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Normative values for the Hospital Anxiety and Depression Scale (HADS) in the general German population
Abstract
Objective The aim of this study was to present normative values for the Hospital Anxiety and Depression Scale (HADS).Methods A representative sample of the German general population (N=4410) was tested with the HADS.Results Females are more anxious than males, and older subjects are more depressed than younger subjects. The mean scores for anxiety / depression are 4.4 / 4.8 (males) and 5.0 / 4.7 (females). Using the cut-off 8+, the percentages of elevated anxiety and depression in the total sample are 21 % and 23 %, respectively. Regression analyses proved a linear but not a curvilinear age trend of anxiety and depression. Percentile rank norms are given for anxiety, depression, and the HADS total score.Conclusion The regression coefficients allow the calculation of expected mean scores for each age and gender distribution of any sample of patients. HADS mean scores are better suited to describe the degree of anxiety and depression in patient samples compared to percentages of subjects with elevated values.
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“There is some debate with respect to whether the HADS is best assessed via the total 14-item score [223–225] or two 7-item subscale (anxiety and depression) scores [219, 222, 225, 226].”
In the citing paper
“The levels of anxiety and depression were elevated in the current sample compared to Swedish and German normative samples [39,40].”
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“Percentile norm values are only given in the British studies [17,18] with the very high anxiety mean scores.”
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Metadata
- Authors
- Hinz, A., & Brähler, E.
- Affiliations
- Leipzig University (DE)
- Corresponding author
- Hinz, Andreas
- Venue
- Journal of Psychosomatic Research
- Publisher
- Elsevier BV
- Published
- 2011-08
- Volume
- 71
- Issue
- 2
- Pages
- 74-78
- ISSN
- 0022-3999 (ISSN-L)
- OpenAlex
- W1985540648
- Cited by
- 413
- References
- 37
- Citations by year
- 2026: 16 · 2025: 37 · 2024: 46 · 2023: 31 · 2022: 36 · 2021: 44 · 2020: 29 · 2019: 28 · 2018: 26 · 2017: 23 · 2016: 25 · 2015: 20 · 2014: 27 · 2013: 8 · 2012: 13
- FWCI
- 21.36
- Type
- journal article
- Language
- en
- Open access
- closed
- 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
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- Hospital Anxiety and Depression Scale, reference values, anxiety, depression, German general population, age differences, gender differences, percentile norms, cut-off values, prevalence of anxiety and depression
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Anxiety, Depression, Female, Germany, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Reference Values, Sex Factors
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