The DOI matches its Crossref record; 23 of the 23 references it cites were found in a registry or an index.
Hospital Anxiety and Depression (HAD) scale: Factor structure, item analyses and internal consistency in a large population
Open accessAbstract
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.
Overview
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The cited source says what the claim attributes to it.
In the citing paper
“Also, it demonstrated good factor structure, intercorrelation, homogeneity and internal consistency.28”
From Protocol for a feasibility and acceptability study using a brief ACT-based intervention for people from Southwest Wales who live with persistent pain (2018) · cites this paper as [28]
The cited source says what the claim attributes to it.
In the citing paper
“The HADS is a validated (Bjelland, Dahl, Haug, & Neckelmann, 2002; Mykletun, Stordal, & Dahl, 2001), 14-item measure of anxiety and depression.”
From A pilot case series of a brief acceptance and commitment therapy (ACT)-based guided self-help intervention for improving quality of life and mood in muscle disorders (2017) · cites this paper as Mykletun, Stordal, & Dahl, 2001
In the citing paper
“Therefore, the Hospital Anxiety and Depression Scale (HADS) seems more appropriate to use: this instrument has shown solid psychometric properties regarding factor analysis and internal consistency.”
From The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries (2015) · cites this paper as Mykletun et al., 2001
In the citing paper
“However, the psychometric approach to evaluate depression used a self-administrated scale with strong psychometric properties.”
From The Psychological Burden of Skin Diseases: A Cross-Sectional Multicenter Study among Dermatological Out-Patients in 13 European Countries (2015) · cites this paper as Mykletun et al., 2001
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Citations
Cites
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
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
Herrmann, C. (1997) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(96)00216-4 · Cited by 2,885
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
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
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
Flagged first, then by citations
Research works printed but not linked: 3
- 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
Cited by
Sorted by citations
Santini, Z. I., Jose, P. E., York Cornwell, E., Koyanagi, A., Nielsen, L., Hinrichsen, C., Meilstrup, C., Madsen, K. R., & Koushede, V. (2020) · The Lancet Public Health · doi:10.1016/s2468-2667(19)30230-0 · Cited by 1,755
LOWE, B. (2004) · Journal of Affective Disorders · doi:10.1016/s0165-0327(02)00237-9 · Cited by 1,060
“There is evidence for the two-factor structure of the instrument, although the two subscales are strongly intercorrelated (Spinhoven et al., 1997; Mykletun et al., 2001).”
BackgroundPallant, J., & Tennant, A. (2007) · British Journal of Clinical Psychology · doi:10.1348/014466506x96931 · Cited by 996
Dalgard, F. J., Gieler, U., Tomas-Aragones, L., Lien, L., Poot, F., Jemec, G. B. E., Misery, L., Szabo, C., Linder, D., Sampogna, F., et al. (2015) · Journal of Investigative Dermatology · doi:10.1038/jid.2014.530 · Cited by 968
“…variance of 30% of the subscales of depression and anxiety, the sensitivity and specificity for the anxiety and depression subscales are high, which allows separation of anxiety disorder from depression (Mykletun et al., 2001; Bjelland et al., 2002; Picardi et al., 2005; Breeman et al., 2014).”
BackgroundMethodInfluentialValidation study of a Portuguese version of the Hospital Anxiety and Depression Scale
Pais-Ribeiro, J., Silva, I., Ferreira, T., Martins, A., Meneses, R., & Baltar, M. (2007) · Psychology, Health & Medicine · doi:10.1080/13548500500524088 · Cited by 774
“Mykletun et al. (2001) explain that several psychometric issues of the HADS need further clarification namely because different studies show a factorial structure with one, two or three factors.”
Background
Metadata
- Authors
- Mykletun, A., Stordal, E., & Dahl, A. A.
- Affiliations
- University of Bergen (NO)
- University of Oslo (NO)
- Corresponding author
- Mykletun, Arnstein
- 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
- 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
- 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
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
