Abstract
BackgroundThe Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool designed as a case detector for clinically relevant anxiety and depression. Recent studies of the HADS in coronary heart disease (CHD) patients in European countries suggest it comprises three, rather than two, underlying sub-scale dimensions. The factor structure of the Chinese version of the HADS was evaluated in patients with CHD in mainland China.MethodsConfirmatory factor analysis (CFA) was conducted on self-report HADS forms from 154 Chinese CHD patients.ResultsLittle difference was observed in model fit between best performing three-factor and two-factor models.ConclusionThe current observations are inconsistent with recent studies highlighting a dominant underlying tri-dimensional structure to the HADS in CHD patients. The Chinese version of the HADS may perform differently to European language versions of the instrument in patients with CHD.
Highlights
The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool designed as a case detector for clinically relevant anxiety and depression
To address the research question confirmatory factor analysis methods were used on a pooled HADS data set from mainland Mandarin-speaking patients admitted to hospital with coronary heart disease (CHD)
Based on Snaith and Zigmond's [29] interpretation of HADS anxiety (HADS-A) and HADS depression (HADSD) scores of 8 or over, approximately one-third of the patients screened positive for anxiety (32%) and/or depression (35%)
Summary
The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool designed as a case detector for clinically relevant anxiety and depression. Recent studies of the HADS in coronary heart disease (CHD) patients in European countries suggest it comprises three, rather than two, underlying sub-scale dimensions. In China, economic transition, urbanization, industrialization and an aging population have quickly increased the incidence and prevalence of coronary heart disease (CHD) in the past decades [1]. The Hospital Anxiety and Depression Scale (HADS) [7] is a widely used, self-administered questionnaire developed to detect anxiety and depression states in hospital and medical out-patient clinic settings. It is composed of two 7-item scales, one for anxiety and one for depression
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