Hospital Anxiety and Depression Scale – HADS
A self-report scale designed to detect and measure the severity of anxiety and depression in patients.
Scale Development & Technical Details
Scale Overview
The Hospital Anxiety and Depression Scale – HADS was developed by A. S. Zigmond, R. P. Snaith (1983). It is designed to measure Anxiety and Depression. The scale is intended for use with Adults, clinical and non-clinical populations.
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 = 0 (Lowest severity option), 1 = 1 (Mild severity option), 2 = 2 (Moderate severity option), 3 = 3 (Highest severity option).
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 (Mild): 8 – 10
- Abnormal (Moderate to Severe): 11 – 21
Psychometric Properties
Internal Consistency: The scale has demonstrated good to excellent internal consistency with reported Cronbach’s alpha values of Cronbach's alpha typically ranges from 0.78 to 0.93 for HADS-A and 0.82 to 0.90 for HADS-D.
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.