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Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients.
Mult Scler. 2009 Dec; 15(12):1518-24.MS

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.

Authors+Show Affiliations

University of Toronto, Toronto, Ontario, Canada, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't
Validation Study

Language

eng

PubMed ID

19965520

Citation

Honarmand, Kimia, and Anthony Feinstein. "Validation of the Hospital Anxiety and Depression Scale for Use With Multiple Sclerosis Patients." Multiple Sclerosis (Houndmills, Basingstoke, England), vol. 15, no. 12, 2009, pp. 1518-24.
Honarmand K, Feinstein A. Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Mult Scler. 2009;15(12):1518-24.
Honarmand, K., & Feinstein, A. (2009). Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. Multiple Sclerosis (Houndmills, Basingstoke, England), 15(12), 1518-24. https://doi.org/10.1177/1352458509347150
Honarmand K, Feinstein A. Validation of the Hospital Anxiety and Depression Scale for Use With Multiple Sclerosis Patients. Mult Scler. 2009;15(12):1518-24. PubMed PMID: 19965520.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Validation of the Hospital Anxiety and Depression Scale for use with multiple sclerosis patients. AU - Honarmand,Kimia, AU - Feinstein,Anthony, Y1 - 2009/11/13/ PY - 2009/12/8/entrez PY - 2009/12/8/pubmed PY - 2010/2/5/medline SP - 1518 EP - 24 JF - Multiple sclerosis (Houndmills, Basingstoke, England) JO - Mult Scler VL - 15 IS - 12 N2 - 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. SN - 1477-0970 UR - https://www.unboundmedicine.com/medline/citation/19965520/Validation_of_the_Hospital_Anxiety_and_Depression_Scale_for_use_with_multiple_sclerosis_patients_ L2 - https://journals.sagepub.com/doi/10.1177/1352458509347150?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -