Validity of the Hospital Anxiety and Depression Scale (HADS) in primary care patients in Colombia

Abstract

ObjectiveTo assess the validity of the Hospital Anxiety and Depression Scale (HADS) for depression and anxiety screening in primary care patients in Colombia. MethodsA criterion validity study was conducted with 243 adults that had completed the HADS and were later assessed using the MINI as a gold standard. Cronbach's alpha, McDonald's omega and factor structure were applied through confirmatory factor analysis (CFA). ROC curve analysis and Youden's statistic were used to determine the cut-off point. ResultsCronbach's α was reported to be 0.85 and 0.82 for McDonalds' ω. CFA supported a two-factor solution demonstrating satisfactory fit. Root mean square error of approximation = 0.04, Comparative Fix Index (CFI) and Tucker-Lewis Index (TLI) = 0.97. For HADS-A, the cut-off point was determined as 6 associated with a sensitivity of 0.76, a specificity of 0.72 and Youden's index of 0.50. The ABC was 0.81. For HADS-D, the cut-off point was determined as 4 associated with a sensitivity of 0.78, a specificity of 0.74 and Youden's index of 0.53. The ABC was 0.82. ConclusionThe HADS is a valid and reliable instrument for anxiety and depression screening in adult patients of primary healthcare services in Colombia.