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Health and Quality of Life Outcomes
Published in: Health and Quality of Life Outcomes 1/2009

Open Access 01-12-2009 | Research

Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations

Authors: Tomomi Matsudaira, Hiromi Igarashi, Hiroyoshi Kikuchi, Rikihachiro Kano, Hiroshi Mitoma, Kiyoshi Ohuchi, Toshinori Kitamura

Published in: Health and Quality of Life Outcomes | Issue 1/2009

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Abstract

Background

The Hospital Anxiety and Depression Scale (HADS) is a common screening instrument excluding somatic symptoms of depression and anxiety, but previous studies have reported inconsistencies of its factor structure. The construct validity of the Japanese version of the HADS has yet to be reported. To examine the factor structure of the HADS in a Japanese population is needed.

Methods

Exploratory and confirmatory factor analyses were conducted in the combined data of 408 psychiatric outpatients and 1069 undergraduate students. The data pool was randomly split in half for a cross validation. An exploratory factor analysis was performed on one half of the data, and the fitness of the plausible model was examined in the other half of the data using a confirmatory factor analysis. Simultaneous multi-group analyses between the subgroups (outpatients vs. students, and men vs. women) were subsequently conducted.

Results

A two-factor model where items 6 and 7 had dual loadings was supported. These factors were interpreted as reflecting anxiety and depression. Item 10 showed low contributions to both of the factors. Simultaneous multi-group analyses indicated a factor pattern stability across the subgroups.

Conclusion

The Japanese version of HADS indicated good factorial validity in our samples. However, ambiguous wording of item 7 should be clarified in future revisions.
Appendix
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Metadata
Title
Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations
Authors
Tomomi Matsudaira
Hiromi Igarashi
Hiroyoshi Kikuchi
Rikihachiro Kano
Hiroshi Mitoma
Kiyoshi Ohuchi
Toshinori Kitamura
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2009
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-7-42

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