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Hospital Anxiety and Depression (HAD) Scale
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, any commercial use of the HAD scale requires copyright permissions or purchase of the questionnaires, both which must be obtained from GL Assessments (link below).
Alternative screening tools for depression
- Two question test3
- "During the last month, have you often been bothered by feeling down, depressed or hopeless?".
- "During the last month, have you often been bothered by little interest or pleasure in doing things?"
It is simple but does not test for anxiety. - Patient Health Questionnaire 9 - (PHQ-9) available here.
Document references
- Zigmond AS, Snaith RP; The hospital anxiety and depression scale. Acta Psychiatr Scand. 1983 Jun;67(6):361-70. [abstract]
- 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.
- Whooley MA, Avins AL, Miranda J, et al; Case-finding instruments for depression. Two questions are as good as many.; J Gen Intern Med. 1997 Jul;12(7):439-45. [abstract]
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: 21
Document Reference: bgp2439
Last Updated: 1 Jun 2009
Planned Review: 31 May 2014
The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest.
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