Hospital Anxiety and Depression Scale (HADS)

Psychological Comorbidity: HADS Scale

The Hospital Anxiety and Depression Scale (HADS) is a widely used self-report tool for assessing psychological distress in non-psychiatric populations, particularly in medical settings. It consists of two subscales:

• HADS-A (Anxiety): Measures symptoms of generalized anxiety.

• HADS-D (Depression): Focuses on anhedonia rather than somatic symptoms of depression.

Key Features:

• 14 items (7 per subscale), scored 0–3, with total subscale scores ranging from 0–21.

• Cut-off scores:

  • 8–10: Indicates doubtful cases.

  • ≥11: Suggests clinically significant symptoms .

• Psychometric Properties:

  • Good internal consistency (Cronbach’s α: 0.83–0.88) .

  • Validated in older populations (65–80 years) and musculoskeletal patients, though some studies suggest removing item 7 (anxiety) due to poor loading .

• Limitations:

  • Pronounced floor effects in older adults .

  • Not diagnostic but useful for screening and monitoring intervention effects .