The validity of the Hospital Anxiety and Depression Scale: An updated literature review

Part I. Experimental Studies: 2. Experiment in psychology 3. Experiments on perceiving III Experiments on imaging 4-8. Experiments on remembering: (a) The method of description (b) The method of repeated reproduction (c) The method of picture writing (d) The method of serial reproduction (e) The method of serial reproduction picture material 9. Perceiving, recognizing, remembering 10. A theory of remembering 11. Images and their functions 12. Meaning Part II. Remembering as a Study in Social Psychology: 13. Social psychology 14. Social psychology and the matter of recall 15. Social psychology and the manner of recall 16. Conventionalism 17. The notion of a collective unconscious 18. The basis of social recall 19. A summary and some conclusions.

Remembering. A Study in Experimental and Social Psychology, Cambridge (University Press) 1964.

Manuscript in preparation

The detection of psychiatric illness by questionnaire

25. Multiple Imputation for Nonresponse in Surveys. By D. B. Rubin. ISBN 0 471 08705 X. Wiley, Chichester, 1987. 258 pp. £30.25.

Multiple Imputation for Nonresponse in Surveys

Background. Research on the dimensional structure and reliability of the Hospital Anxiety and Depression Scale (HADS) and its relationship with age is scarce. Moreover, its ecacy in determining the presence of depression in dierent patient groups has been questioned. Methods. Psychometric properties of the HADS were assessed in six dierent groups of Dutch subjects (N fl 6165): (1) a random sample of younger adults (age 18‐65 years) (N fl 199); (2) a random sample of elderly subjects of 57 to 65 years of age (N fl 1901); (3) a random sample of elderly subjects of 66 years or older (N fl 3293); (4) a sample of consecutive general practice patients (N fl 112); (5) a sample of consecutive general medical out-patients with unexplained somatic symptoms (N fl 169); and (6) a sample of consecutive psychiatric out-patients (N fl 491). Results. Evidence for a two-factor solution corresponding to the original two subscales of the HADS was found, although anxiety and depression subscales were strongly correlated. Homogeneity and test‐retest reliability of the total scale and the subscales were good. The dimensional structure and reliability of the HADS was stable across medical settings and age groups. The correlations between HADS scores and age were small. The total HADS scale showed a better balance between sensitivity and positive predictive value (PPV) in identifying cases of psychiatric disorder as defined by the Present State Examination than the depression subscale in identifying cases of unipolar depression as defined by ICD-8. Conclusions. The moderate PPV suggests that the HADS is best used as a screening questionnaire and not as a ‘case-identifier’ for psychiatric disorder or depression.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/CB73C315E1C08381CA55AC48D8215B43/S0033291796004382a.pdf/div-class-title-a-validation-study-of-the-hospital-anxiety-and-depression-scale-hads-in-different-groups-of-dutch-subjects-div.pdf

A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

Recurrent exacerbations are a major cause of morbidity and medical expenditure in patients with asthma. Various exogenous and endogenous factors are thought to influence the level of asthma control, but systematical data on the involvement of these factors in the recurrence of asthma exacerbations are scarce. In this study, 13 clinical and environmental factors potentially associated with recurrent exacerbations were investigated in 136 patients with difficult-to-treat asthma. Patients with more than three severe exacerbations (n = 39) in the previous year were compared with those with only one exacerbation per year (n = 24). A systematic diagnostic protocol was used to assess 13 potential risk factors. Factors significantly associated with frequent exacerbations included: severe nasal sinus disease (adjusted odds ratio (OR) 3.7); gastro-oesophageal reflux (OR 4.9); recurrent respiratory infections (OR 6.9); psychological dysfunctioning (OR 10.8); and obstructive sleep apnoea (OR 3.4). Severe chronic sinus disease and psychological dysfunctioning were the only independently associated factors (adjusted OR 5.5 and 11.7, respectively). All patients with frequent exacerbations exhibited at least one of these five factors, whilst 52% showed three or more factors. In conclusion, the results show that recurrent exacerbations in asthma are associated with specific co-morbid factors that are easy to detect and that are treatable. Therapeutic interventions aimed at correcting these factors are likely to reduce morbidity and medical expenditure in these patients.

https://erj.ersjournals.com/content/erj/26/5/812.full.pdf

Risk factors of frequent exacerbations in difficult-to-treat asthma

https://scholarlypublications.universiteitleiden.nl/access/item%3A2881018/view

Psychiatric comorbidity in epilepsy

Background
The criterion validity of the Center for Epidemiological Studies Depression scale (CES-D) was assessed in a group of elderly Dutch community-residents who were self-referred to a prevention program for depression.

Methods
Paper-and-pencil administration of the CES-D to 318 elders (55–85 years). Criterion validity was evaluated with the Mini International Neuropsychiatric Interview (MINI), a clinical diagnostic interview based on DSM-IV. Sensitivity and specificity for various cut-off scores of CES-D were compared with the DSM-IV major depressive disorder (MDD) and with clinically relevant depression (CRD), a composite diagnosis of MDD, subthreshold depression or dysthymia. Furthermore the characteristics of true versus false positives were analyzed.

Results
For MDD, the optimal cut-off score was 25, (sensitivity 85%, specificity 64%, and positive predicted value of 63%). For CRD, the optimal cut-off was 22 (sensitivity 84%, specificity 60%, and positive predicted value 77%). True positives, MDD and CRD, reported significantly more anxiety symptomatology and more co-morbid anxiety disorders, false positives reported more previous depressive episodes.

Conclusions
The criterion validity of the CES-D for MDD and CRD was satisfactory in this semi-clinical sample of elders. Subjects scoring ≥25 constitute a target group for further diagnostic assessment in order to determine appropriate treatment. Copyright © 2004 John Wiley & Sons, Ltd.

The criterion validity of the Center for Epidemiological Studies Depression Scale (CES‐D) in a sample of self‐referred elders with depressive symptomatology

Using cases of dissociative disorder (n=50) and other DSM-IV diagnoses (n=50), a somatoform dissociation self-report questionnaire was developed and its capacity to function as a screening device for dissociative disorders was analysed. A list of 75 items was constructed which, according to clinical experience and expert judgement, could reflect instances of somatoform dissociation. Statistical analyses revealed the 20 best discriminating items. Stepwise forward logistic analysis detected five items which, as a group, provided optimal discrimination between the two groups. At an estimated prevalence rate of dissociative disorders of 10% among psychiatric patients the sensitivity would be 94%, the specificity would be 96%, the positive predictive value would be 72%, and the negative predictive value would be 99%. Cross-validation in an independent sample (n=33/42) largely corroborated the initial findings. The SDQ-5 can be used as a brief screening device for dissociative disorders.

Ph. Spinhoven

Papers

A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects

Risk factors of frequent exacerbations in difficult-to-treat asthma

Psychiatric comorbidity in epilepsy

The criterion validity of the Center for Epidemiological Studies Depression Scale (CES‐D) in a sample of self‐referred elders with depressive symptomatology

The development of the somatoform dissociation questionnaire (SDQ-5) as a screening instrument for dissociative disorders