Psychometric Properties Of Hospital Anxiety And Depression Scale Research Articles

Psychometric validation of the Hospital Anxiety and Depression Scale (HADS) in community-dwelling older adults

ObjectivesThe Hospital Anxiety and Depression Scale (HADS) is commonly used to measure anxiety and depression, but the number of studies validating psychometric properties in older adults are limited. To our knowledge, no previous studies have utilized confirmative factor analyses in community-dwelling older adults, regardless of health conditions. Thus, this study aimed to examine the psychometric properties of HADS in older adults 70 + living at home in a large Norwegian city.MethodsIn total, 1190 inhabitants ≥ 70 (range 70 – 96) years completed the HADS inventory in the population-based Trøndelag Health Study (HUNT), termed “HUNT4 70 + ” in Trondheim, Norway. Confirmatory factor analyses were performed to test the dimensionality, reliability, and construct validity.ResultsThe original two-factor-solution (Model-1) revealed only partly a good fit to the present data; however, including a cross-loading for item 6D (“I feel cheerful”) along with a correlated error term between item 2D (“I still enjoy the things I used to enjoy”) and 12D (“I look forward with enjoyment to things”) improved the fit substantially. Good to acceptable measurement reliability was demonstrated, and the construct validity was acceptable.ConclusionsThe HADS involves some items that are not reliable and valid indicators for the depression construct in this population, especially item 6 is problematic. To improve the reliability and validity of the Norwegian version of HADS, we recommend that essential aspects of depression in older adults should be included.

Psychometric Properties of the Hospital Anxiety and Depression Scale in Individuals With Chronic Obstructive Pulmonary Disease: Protocol for a Systematic Review.

BackgroundIn individuals with chronic obstructive pulmonary disease (COPD), anxiety and depression contribute to increased mortality and exacerbations, decreased physical functioning, and deteriorated health-related quality of life. The Hospital Anxiety and Depression Scale (HADS) is a patient-reported tool developed to measure symptoms of anxiety and depression in clinical settings. The HADS has been frequently used with individuals with COPD; however, its measurement properties lack critical appraisal in this population.ObjectiveThis review aims to summarize and critically appraise the validity, reliability, and responsiveness of the HADS in individuals with COPD.MethodsFive electronic databases (MEDLINE, Embase, Scopus, PsychINFO, and Web of Science) will be systematically searched. Articles will be included if they assessed the measurement properties of the HADS in COPD; were published in a peer-reviewed journal; and were written in English. The COSMIN (Consensus-based Standards for the Selection of Health Measurement Instruments) guidelines will be used to assess the methodological quality and level of evidence in the selected studies.ResultsTo date, 12 articles met the inclusion criteria and will be included in the systematic review. The results of the psychometric properties of HADS will be qualitatively summarized and compared against the criteria for good measurement properties. The overall quality of evidence will be graded using the modified Grading of Recommendations, Assessment, Development and Evaluation approach. We expect to complete the systematic review by December 2022.ConclusionsThis systematic review will be the first to evaluate the psychometric properties of the HADS in individuals with COPD. Given the negative impact of anxiety and depression on physical functioning and health-related quality of life, this systematic review provides an opportunity to use the HADS as a validated measurement tool for the assessment and treatment of anxiety and depression in individuals with COPD.Trial RegistrationPROSPERO CRD42022302064; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=302064International Registered Report Identifier (IRRID)PRR1-10.2196/37854

Psychometric properties of the Danish Hospital Anxiety and Depression Scale in patients with cardiac disease: results from the DenHeart survey

BackgroundAnxiety and depression symptoms are common among cardiac patients. The Hospital Anxiety and Depression Scale (HADS) is frequently used to measure symptoms of anxiety and depression; however, no study on the validity and reliability of the scale in Danish cardiac patients has been done. The aim, therefore, was to evaluate the psychometric properties of HADS in a large sample of Danish patients with the four most common cardiac diagnoses: ischemic heart disease, arrhythmias, heart failure and heart valve disease.MethodsThe DenHeart study was designed as a national cross-sectional survey including the HADS, SF-12 and HeartQoL and combined with data from national registers. Psychometric evaluation included analyses of floor and ceiling effects, structural validity using both exploratory and confirmatory factor analysis and hypotheses testing of convergent and divergent validity by relating the HADS scores to the SF-12 and HeartQoL. Internal consistency reliability was evaluated by Cronbach’s alpha, and differential item functioning by gender was examined using ordinal logistic regression.ResultsA total of 12,806 patients (response rate 51%) answered the HADS. Exploratory factor analysis supported the original two-factor structure of the HADS, while confirmatory factor analysis supported a three-factor structure consisting of the original depression subscale and two anxiety subscales as suggested in a previous study. There were floor effects on all items and ceiling effect on item 8. The hypotheses regarding convergent validity were confirmed but those regarding divergent validity for HADS-D were not. Internal consistency was good with a Cronbach’s alpha of 0.87 for HADS-A and 0.82 for HADS-D. There were no indications of noticeable differential item functioning by gender for any items.ConclusionsThe present study supported the evidence of convergent validity and high internal consistency for both HADS outcomes in a large sample of Danish patients with cardiac disease. There are, however, conflicting results regarding the factor structure of the scale consistent with previous research.Trial registrationClinicalTrials.gov: NCT01926145.

PMS15 - Psychological Distress In Chinese Patients With Rheumatoid Arthritis And Psychometric Validation Of Chinese Hospital Anxiety And Depression Scale

To validate the psychometric properties of Chinese Hospital Anxiety and Depression Scale (HADS) and investigate the psychological distress in patients with Rheumatoid Arthritis (RA) in Mainland China. The psychometric properties of HADS were validated by interviewing subjects with questionnaires containing the HADS, EQ-5D, and SF-12. Reliability was assessed by Cronbach's alpha and construct validity by assessing a priori hypotheses. Prevalence of anxiety and depression were summarized by region and ACR classification according to HADS scale cut-off values. Potential factors related to co-morbidities were analysed by fitting two mixed models Questionnaires were administered to a consecutive sample of 133 RA patients. Regarding the validation of HADS, Cronbach's alpha showed a strong reliability among all the items, achieving 0.872 for the anxiety subscale and 0.788 for the depression subscale. Construct validity was supported by achieving both a priori hypotheses based on correlations between the HAQ scores and scales of EQ-5D and SF-12. About the prevalence of psychological distress, majority of RA patients showed either doubtful (15.8%) or definite (38.3%) anxiety; and with doubtful (26.3%) or definite (36.1%) depression. Physical function loss due to RA was tested to be a significant factor for both anxiety and depression (P<0.05). The results are generally consistent between subgroups from north and south China. The Chinese version of HADS demonstrated good patient acceptability and psychometric properties (including internal consistency reliability, and construct validity) in RA patients from north and south of China supporting its use for routine screening in Chinese RA patients. Prevalence of psychological distress in Chinese RA patients, especially the ones with severe physical function loss due to RA, is high and need more efforts of screening and intervention.