Cited by 437Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesMultiple Sclerosis Research StudiesCancer survivorship and care

Validation of the Hospital anxiety and depression scale for use with multiple sclerosis patients

Honarmand, Kimia, Feinstein, Anthony·2009·Multiple Sclerosis Journal

Abstract

Detecting clinically significant symptoms of depression and anxiety in medically ill patients using self-report rating scales presents a challenge because of somatic confounders. The Hospital Anxiety and Depression Scale (HADS) was developed with this in mind, but has never been validated for a multiple sclerosis population. Our objective was to validate the HADS for multiple sclerosis patients. Multiple sclerosis patients were interviewed for the presence of major depression (n = 180) and anxiety disorders (n = 140) with the Structured Clinical Interview for DSM-IV disorders. A receiver operating characteristic (ROC) analysis was undertaken to assess which HADS cut-off scores give the best yield with respect to diagnoses of major depression and all anxiety disorders defined by the Structured Clinical Interview for DSM-IV. A threshold score of 8 or greater on the HADS depression subscale provides a sensitivity of 90% and specificity of 87.3% (ROC area under the curve 0.938). The same cut-off score gives a sensitivity of 88.5% and a specificity of 80.7% on the anxiety subscale (ROC area under the curve 0.913), but for generalized anxiety disorder only. The study confirms the usefulness of the HADS as a marker of major depression and generalized anxiety disorder, but not other anxiety disorders, in multiple sclerosis patients.

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Crossref · 10.1177/1352458509347150

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Authors
Honarmand, K., & Feinstein, A.
Affiliations
Sunnybrook Health Science Centre (CA)
Venue
Multiple Sclerosis Journal
Published
2009-11-13
Volume
15
Issue
12
Pages
1518-1524
ISSN
  • 1352-4585 (ISSN-L)
  • 1477-0970
OpenAlex
W2114728329
Cited by
436
References
43
Citations by year
2026: 23 · 2025: 32 · 2024: 36 · 2023: 31 · 2022: 34 · 2021: 43 · 2020: 23 · 2019: 27 · 2018: 34 · 2017: 26 · 2016: 32 · 2015: 26 · 2014: 23 · 2013: 12 · 2012: 15
FWCI
14.36
Type
journal article
Language
en
Open access
closed
Locations
  • Multiple Sclerosis Journal (publishedVersion)
  • PubMed (publishedVersion)
Funders
Multiple Sclerosis Society
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
  • Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
Hospital Anxiety and Depression Scale, multiple sclerosis, depression, anxiety disorders, generalized anxiety disorder, psychometric validation, cut-off values, sensitivity and specificity, self-report scale
MeSH terms
Adolescent, Adult, Aged, Anxiety Disorders, Major Depressive Disorder, Female, Humans, Male, Middle Aged, Multiple Sclerosis, Predictive Value of Tests, Psychiatric Status Rating Scales, Surveys and Questionnaires, ROC Curve, Sensitivity and Specificity, Severity of Illness Index, Reproducibility of Results, Logistic Models, Young Adult

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