Validity and reliability of the Hospital Anxiety and Depression Scale in a hypertrophic cardiomyopathy clinic: the HADS in a cardiomyopathy population
Abstract
Objective The purpose of this study is the validation of the Hospital Anxiety and Depression Scale (HADS) in patients suffering from hypertrophic cardiomyopathy in an inner city teaching hospital. The secondary objective was to establish whether the use of the total HADS score to detect "caseness" is justified.Methods One hundred fifteen patients in a cardiac outpatient clinic completed the HADS, which was compared against the gold standard Structured Clinical Interview for DSM-III-R nonpatient version (SCID-np). Receiver operating characteristic (ROC) curves were created for the anxiety and depression subscales, as well as the total score, then sensitivity, specificity, likelihood ratios and positive and negative predictive values were calculated. Retest correlation was assessed at 2 weeks in 31 patients.Results The depression subscale was highly sensitive (100%) when the cutoff score 8 was used; however, the corresponding specificity was poor (79%). Raising the cutoff to 10 improved specificity but compromised sensitivity. The anxiety subscale was performed similarly though with less accuracy. The total HADS score produced a poor ROC curve and performed best when the cutoff was 14.Conclusions The HADS performs well as a screening instrument for anxiety and depression in this population at the designed cutoff score 8. However, its use as a research instrument and the practice of using the total score to detect caseness are not supported by this study.
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Mindfulness-based interventions have traditionally been delivered in a face-to-face group setting.
“Mindfulness-based interventions have been traditionally delivered in a face-to-face group setting [55].”
From Distant delivery of a mindfulness-based intervention for people with Parkinson's disease: The study protocol of a randomised pilot trial (2017) · cites this paper as [55]
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- Authors
- Poole, N. A., & Morgan, J. F.
- Affiliations
- St George's Hospital (GB)
- Corresponding author
- Poole, Norman A.
- ORCID
- Poole, Norman A.
- Venue
- General Hospital Psychiatry
- Publisher
- Elsevier BV
- Published
- 2006-01
- Volume
- 28
- Issue
- 1
- Pages
- 55-58
- ISSN
- 0163-8343 (ISSN-L)
- OpenAlex
- W2147381854
- Cited by
- 72
- References
- 17
- Citations by year
- 2026: 2 · 2025: 1 · 2023: 2 · 2022: 9 · 2021: 3 · 2020: 2 · 2019: 4 · 2018: 2 · 2017: 3 · 2016: 4 · 2015: 2 · 2014: 3 · 2013: 6 · 2012: 7
- FWCI
- 2.17
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- General Hospital Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Social Sciences › Education › Health Education and Validation
- Keywords
- Hospital Anxiety and Depression Scale, hypertrophic cardiomyopathy, anxiety screening, depression screening, psychometric validation, cut-off values, sensitivity and specificity, test-retest reliability, cardiology outpatients
- MeSH terms
- Adult, Anxiety Disorders, Cardiomyopathy, Hypertrophic, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Reproducibility of Results
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