Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65–80 years old? A psychometric evaluation study

Health and Quality of Life Outcomes

Research

Ingrid Djukanovic¹  Jörg Carlsson¹  Kristofer Årestedt² 

[1] Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, SE, Sweden;Faculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, SE, Sweden;Department of Research, Kalmar County Hospital, Kalmar, Sweden;Department of Medical and Health Sciences, Linköping University, Linköping, Sweden;

关键词: Validation;    Psychometric;    Elderly;    Anxiety;    Depression;   

DOI  :  10.1186/s12955-017-0759-9

 received in 2017-04-04, accepted in 2017-09-17,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe HADS (Hospital Anxiety and Depression Scale) aims to measure symptoms of anxiety (HADS Anxiety) and depression (HADS Depression). The HADS is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms. There is also a lack of psychometric evaluations of the HADS in non-clinical samples of older people. The aim of the study was to evaluate the factor structure of the HADS in a general population 65–80 years old and to exam possible presence of differential item functioning (DIF) with respect to sex.MethodsThis study was based on data from a Swedish sample, randomized from the total population in the age group 65–80 years (n = 6659). Confirmatory factor analyses (CFA) were performed to examine the factor structure. Ordinal regression analyses were conducted to detect DIF for sex. Reliability was examined by both ordinal as well as traditional Cronbach’s alpha.ResultsThe CFA showed a two-factor model with cross-loadings for two items (7 and 8) had excellent model fit. Internal consistency was good in both subscales, measured with ordinal and traditional alpha. Floor effects were presented for all items. No indication for meaningful DIF regarding sex was found for any of the subscales.ConclusionsHADS Anxiety and HADS Depression are unidimensional measures with acceptable internal consistency and are invariant with regard to sex. Despite pronounced ceiling effects and cross-loadings for item 7 and 8, the hypothesized two-factor model of HADS can be recommended to assess psychological distress among a general population 65–80 years old.

【 授权许可】

CC BY   
© The Author(s). 2017