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Published in: Health and Quality of Life Outcomes 1/2003

Open Access 01-12-2003 | Research

The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version

Authors: Ali Montazeri, Mariam Vahdaninia, Mandana Ebrahimi, Soghra Jarvandi

Published in: Health and Quality of Life Outcomes | Issue 1/2003

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Abstract

Background

The Hospital Anxiety and Depression Scale (HADS) is a widely used instrument to measure psychological morbidity in cancer patients. This study aimed to translate and test the reliability and validity of the Iranian version of the HADS.

Methods

The English language version of the HADS was translated into Persian (Iranian language) and was used in this study. The questionnaire was administered to a consecutive sample of 167 breast cancer patients and statistical analysis was performed to test the reliability and validity of the HADS.

Results

In general the Iranian version of the HADS was found to be acceptable to almost all patients (99%). Cronbach's alpha coefficient (to test reliability) has been found to be 0.78 for the HADS anxiety sub-scale and 0.86 for the HADS depression sub-scale. Validity as performed using known groups comparison analysis showed satisfactory results. Both anxiety and depression sub-scales discriminated well between sub-groups of patients differing in clinical status as defined by their disease stage.

Conclusion

This preliminary validation study of the Iranian version of the HADS proved that it is an acceptable, a reliable and valid measure of psychological distress among cancer patients.
Literature
1.
go back to reference Herrmann C: International experiences with the Hospital Anxiety and Depression Scale: a review of validation data and clinical results. J Psychosom Res 1997, 42: 17–41. 10.1016/S0022-3999(96)00216-4PubMedCrossRef Herrmann C: International experiences with the Hospital Anxiety and Depression Scale: a review of validation data and clinical results. J Psychosom Res 1997, 42: 17–41. 10.1016/S0022-3999(96)00216-4PubMedCrossRef
2.
go back to reference Bjelland I, Dahl AA, Tangen Haug T, Neckelmann : The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 2002, 52: 69–77. 10.1016/S0022-3999(01)00296-3PubMedCrossRef Bjelland I, Dahl AA, Tangen Haug T, Neckelmann : The validity of the Hospital Anxiety and Depression Scale: an updated literature review. J Psychosom Res 2002, 52: 69–77. 10.1016/S0022-3999(01)00296-3PubMedCrossRef
3.
go back to reference Montazeri A, Harirchi I, Vahdani M, et al.: Anxiety and depression in Iranian breast cancer patients before and after diagnosis. Eur J Cancer Care 2000, 9: 151–157. 10.1046/j.1365-2354.2000.00219.xCrossRef Montazeri A, Harirchi I, Vahdani M, et al.: Anxiety and depression in Iranian breast cancer patients before and after diagnosis. Eur J Cancer Care 2000, 9: 151–157. 10.1046/j.1365-2354.2000.00219.xCrossRef
4.
go back to reference Nunnally JC, Bernstien IH: Psychometric Theory. New York: MacGraw-Hill 3 Edition 1994. Nunnally JC, Bernstien IH: Psychometric Theory. New York: MacGraw-Hill 3 Edition 1994.
5.
go back to reference Montazeri A, Harirchi I, Vahdani M, et al.: The European Organization for Research and Treatment of Cancer: translation and validation study of the Iranian version. Support Care Cancer 1999, 7: 400–406. 10.1007/s005200050300PubMedCrossRef Montazeri A, Harirchi I, Vahdani M, et al.: The European Organization for Research and Treatment of Cancer: translation and validation study of the Iranian version. Support Care Cancer 1999, 7: 400–406. 10.1007/s005200050300PubMedCrossRef
6.
go back to reference Zigmond AS, Snaith PR: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983, 67: 361–370.PubMedCrossRef Zigmond AS, Snaith PR: The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983, 67: 361–370.PubMedCrossRef
7.
go back to reference Fayers P, Aaronson N, Bjordal K, Groenvold M, Curran D, Bottomley A: The EORTC QLQ-C30 Scoring Manual. Brussels: EORTC Quality of Life Group 3 Edition 2001. Fayers P, Aaronson N, Bjordal K, Groenvold M, Curran D, Bottomley A: The EORTC QLQ-C30 Scoring Manual. Brussels: EORTC Quality of Life Group 3 Edition 2001.
8.
go back to reference Lyons RA, Wareham K, Lucas M, et al.: SF-36 scores vary by method of administration: implication for study design. J Publ Hlth Med 1999, 21: 41–45. 10.1093/pubmed/21.1.41CrossRef Lyons RA, Wareham K, Lucas M, et al.: SF-36 scores vary by method of administration: implication for study design. J Publ Hlth Med 1999, 21: 41–45. 10.1093/pubmed/21.1.41CrossRef
9.
go back to reference Costantini M, Musso M, Viterbori P, et al.: Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer 1999, 7: 121–127. 10.1007/s005200050241PubMedCrossRef Costantini M, Musso M, Viterbori P, et al.: Detecting psychological distress in cancer patients: validity of the Italian version of the Hospital Anxiety and Depression Scale. Support Care Cancer 1999, 7: 121–127. 10.1007/s005200050241PubMedCrossRef
10.
go back to reference Mykletun A, Stordal E, Dahl AA: Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatr 2001, 179: 540–544. 10.1192/bjp.179.6.540CrossRef Mykletun A, Stordal E, Dahl AA: Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatr 2001, 179: 540–544. 10.1192/bjp.179.6.540CrossRef
11.
go back to reference Hall A, A'Hern R, Fallowfield L: Are we using appropriate self-report questionnaire for detecting anxiety and depression in women with early breast cancer? Eur J Cancer 1999, 35: 79–85. 10.1016/S0959-8049(98)00308-6PubMedCrossRef Hall A, A'Hern R, Fallowfield L: Are we using appropriate self-report questionnaire for detecting anxiety and depression in women with early breast cancer? Eur J Cancer 1999, 35: 79–85. 10.1016/S0959-8049(98)00308-6PubMedCrossRef
12.
go back to reference Love AW, Kissane DW, Bloch S, Clarke DM: Diagnostic efficiency of the Hospital Anxiety and Depression Scale in women with early stage breast cancer. Aust & N Z J Psychiatr 2002, 36: 246–250. 10.1046/j.1440-1614.2002.01014.xCrossRef Love AW, Kissane DW, Bloch S, Clarke DM: Diagnostic efficiency of the Hospital Anxiety and Depression Scale in women with early stage breast cancer. Aust & N Z J Psychiatr 2002, 36: 246–250. 10.1046/j.1440-1614.2002.01014.xCrossRef
13.
go back to reference Ramirez AJ, Richards MA, Jarrett SR, Fentiman IS: Can mood disorder in women with breast cancer be identified prospectively? Br J Cancer 1995, 27: 1509–1512.CrossRef Ramirez AJ, Richards MA, Jarrett SR, Fentiman IS: Can mood disorder in women with breast cancer be identified prospectively? Br J Cancer 1995, 27: 1509–1512.CrossRef
14.
go back to reference Payen DK, Hoffman RG, Theodoulou M, et al.: Screening for anxiety and depression in women with breast cancer. Psychiatry and medical oncology gear up for managed care. Psychosomatics 1999, 40: 64–69.CrossRef Payen DK, Hoffman RG, Theodoulou M, et al.: Screening for anxiety and depression in women with breast cancer. Psychiatry and medical oncology gear up for managed care. Psychosomatics 1999, 40: 64–69.CrossRef
15.
go back to reference Lisspers J, Nygren A, Soderman E: Hosptial Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample. Acta Psychiatr Scand 1997, 96: 281–286.PubMedCrossRef Lisspers J, Nygren A, Soderman E: Hosptial Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample. Acta Psychiatr Scand 1997, 96: 281–286.PubMedCrossRef
16.
go back to reference Caplan RP: Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers. Br Med J 1994, 309: 1261–1263.CrossRef Caplan RP: Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers. Br Med J 1994, 309: 1261–1263.CrossRef
17.
go back to reference Quintana JM, Padierna A, Esteban C, Arostegui I, Bilbao A, Ruiz I: Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 2003, 107: 216–221. 10.1034/j.1600-0447.2003.00062.xPubMedCrossRef Quintana JM, Padierna A, Esteban C, Arostegui I, Bilbao A, Ruiz I: Evaluation of the psychometric characteristics of the Spanish version of the Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 2003, 107: 216–221. 10.1034/j.1600-0447.2003.00062.xPubMedCrossRef
Metadata
Title
The Hospital Anxiety and Depression Scale (HADS): translation and validation study of the Iranian version
Authors
Ali Montazeri
Mariam Vahdaninia
Mandana Ebrahimi
Soghra Jarvandi
Publication date
01-12-2003
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2003
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-1-14

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