Cited by 908Anxiety, Depression, Psychometrics, Treatment, Cognitive ProcessesPsychometric Methodologies and TestingHealth Education and Validation

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Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population

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Mykletun, Arnstein, Stordal, Eystein, Dahl, Alv A.·2001·British Journal of Psychiatry

DOI 10.1192/bjp.179.6.540

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Abstract

Background: The Hospital Anxiety and Depression (HAD) rating scale is a commonly used questionnaire. Former studies have given inconsistent results as to the psychometric properties of the HAD scale. Aims: To examine the psychometric properties of the HAD scale in a large population. Method: All inhabitants aged 20–89 years (n=92 100) were invited to take part in The Nord-Tr⊘ndelag Health Study, Norway. A total of 65 648 subjects participated, and only completed HAD scale forms (n=51 930) formed the basis for the psychometric examinations. Results: Principal component analysis extracted two factors in the HAD scale that accounted for 57% of the variance. The anxiety and depression sub-scales shared 30% of the variance. Both sub-scales were found to be internally consistent, with values of Cronbach's coefficient (a) being 0.80 and 0.76, respectively. Conclusions: Based on data from a large population, the basic psychometric properties of the HAD scale as a self-rating instrument should be considered as quite good in terms of factor structure, intercorrelation, homogeneity and internal consistency.

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The Hospital Anxiety and Depression Scale
Zigmond, A. S., & Snaith, R. P. (1983) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1983.tb09716.x · Cited by 47,139
Lifetime and 12-Month Prevalence of DSM-III-R Psychiatric Disorders in the United States: Results From the National Comorbidity Survey
Kessler, R. C. (1994) · Archives of General Psychiatry · doi:10.1001/archpsyc.1994.03950010008002 · Cited by 12,370
Tripartite model of anxiety and depression: psychometric evidence and taxonomic implications
Clark, L. A., & Watson, D. (1991) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.100.3.316 · Cited by 4,601
International experiences with the Hospital Anxiety and Depression Scale-A review of validation data and clinical results
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885
A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects
SPINHOVEN, P., ORMEL, J., SLOEKERS, P. P. A., KEMPEN, G. I. J. M., SPECKENS, A. E. M., & HEMERT, A. M. V. (1997) · Psychological Medicine · doi:10.1017/s0033291796004382 · Cited by 2,158
Comorbidity of anxiety and unipolar mood disorders
Mineka, S., Watson, D., & Clark, L. A. (1998) · Annual Review of Psychology · doi:10.1146/annurev.psych.49.1.377 · Cited by 1,573
Testing a tripartite model: I. Evaluating the convergent and discriminant validity of anxiety and depression symptom scales.
Watson, D., Weber, K., Assenheimer, J. S., Clark, L. A., Strauss, M. E., & McCormick, R. A. (1995) · Journal of Abnormal Psychology · doi:10.1037/0021-843x.104.1.3 · Cited by 1,423
Hospital anxiety and depression scale (had): Some psychometric data for a swedish sample
Lisspers, J., Nygren, A., & Söderman, E. (1997) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.1997.tb10164.x · Cited by 706
The Factor Structure and Factor Stability of the Hospital Anxiety and Depression Scale in Patients with Cancer
Moorey, S., Greer, S., Watson, M., Gorman, C., Rowden, L., Tunmore, R., Robertson, B., & Bliss, J. M. (1991) · The British Journal of Psychiatry · doi:10.1192/bjp.158.2.255 · Cited by 653
Screening for Adjustment Disorders and Major Depressive Disorders in Cancer In-Patients
Razavi, D., Delvaux, N., Farvacques, C., & Robaye, E. (1990) · British Journal of Psychiatry · doi:10.1192/bjp.156.1.79 · Cited by 514

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Nunnally, 1994, Psychometric Theory
Bjelland, I. , Neckelmann, D. , Tangen Haug, T. , et al (2001) A review of validation studies of the Hospital Anxiety and Depression Scale. Journal of Psychosomatic Research, in press.
Üstun, 1995, Mental Illness in General Health Care

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Method
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Method
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Method
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Method
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Background
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Method
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Method
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Result
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BackgroundResult
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Biringer, E., Keßler, U., Howard, L. M., Pasupathy, D., & Mykletun, A. (2018) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2018.07.001 · Cited by 14
Self-citation
Executive Function, Eating Behavior, and Preoperative Weight Loss in Bariatric Surgery Candidates: An Observational Study
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Frequency of positive states of mind as a moderator of the effects of stress on psychological functioning and perceived health
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“There are studies indicating that positive affective states are associated with greater Correspondence: richard.branstrom@ki.se Department of Clinical Neuroscience and Department of Public Health Sciences, Karolinska Institute, Stockholm 171 77, Sweden © 2013 Bränström; licensee BioMed Central Ltd.”
Background
Eyewitness memory: The impact of a negative mood during encoding and/or retrieval upon recall of a non-emotive event
Thorley, C., Dewhurst, S. A., Abel, J. W., & Knott, L. M. (2015) · Memory · doi:10.1080/09658211.2015.1058955 · Cited by 15
Cardiovascular Risk Among Patients Who Smoke: Risk Profiles and Differences by Sex
Allagbé, I., Zeller, M., Thomas, D., Airagnes, G., Limosin, F., Boussadi, A., Chague, F., & Faou, A.-L. L. (2022) · American Journal of Preventive Medicine · doi:10.1016/j.amepre.2022.04.028 · Cited by 16
Evaluation of Autonomic Reserves in Cardiac Surgery Patients
Deschamps, A., Denault, A. Y., Rochon, A. G., Cogan, J., Pagé, P., & D’Antono, B. (2012) · Journal of Cardiothoracic and Vascular Anesthesia · doi:10.1053/j.jvca.2012.07.016 · Cited by 13
Psychometric properties of the Norwegian version of the short form of The Problem Areas in Diabetes scale (PAID-5): a validation study
Vislapuu, M., Broström, A., Igland, J., Vorderstrasse, A. A., & Iversen, M. M. (2019) · BMJ Open · doi:10.1136/bmjopen-2018-022903 · Cited by 13
“Missing substitution with the mean was used for the HAD depression scale when at least 5 items of 7 were answered.(25) For all other questionnaires, when less than 50% was missing, missing data were replaced with the case mean.”
BackgroundMethod
Caregivers’ effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial
Kootker, J. A., Heugten, C. M. V., Kral, B., Rasquin, S. M. C., Geurts, A. C. H., & Fasotti, L. (2019) · Clinical Rehabilitation · doi:10.1177/0269215519833013 · Cited by 13
Adults with Loeys-Dietz syndrome and vascular Ehlers-Danlos syndrome: a cross-sectional study of patient experiences with physical activity
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“The Norwegian version of HADS is a well-validated screening instrument for symptoms of psychological distress [29].”
Method
Training for Awareness, Resilience and Action (TARA) for medical students: a single-arm mixed methods feasibility study to evaluate TARA as an indicated intervention to prevent mental disorders and stress-related symptoms
Ekbäck, E., von Knorring, J., Löfgren‐Burström, A., Hunhammar, D., Dennhag, I., Molin, J., & Henje, E. (2022) · BMC Medical Education · doi:10.1186/s12909-022-03122-2 · Cited by 15
“Psychometric properties are good to excellent [38, 39].”
Relationships among Demographic, Clinical, and Psychological Factors Associated with Family Caregiver Readiness to Participate in Intensive Care Unit Care
Hetland, B. D., McAndrew, N. S., Kupzyk, K. A., Krutsinger, D. C., Turnbull, A. E., Pozehl, B., & Heusinkvelt, J. M. (2022) · Annals of the American Thoracic Society · doi:10.1513/annalsats.202106-651oc · Cited by 13
Negative Recurrent Thinking as a Moderator of the Relationship Between Perceived Stress and Depressive Symptoms
Nikčević, A. V., Caselli, G., Green, D., & Spada, M. M. (2014) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-014-0192-5 · Cited by 13
Management of trapeziometacarpal osteoarthritis pain and dysfunction using mobilization with movement technique in combination with kinesiology tape: a case report
Villafañe, J. H., Langford, D., Diego, I. M. A., & Fernández‐Carnero, J. (2013) · Journal of Chiropractic Medicine · doi:10.1016/j.jcm.2013.06.001 · Cited by 13
Plasma Peptide Concentrations and Peptide-Reactive Immunoglobulins in Patients with Eating Disorders at Inclusion in the French EDILS Cohort (Eating Disorders Inventory and Longitudinal Survey)
Galmiche, M. C., Lucas, N., Déchelotte, P., Deroissart, C., Solliec, M.-A. L., Rondeaux, J., Azhar, S., Grigioni, S., Colange, G., Delay, J., et al. (2020) · Nutrients · doi:10.3390/nu12020522 · Cited by 13
“Finally, the HAD questionnaire was used to evaluate anxiety and depression [26].”
Method
The effect evaluation of Individual Placement and Support (IPS) for patients with substance use disorders: study protocol for a randomized controlled trial of IPS versus enhanced self-help
Rognli, E. B., Aas, E. M., Drake, R. E., Marsden, J., Anders, P., Bond, G. R., Lystad, J. U., Rème, S. E., & Arnevik, E. A. (2021) · Trials · doi:10.1186/s13063-021-05673-z · Cited by 14
“We will use the following validated questionnaires to assess mental health status, substance use, and quality of life at baseline and follow-ups: Mental health status will be assessed by use of the Hospital Anxiety and Depression Scale (HADS) [28, 29], a 14-item questionnaire with a depression subscale and an anxiety…”
Method
Women with breast cancer: relationships between social factors involving anxiety and depression
Bulotienė, G., Vesėliūnas, J., Ostapenko, V., & Furmonavičius, T. (2008) · Cited by 13
Psychological effects of colorectal cancer screening: Participantsvsindividuals not invited
Kirkøen, B., Berstad, P. M., Botteri, E., Bernklev, L., El‐Safadi, B., Hoff, G. S., de Lange, T., & Bernklev, T. (2016) · World Journal of Gastroenterology · doi:10.3748/wjg.v22.i43.9631 · Cited by 14
Loneliness in patients with somatic symptom disorder
Vos, A. E. C. C., Jongen, E. M. M., van den Hout, A. J. H. C., & van Lankveld, J. J. D. M. (2022) · Scandinavian Journal of Pain · doi:10.1515/sjpain-2022-0057 · Cited by 14
Sleep disruption in patients with active and treated endogenous Cushing’s syndrome
Geer, E. B., Grillo, I., Li, Q., Robins, H. E., Cohen, V., Baratz, H., Garcia, C. A., Sazo, M., Lin, A., Cohen, M. A., et al. (2024) · Pituitary · doi:10.1007/s11102-024-01450-8 · Cited by 8
“The reliability, validity, and factor structure of the HADS has been established in a variety of clinical populations, including pituitary Cushing’s patients [32].”
Background
Prevalence and Sex Distribution of Temporomandibular Disorder and Their Association with Anxiety and Depression in Indian Medical University Students
Majumder, K., Sharma, S., Rao, J. D., Siwach, V., Arya, V., & Gulia, S. (2015) · International Journal of Clinical Medicine · doi:10.4236/ijcm.2015.68076 · Cited by 12
“In both scales a score of 0 - 7 indicates absence of anxiety or depression, a score of 8 10 indicates possible anxiety or depression, and a score of 11 or higher indicates presence of anxiety or depression [15] [16].”
Background
Glutamate cysteine ligase (GCL) and self reported depression: An association study from the HUNT
Berk, M., Johansson, S., Wray, N. R., Williams, L. J., Olsson, C. A., Haavik, J., & Bjerkeset, O. A. (2011) · Journal of Affective Disorders · doi:10.1016/j.jad.2010.12.019 · Cited by 12
“, 2002), including the Norwegian version used in HUNT 2 (Mykletun et al., 2001).”
MethodResult
The association between the clinical diversity of psoriasis and depressive symptoms: the HUNT Study, Norway
Modalsli, E. H., Åsvold, B. O., Snekvik, I., Romundstad, P. R., Naldi, L., & Saunes, M. (2017) · Journal of the European Academy of Dermatology and Venereology · doi:10.1111/jdv.14449 · Cited by 12
Frustration Discomfort Scale (FDS). A Psychometric Study of the Italian Version
Tripaldi, S., Paparusso, M., Amabili, M., Manfredi, C., Caselli, G., Scarinci, A., Valenti, V., & Mezzaluna, C. (2018) · Journal of Rational-Emotive & Cognitive-Behavior Therapy · doi:10.1007/s10942-018-0286-6 · Cited by 12
Written benefit finding for improving psychological health during the Covid-19 pandemic first wave lockdown
Hansen, S. R., Wetherell, M. A., & Smith, M. (2021) · Psychology and Health · doi:10.1080/08870446.2021.1936521 · Cited by 12
“The internal consistency for the anxiety subscale has been estimated to range between α = 0.78 and 0.93, and for the depression scale between α = 0.82 and 0.90 (Mykletun et al., 2001).”
MethodInfluential
Depressive symptoms in the general population: The 7th Tromsø Study
Grønli, O., Bramness, J. G., Wynn, R., & Høye, A. (2022) · Journal of Affective Disorders Reports · doi:10.1016/j.jadr.2022.100322 · Cited by 15
Anxiety and depression in intensive care patients six months after admission to an intensive care unit: A cohort study
Bjørnøy, I., Rustøen, T., Mesina, R. S., & Hofsø, K. (2023) · Intensive and Critical Care Nursing · doi:10.1016/j.iccn.2023.103473 · Cited by 13
Alteraciones emocionales y psicopatológicas en pacientes oncológicos laringectomizados
Piñero, N. B., Jurado, R. A., Franco, L. R., Guerra, E. I., Herrero-Salado, T. F., & Sánchez‐Gómez, S. (2014) · Acta Otorrinolaringológica Española · doi:10.1016/j.otorri.2014.09.006 · Cited by 12
RELIABILITY AND VALIDATION OF A CHINESE VERSION OF THE AGING MALES' SYMPTOMS SCALE
Chen, C.-Y., Wang, W.-S., Liu, C.-Y., & Lee, S. (2007) · Psychological Reports · doi:10.2466/pr0.101.1.27-38 · Cited by 12
The use of nitrous oxide in paediatric anaesthetic practice in the United Kingdom: a questionnaire survey*
Sheraton, T. E., Gildersleve, C. D., & Hall, J. E. (2006) · Anaesthesia · doi:10.1111/j.1365-2044.2006.04857.x · Cited by 13
Prevalence of Emotional Distress in Cancer Patients
Santre, M., Rathod, J., & Maidapwad, S. (2014) · IOSR Journal of Dental and Medical Sciences · doi:10.9790/0853-13650914 · Cited by 12
Measurement of Anxiety for Patients With Cardiac Disease
Jong, M. J. D., & Hall, L. A. (2006) · The Journal of Cardiovascular Nursing · doi:10.1097/00005082-200609000-00013 · Cited by 12
The co-morbidity of depression and other chronic non-communicable diseases: a review of literature on the epidemiology, diagnosis and health effects
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“Farklı yaş ve gruplarda, HADÖ’nün depresyon alt boyutunun 0,73 ile 0,83 arasında, anksiyete alt boyutunun 0,77 ile 0,85 arasında iç tutarlılık katsayısı gösterdiği belirtilmiştir (127).”
Faces Anxiety Scale as a screening measure of preoperative anxiety: Validation and diagnostic accuracy study
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Metacognitions about desire thinking predict the severity of binge eating in a sample of Italian women
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Impaired psychometric testing in polyglandular autoimmunity
Storz, S., Wylenzek, S. A. M., Matheis, N., Weber, M. M., & Kahaly, G. J. (2010) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2010.03952.x · Cited by 12
Change in quality of life of medically hospitalized patients – A one-year follow-up study
Helvik, A., Engedal, K., & Selbæk, G. (2012) · Aging & Mental Health · doi:10.1080/13607863.2012.715137 · Cited by 12
“The HAD questionnaire has been validated in Norway and used in several studies including some among the elderly (Helvik, Engedal, Skancke, & Selbaek, 2011 ; Mykletun, Stordal, & Dahl, 2001 ; Olsson, Mykletun, & Dahl, 2005 ; Stordal et al, 2001 ).”
Method
Correlations between the responses of electrogastrograms, heart rate and respiratory rate to the stress of the mirror drawing test in human subjects
Homma, S. (2006) · Journal of Smooth Muscle Research · doi:10.1540/jsmr.42.9 · Cited by 12
“Anxiety and depression scores were estimated using HADS (hospital anxiety and depression scales) (Zigmond and Snaith, 1983; Mykletun et al., 2001).”
Method
Botulinum toxin type A combined with neurodynamic mobilization for lower limb spasticity: a case report
Villafañe, J. H. (2013) · Journal of Chiropractic Medicine · doi:10.1016/j.jcm.2013.01.001 · Cited by 12

Authors: Mykletun, A., Stordal, E., & Dahl, A. A.
Affiliations: University of Bergen (NO)
University of Oslo (NO)
Corresponding author: Mykletun, Arnstein
ORCID: Mykletun, Arnstein
Stordal, Eystein
Dahl, Alv A.
Venue: British Journal of Psychiatry
Publisher: Royal College of Psychiatrists
Published: 2001-12
Volume: 179
Issue: 6
Pages: 540-544
ISSN: 0007-1250 (ISSN-L)
1472-1465
DOI: 10.1192/bjp.179.6.540
OpenAlex: W2106572906
Cited by: 908
References: 23
Citations by year: 2026: 16 · 2025: 28 · 2024: 33 · 2023: 31 · 2022: 39 · 2021: 31 · 2020: 28 · 2019: 31 · 2018: 36 · 2017: 38 · 2016: 48 · 2015: 60 · 2014: 58 · 2013: 61 · 2012: 56
FWCI: 21.49
Type: journal article
Language: en
Open access: bronze
doi.org
Licence: www.cambridge.org/core/terms (unspecified, 5876 d)
Locations: The British Journal of Psychiatry (publishedVersion)
PubMed (publishedVersion)
Funders: Norges Teknisk-Naturvitenskapelige Universitet
Topics: Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
Health Sciences › Nursing › Research and Theory › Health Education and Validation
Keywords: Hospital Anxiety and Depression Scale, psychometric properties, factor structure, internal consistency, anxiety, depression, self-report questionnaire, Nord-Trøndelag Health Study, item analysis
MeSH terms: Adult, Aged, Aged, 80 and over, Anxiety Disorders, Mental Disorders, Depressive Disorder, Female, Humans, Male, Middle Aged, Psychiatric Status Rating Scales, Psychometrics, Reproducibility of Results

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Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population

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