Scale Overview
The Hospital Anxiety and Depression Scale (HADS) was developed by Zigmond AS, Snaith RP (1983). It is designed to measure Anxiety and Depression. The scale is intended for use with Adults.
Scale Structure
This instrument consists of 14 items organized into 2 factors/subscales: Anxiety, Depression.
| Factor / Subscale |
Items |
N |
| Anxiety |
1,3,5,7,9,11,13 |
7 |
| Depression |
2,4,6,8,10,12,14 |
7 |
Response Format
Respondents rate each item using a custom response format.
Response anchors: 0 = Not at all / Only occasionally, 1 = Some of the time / Sometimes, 2 = A lot of the time / Often, 3 = Most of the time / Very often.
The scale includes 6 reverse-scored items to reduce acquiescence bias.
Scoring
Items are scored by subscale, with each subscale sum representing a distinct dimension.
Total scores range from 0 to 21. Interpretation guidelines:
- Normal: 0 – 7
- Borderline abnormal: 8 – 10
- Abnormal: 11 – 21
Psychometric Properties
Internal Consistency: The scale has demonstrated good to excellent internal consistency with reported Cronbach’s alpha values of HADS-A: 0.68-0.93, HADS-D: 0.67-0.90.
Administration
The scale is self-administered and typically takes approximately 5 minutes to complete. It can be administered individually or in group settings. No special training is required for administration.