Comparison of three scales to detect anxiety in general hospital outpatients: HADS, SAS and HAMA

Abstract

Objective To the hospital anxiety and depression scale (HADS) and the self-rating anxiety scale(SAS)and hamilton anxiety scale (HAMA) in assessment anxiety among outpatients in general hospital. Methods 229 outpatients from 15 general hospitals who have tested with HADS(HADS≥8)completed the SAS and HAMA.Analyses with respect to internal consistency, correlation analysis, and agreement (Kappa coefficient and McNemar test) at recommended cut-off score were performed. Results The HADS, HAD-A and SAS had high internal consistency with Cronbach coefficient (0.866, 0.849, 0.832 respectively). Significant positive correction was observed among HADS, HAD-A and SAS, HAMA score(r=0.494--0.874, P<0.01). The best agreement with HAMA≥ 14 was HAD-A≥ 8, SAS≥46, their Kappa values were 0.314, 0.524 respectively(P<0.01). The Kappa values between HAD-A≥8 and SAS≥46, SAS≥50 were 0.401, 0.265(P<0.01). Conclusion HDAS and SAS scale have high internal consistency. The agreement in assessment anxiety between HAD-A and SAS, HAMA at the best suitable cut-off score is mild to moderate. Key words: Hospital anxiety and depression scale; Self-rating anxiety scale; Hamilton anxiety scale