 6indicatesdepressivedisorder;lowercutoffscorethanrecommendedcutoffscoretoimprovetestsensitivitywhilemaintainingspecificity(sensitivity=80;specificity=77.8) Test/RetestReliability CoronaryHeartDisease:(Wang,2008;n=173withcoronaryheartdisease) Excellent at2weeks(r=0.86-0.90) CoronaryHeartDisease:(Robertsetal,2001;n=130peoplewithcoronaryheartdisease) Adequate at8weeks(r=0.63-0.79) InternalConsistency CoronaryHeartDisease:(Staffordetal,2007) Excellent internalconsistency(Cronbach’salpha=0.81) ConstructValidity CoronaryHeartDisease: (Wangetal,2009) Factoranalysisrevealsathree-factorsolution(depression,psychicanxiety,andpsychomotoranxiety)inCHDpatientpopulation Responsiveness CoronaryHeart: (Bambaueretal,2005) Scoresof8ontheHADSmeasuresshowedlowersensitivityandhighspecificity.  Usingacutoffof7(Bambaueretal,2005)demonstratesabalancebetweensensitivityandspecificity. Usingacutoffof6(Staffordetal,2007)demonstratesabalancebetweensensitivityandspecificity. Cut-OffScores AcuteStroke:(Abenetal,2002; n =202;meanage=68.5(11.6)years;assessed<1monthpost-stroke;Dutchsample) > 8indicatesdepression (sensitivity:73.1,specificity:81.6) InternalConsistency AcuteStroke: (Abenetal,2002) Excellent internalconsistency(Cronbach’salpha =0.85) ConstructValidity AcuteStroke: (Abenetal.2002) Excellent convergentvalidity(r =0.67)betweenHADS-AandHADS-Dsubscales NormativeData ChronicSCI: (Woolrichetal,2006; n =963;meanage=48.1(12.7)years;meantimesinceinjury=19.5(12.26)years;65.2%=paraplegic,34.8%=tetraplegic,94%usedawheelchair)      HospitalAnxietyandDepressionScaleNorms:       Sample HADS-A HADS-D HADS-total Total 6.9(4.2) 5.5(3.7) 12.3(7.1) Male 6.7(4.2) 5.5(3.8) 12.1(7.1) Female 8.1(4.2) 5.5(3.7) 13.2(7.2) Tetraplegic 7.0(4.0) 5.9(3.5) 12.7(6.6) Paraplegic 6.9(4.3) 5.4(3.8) 12.1(7.4) HADS-A=HospitalAnxietyandDepressionScaleanxiety HADS-D=HospitalAnxietyandDepressionScaledepression       InternalConsistency ChronicSCI:(Woolrichetal.2006)  Excellent InternalconsistencyHADS-A(Cronbach'salpha=0.85) Adequate InternalconsistencyHADS-D(Cronbach'salpha=0.79)   ConstructValidity ChronicSCI:(Woolrichetal.2006)  Excellent DivergentValiditybetweentheLifeSatisfactionQuestionnaire(LSQ)andHADS-D(r =-0.660) Adequate DivergentvaliditybetweentheLSQandHADS-A(r =-0.419)andHADStotalscore(r =-0.585) Bibliography Aben,I.,Verhey,F.,etal.(2002)."Validityofthebeckdepressioninventory,hospitalanxietyanddepressionscale,SCL-90,andhamiltondepressionratingscaleasscreeninginstrumentsfordepressioninstrokepatients."Psychosomatics43:386-393. FinditonPubMed Bambauer,K.Z.,Locke,S.E.,etal.(2005)."UsingtheHospitalAnxietyandDepressionScaletoscreenfordepressionincardiacpatients."GenHospPsychiatry27(4):275-284. FinditonPubMed Bjelland,I.,Dahl,A.A.,etal.(2002)."ThevalidityoftheHospitalAnxietyandDepressionScale.Anupdatedliteraturereview."JPsychosomRes52:69-77. FinditonPubMed Brennan,C.,Worrall-Davies,A.,etal.(2010)."TheHospitalAnxietyandDepressionScale:adiagnosticmeta-analysisofcase-findingability."JPsychosomRes69(4):371-378. FinditonPubMed Chandarana,P.C.,Eals,M.,etal.(1987)."Thedetectionofpsychiatricmorbidityandassociatedfactorsinpatientswithrheumatoidarthritis."CanJPsychiatry32(5):356-361. FinditonPubMed Flint,A.J.andRifat,S.L.(2002)."Factorstructureofthehospitalanxietyanddepressionscaleinolderpatientswithmajordepression."IntJGeriatrPsychiatry17(2):117-123. FinditonPubMed Herrmann,C.(1997)."InternationalexperienceswiththeHospitalAnxietyandDepressionScale--areviewofvalidationdataandclinicalresults."JPsychosomRes42:17-41. FinditonPubMed Johnson,G.,Burvill,P.W.,etal.(1995)."Screeninginstrumentsfordepressionandanxietyfollowingstroke:experienceinthePerthcommunitystrokestudy."ActaPsychiatrScand91:252-257. FinditonPubMed Lisspers,J.,Nygren,A.,etal.(1997)."HospitalAnxietyandDepressionScale(HAD):somepsychometricdataforaSwedishsample."ActaPsychiatrScand96(4):281-286. FinditonPubMed \ Roberts,S.B.,Bonnici,D.M.,etal.(2001)."PsychometricevaluationoftheHospitalAnxietyandDepressionScale(HADS)amongfemalecardiacpatients."BrJHealthPsychol6(Part4):373-383. FinditonPubMed Savard,J.,Laberge,B.,etal.(1998)."EvaluatinganxietyanddepressioninHIV-infectedpatients."JPersAssess71(3):349-367. FinditonPubMed Snaith,R.P.andTaylor,C.M.(1985)."Ratingscalesfordepressionandanxiety:acurrentperspective."BrJClinPharmacol19Suppl1:17S-20S. FinditonPubMed Spinhoven,P.,Ormel,J.,etal.(1997)."AvalidationstudyoftheHospitalAnxietyandDepressionScale(HADS)indifferentgroupsofDutchsubjects."PsycholMed27(2):363-370. FinditonPubMed Stafford,L.,Berk,M.,etal.(2007)."ValidityoftheHospitalAnxietyandDepressionScaleandPatientHealthQuestionnaire-9toscreenfordepressioninpatientswithcoronaryarterydisease."GenHospPsychiatry29(5):417-424. FinditonPubMed Tedman,B.M.,Young,C.A.,etal.(1997)."Assessmentofdepressioninpatientswithmotorneurondiseaseandotherneurologicallydisablingillness."JNeurolSci152Suppl1:S75-79. FinditonPubMed Wang,W.,Chair,S.Y.,etal.(2009)."ApsychometricevaluationoftheChineseversionoftheHospitalAnxietyandDepressionScaleinpatientswithcoronaryheartdisease."JClinNurs18(17):2436-2443. FinditonPubMed Wilkinson,M.J.andBarczak,P.(1988)."Psychiatricscreeningingeneralpractice:comparisonofthegeneralhealthquestionnaireandthehospitalanxietydepressionscale."JRCollGenPract38(312):311-313. FinditonPubMed Woolrich,R.A.,Kennedy,P.,etal.(2006)."ApreliminarypsychometricevaluationoftheHospitalAnxietyandDepressionScale(HADS)in963peoplelivingwithaspinalcordinjury."PsycholHealthMed11(1):80-90. FinditonPubMed updated Nov1,2021 6MinutePushTest readmore updated Aug21,2021 Nine-HolePegTest readmore updated Aug6,2021 ComprehensiveCoordination... readmore