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Hospital Anxiety and Depression (HAD) Scale

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This article is currently under review. The intention is to implement a calculator that interacts with the clinical record.

This is a self screening questionnaire for depression and anxiety.¹ The patient should be instructed not to take too long over their replies: their immediate reaction to each item will probably be more accurate than a long thought-out response. It consists of 14 questions, seven for anxiety and seven for depression. Although it was designed for hospital General Medical Outpatients, it has been extensively used in Primary Care.²

Although the detail of the HAD scale may be available on the internet, copyright of the HAD scale is claimed by GL Assessments. Printed questionnaires can be obtained from them (see link below).

The Patient Health Questionnaire 9 - (PHQ-9), available here, is an alternative screening for depression tool.

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Document references

1. Zigmond AS, Snaith RP; The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. [abstract]
2. Wilkinson MJ, Barczak P; Psychiatric screening in general practice: comparison of the general health questionnaire and the hospital anxiety depression scale. J R Coll Gen Pract. 1988 Jul;38(312):311-3.

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Internet and further reading

• GL Assessments; For purchase of questionnaire.
• Bjelland I, Dahl AA, Haug TT, et al; The validity of the Hospital Anxiety and Depression Scale. An updated literature review. J Psychosom Res. 2002 Feb;52(2):69-77. [abstract]

Acknowledgements EMIS is grateful to Dr Huw Thomas for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2009.
Document ID: 2271
Document Version: 24
Document Reference: bgp2439
Last Updated: 3 Nov 2009
Planned Review: 2 Nov 2014

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