Cited by 374Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMental Health Treatment and AccessMaternal Mental Health During Pregnancy and Postpartum

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The Hospital Anxiety and Depression Scale: A diagnostic meta-analysis of case-finding ability

Brennan, Cathy, Worrall-Davies, Anne, McMillan, Dean, Gilbody, Simon, House, Allan·2010·Journal of Psychosomatic Research

DOI 10.1016/j.jpsychores.2010.04.006

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Abstract

Objective To quantify the accuracy of the Hospital Anxiety and Depression Scale (HADS) as a case-finding instrument for anxiety and depressive disorders.Method MEDLINE, PSYCHINFO, EMBASE, CINAHL, BNI, and AMED were searched from January 1983 to June 2006. Studies were included that administered the HADS, used a standardized psychiatric interview to establish a diagnosis of anxiety or depression, and provided sufficient data on sensitivity and specificity (N=41). Summary sensitivity, specificity, likelihood ratios, and diagnostic odds ratios were calculated for each study. Random effects meta-analytic pooling across studies at the recommended clinical (7/8) and research (10/11) cutoff points was undertaken and summary receiver operating characteristic curves constructed.Results For major depressive disorders, a cut point of ≥8 gave a sensitivity of 0.82 (95% CI, 0.73-0.89) and a specificity of 0.74 (95% CI, 0.60-0.84) and a cut point ≥11 gave a sensitivity of 0.56 (95% CI, 0.40-0.71) and a specificity of 0.92 (95% CI, 0.79-0.97).Conclusions Many studies have shown that the HADS is a useful screening tool to identify emotional distress in nonpsychiatric patients. However, it does not appear to be superior to other screening instruments in terms of identifying specific mental disorders in physical health settings.

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Authors: Brennan, C., Worrall-Davies, A., McMillan, D., Gilbody, S., & House, A.
Affiliations: University of Leeds (GB)
Corresponding author: Brennan, Cathy
ORCID: Brennan, Cathy
McMillan, Dean
Gilbody, Simon
House, Allan
Venue: Journal of Psychosomatic Research
Publisher: Elsevier BV
Published: 2010-10
Volume: 69
Issue: 4
Pages: 371-378
ISSN: 0022-3999 (ISSN-L)
DOI: 10.1016/j.jpsychores.2010.04.006
OpenAlex: W2017953368
Cited by: 374
References: 54
Citations by year: 2026: 22 · 2025: 22 · 2024: 34 · 2023: 23 · 2022: 34 · 2021: 33 · 2020: 36 · 2019: 23 · 2018: 21 · 2017: 26 · 2016: 17 · 2015: 21 · 2014: 13 · 2013: 21 · 2012: 19
FWCI: 1.91
Type: journal article
Language: en
Open access: closed
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations: Journal of Psychosomatic Research (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
Keywords: Hospital Anxiety and Depression Scale, anxiety disorders, depressive disorders, case finding, screening accuracy, sensitivity and specificity, diagnostic odds ratio, likelihood ratios, receiver operating characteristic, cut-off values
MeSH terms: Anxiety, Anxiety Disorders, Depression, Depressive Disorder, Humans, Predictive Value of Tests, Psychiatric Status Rating Scales, Sensitivity and Specificity, Odds Ratio

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The Hospital Anxiety and Depression Scale: A diagnostic meta-analysis of case-finding ability

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