Measures Registry

The Hospital Anxiety and Depression Scale (HADS)

Description

The Hospital Anxiety and Depression Scale (HADS) was developed to detect states of anxiety and depression in hospital medical outpatient clinic settings. The anxiety and depression subscales of this measure are also valid measures of the severity of the accompanying emotional disorder.

Purpose

The purpose of this scale is to detect states of anxiety and depression in patients at non-psychiatric hospital medical outpatient clinic settings. With detection, patients can be directed to additional care needed.

Population

Adult patients (ages 16-65) in non-psychiatric hospital medical outpatient clinic settings

Year of Publication

1982

Reference

Source Article: Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Danish Translation Article: Christensen, A. V., Dixon, J. K., Juel, K., Ekholm, O., Rasmussen, T. B., Borregaard, B., Mols, R. E., Thrysøe, L., Thorup, C. B., & Berg, S. K. (2020). Hospital Anxiety and Depression Scale--Danish Version (HADS) [Database record]. APA PsycTests.
https://doi.org/10.1037/t77781-000

Number of Items

Scale Types (Likert=Likert Type; MC=Multiple Choice; T/F=True/False; OR=Open Response)

Likert Type

Likert: The order of levels vary depending on the item. Depression items are scored with higher values indicating greater severity of depression (e.g., "I feel cheerful." is scored as 3 = Not at all to 0 = Most of the time). Similarly, anxiety items are scored with higher values indicating greater severity of anxiety (e.g., "I can sit at ease and feel relaxed." is scored as 3 = Not at all to 0 = Definitely).

Subscales

Anxiety Depression

Scoring

Table 1 in the source article displays cutoff scores for Anxiety and Depression severity. Non-cases of anxiety or depression have sum scores of 7 or less, doubtful cases of anxiety or depression have sum scores between 8-11, and definite cases of anxiety or depression have sum scores of 11 or more.

Administration

Self-Administered

Readability/ Literacy Level

N/A

Languages

English, Danish (Christensen et al., 2020)

Reliability

N/A

Validity

Convergent validity was assessed by comparing subscale scores to psychiatric ratings of anxiety or depression. The Spearman correlations were 0.70 for depression and 0.74 for anxiety, demonstrating that the subscale scores could be used as valid measures of anxiety and depression severity.

Limitations

N/A

Availability

Publicly Available

Cost

Free

Other Considerations

N/A