Hospital Anxiety and Depression Scale | Occupational Medicine

The Hospital Anxiety and Depression Scale (HADS) was devised 30 years ago by ... It is currently available to purchase from http://shop.gl-assessment.co.uk. 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Issue5 July2014 ArticleContents Briefhistory Description Items Validity Keyresearchinwhichthequestionnairehasbeenused Source Acknowledgements References ArticleNavigation ArticleNavigation JournalArticle TheHospitalAnxietyandDepressionScale AnnaF.Stern AnnaF.Stern Searchforotherworksbythisauthoron: OxfordAcademic PubMed GoogleScholar OccupationalMedicine,Volume64,Issue5,July2014,Pages393–394,https://doi.org/10.1093/occmed/kqu024 Published: 28June2014 Articlehistory Received: 14January2014 Accepted: 24January2014 Published: 28June2014 PDF SplitView Views Articlecontents Figures&tables Video Audio SupplementaryData Cite Cite AnnaF.Stern,TheHospitalAnxietyandDepressionScale,OccupationalMedicine,Volume64,Issue5,July2014,Pages393–394,https://doi.org/10.1093/occmed/kqu024 SelectFormat Selectformat .ris(Mendeley,Papers,Zotero) .enw(EndNote) .bibtex(BibTex) .txt(Medlars,RefWorks) Downloadcitation Close PermissionsIcon Permissions Share Email Twitter Facebook More NavbarSearchFilter OccupationalMedicineThisissue OccupationalMedicineBooksJournalsOxfordAcademic MobileMicrositeSearchTerm Search SignIn Close NavbarSearchFilter OccupationalMedicineThisissue OccupationalMedicineBooksJournalsOxfordAcademic MicrositeSearchTerm Search AdvancedSearch SearchMenu Briefhistory TheHospitalAnxietyandDepressionScale(HADS)wasdevised30yearsagobyZigmondandSnaith[1]tomeasureanxietyanddepressioninageneralmedicalpopulationofpatients.Ithasbecomeapopulartool,forclinicalpracticeandresearch:aPubMedsearchreturned1961papers!Description ThebeautyoftheHADSscoreisitssimplicity,speedandeaseofuse.Veryfew(literate)peoplehavedifficultycompletingit,onpaperorelectronically.Itassessesbothanxietyanddepression,whichcommonlycoexist[2].Anxietyispoorlyrecognizedbyclinicians,soshouldbeactivelysought[3].Anxietyoftenprecedesdepressioninresponsetostressors,andidentifyingtheemployeewithhighorrisinganxietybeforedepressionallowsoccupationalhealthpractitionerstoadviseonearlyinterventionmeasureswhiletheemployeeisstillatworkandpotentiallyavoidsicknessabsence.ThiswouldbemissedusingadepressiononlyquestionnairesuchasthePatientHealthQuestionnaire(PHQ9).HADSfocusesonnon-physicalsymptomssothatitcanbeusedtodiagnosedepressioninpeoplewithsignificantphysicalill-health.Anyoverlap,forinstanceimpairedconcentrationsecondarytopainratherthandepression,isusuallyeasytoseparateonanindividualbasis.HADSdoesnotincludeallofthediagnosticcriteriaofdepression(DiagnosticandStatisticalManualofMentalDisorders,Fourth/FifthEdition(DSMIV/V))orallthoserequiredbytheHealthandWorkDevelopmentUnit(HWDU)NationalDepressionandLongTermSicknessAbsenceScreeningAudit[4].Forthis,additionalquestionsonappetite,sleepandself-harm/suicidalthoughtshavetobeasked.Ariskassessmentforself-harmorsuicideshouldofcoursebecarriedoutinappropriatecases.Items Thequestionnairecomprisessevenquestionsforanxietyandsevenquestionsfordepression,andtakes2–5mintocomplete.Althoughtheanxietyanddepressionquestionsareinterspersedwithinthequestionnaire,itisvitalthatthesearescoredseparately.Cut-offscoresareavailableforquantification,forexampleascoreof8ormoreforanxietyhasaspecificityof0.78andasensitivityof0.9,andfordepressionaspecificityof0.79andasensitivityof0.83[5](Table1). Table1.HADSscoreForbothscales,scoresoflessthan7indicatenon-cases . 8–10 Mild 11–14 Moderate 15–21 Severe Forbothscales,scoresoflessthan7indicatenon-cases . 8–10 Mild 11–14 Moderate 15–21 Severe Note:Scoreanxietyanddepressionseparately. Openinnewtab Table1.HADSscoreForbothscales,scoresoflessthan7indicatenon-cases . 8–10 Mild 11–14 Moderate 15–21 Severe Forbothscales,scoresoflessthan7indicatenon-cases . 8–10 Mild 11–14 Moderate 15–21 Severe Note:Scoreanxietyanddepressionseparately. Openinnewtab Validity TheHADSquestionnairehasbeenvalidatedinmanylanguages,countriesandsettingsincludinggeneralpracticeandcommunitysettings[5–7].Itisusefulforinitialdiagnosisandtotrackprogression(orresolution)ofpsychologicalsymptoms.ItisoneoftheNationalInstituteforHealthandCareExcellence(NICE)recommendedtoolsfordiagnosisofdepressionandanxiety[3].Keyresearchinwhichthequestionnairehasbeenused HADShasbeeninvestigatedextensivelyinageneralmedicalsetting.Inoccupationalhealth,apaperontheuseofevidence-basedclinicaltoolsinoccupationalmedicinebyBailey[8]concludedthatoverhalfthe(214)SocietyofOccupationalMedicinememberswhorespondedtothestudyusedHADS.IntheHordalandHealthStudy(17384workersinNorway),occupationaldifferencesinthelevelsofanxietyanddepressionwereinvestigatedusingHADSscore.HADSlevelsshowedaninverseassociationwithskilllevelespeciallyfordepression.Screeningfordepressioninlow-skillworkerswasrecommendedforconsideration[9].Source Thequestionnairewashistoricallyfreelyavailable.Itiscurrentlyavailabletopurchasefromhttp://shop.gl-assessment.co.uk.Acknowledgements IwouldliketothankJudySharpey-Schaferforhelpfuldiscussion,commentsandreferences.References 1. Zigmond AS Snaith RP . TheHospitalAnxietyandDepressionScale. ActaPsychiatrScand 1983;67:361–370.GoogleScholarCrossrefSearchADSPubMedWorldCat 2. McManus S Meltzer H Brugha T Bebbington P Jenkins R ,edsAdultPsychiatricMorbidityinEngland2007.ResultsofHouseholdSurvey. http://www.hscic.gov.uk/catalogue/PUB02931/adul-psyc-morb-res-hou-sur-eng-2007-rep.pdf(February2014,datelastaccessed).3.NationalCollaboratingCentreforMentalHealth.CommonMentalHealthDisorders:TheNICEGuidelineonIdentificationandPathwaystoCare.NationalClinicalGuidelineNumber123.http://www.nice.org.uk/nicemedia/live/13476/54604/54604.pdf(February2014,datelastaccessed).4.OccupationalHealthClinicalEffectivenessUnitAuditDevelopmentGroup.NHSHealthatWorkNetwork/ClinicalExcellence/Audit/DepressionandLong-termSicknessAbsence.http://www.nhshealthatwork.co.uk/depression-longterm.asp(February2014,datelastaccessed).5. Bjelland I Dahl AA Haug TT Neckelmann D . ThevalidityoftheHospitalAnxietyandDepressionScale.Anupdatedliteraturereview. JPsychosomRes 2002;52:69–77.GoogleScholarCrossrefSearchADSPubMedWorldCat 6. Snaith RP . TheHospitalAnxietyandDepressionScale. HealthQualLifeOutcomes 2003;1:29.doi:10.1186/1477-7525-1-29 GoogleScholarCrossrefSearchADSPubMedWorldCat 7. Herrmann C . InternationalexperienceswiththeHospitalAnxietyandDepressionScale—areviewofvalidationdataandclinicalresults. JPsychosomRes 1997;42:17–41.GoogleScholarCrossrefSearchADSPubMedWorldCat 8. Bailey K . Theuseofevidence-basedclinicaltoolsinoccupationalmedicine. OccupMed(Lond) 2008;58:556–560. GoogleScholarCrossrefSearchADSPubMedWorldCat 9. Sanne B Mykletun A Dahl AA Moen BE Tell GS ;HordalandHealthStudy. Occupationaldifferencesinlevelsofanxietyanddepression:theHordalandHealthStudy. 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