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Some results from MedLine, searching for HADS, access provided by Community of Science in 1996
| Citation: |
Leung CM, Ho S, Kan CS, Hung CH, Chen CN, Evaluation of the Chinese
version of the Hospital Anxiety and Depression Scale. A cross-cultural
perspective., Int J Psychosom 40: 1-4, 29-34, , 1993. |
| Abstract |
| The authenticity of the Chinese translation of the Hospital
Anxiety and Depression Scale (HAD) was tested in a sample of medical students.
The Chinese version demonstrated good agreement with the English original.
There was a large difference between the mean anxiety and depression subscores.
Factor analysis consistently yielded three factors, suggesting the existence
of a somatic factor. It is suggested that a common cut-off point for the
subscales of the HAD scale is not advisable and a multidimensional model
for mood disorders is more appropriate in a cross-cultural context. |
| Citation: |
Lam CL, Pan PC, Chan AW, Chan SY, Munro C, Can the Hospital Anxiety
and Depression (HAD) Scale be used on Chinese elderly in general practice?,
Fam Pract 12: 2, 149-54, Jun, 1995. |
| Abstract |
| A study was carried out in a general practice in Hong Kong
to find out if the Hospital Anxiety and Depression (HAD) Scale could be
used to detect psychological problems in Chinese elderly. The HAD Scale
was translated into Cantonese and administered by an interviewer to 298
Chinese aged 60 or above before their doctor consultations. The acceptance
rate of the Scale was 96% and each interview took only 5-10 min to complete.
All 298 elderly understood and completed the HAD Scale. Validation of the
results of the HAD Scale by the Clinical Interview Schedule (CIS) was done
on a random sample of 100 elderly. Relative operating characteristic (ROC)
analysis showed that the optimal cut-off points of the HAD Scale was a
depression score of 6 and an anxiety score of 3. The sensitivity was "80%",
specificity was 90%, OMR (overall misclassification rate) was 12%, positive
predictive value was 67% and negative predictive value was 95%. Thirty-six
per cent of the elderly had scores above these cut-off points. More females
than males had high anxiety scores. Nearly half of those with positive
HAD scores were not known to have any psychological illness. The HAD Scale
has great potential to be used as a screening instrument for psychological
illnesses in Cantonese-speaking Chinese elderly all over the world. |
| Citation: |
Abiodun OA, A validity study of the Hospital Anxiety and Depression
Scale in general hospital units and a community sample in Nigeria.,
Br J Psychiatry 165: 5, 669-72, Nov, 1994. |
| Abstract |
| BACKGROUND. The utility of the Hospital Anxiety and Depression
Scale (HADS) as a screening instrument for anxiety and depressive disorders
in non-psychiatric units (medical & surgical wards; gynaecology &
antenatal clinics of a teaching hospital) and a community sample in Nigeria
was investigated. METHOD. A two-stage screening procedure was employed.
This involved the use of GHQ-12/GHQ-30 and HADS against the criteria of
a standardised (PSE schedule) psychiatric interview, with psychiatric diagnosis
assigned in accordance with ICD-9 criteria.
RESULTS. Sensitivity for the anxiety sub-scale ranged from 85.0% in
the medical and surgical wards to 92.9% in the ante-natal clinic, while
sensitivity for the depression sub-scale ranged from 89.5% in the community
sample to 92.1% in the gynaecology clinic. Specificity for the anxiety
sub-scale ranged from 86.5% in the gynaecology clinic to 90.6% in the community
sample, while specificity for the depression sub-scale ranged from 86.6%
in the medical and surgical wards to 91.1% in the ante-natal clinic and
community sample. Misclassification rates ranged from 9.9% in the community
sample to 13.2% in the medical and surgical wards. Relative Operating Characteristic
(ROC) analyses showed the HADS and the GHQ-12 to be quite similar in ability
to discriminate between cases (anxiety and depression) and non-cases.
CONCLUSIONS. The HADS is valid for use as a screening instrument in
non-psychiatric units and although initially developed for use in hospital
settings, it could be usefully employed in community settings of developing
countries to screen for mental morbidity.
|
| Citation: |
el-Rufaie OE, Absood GH, Retesting the validity of the Arabic version
of the Hospital Anxiety and Depression (HAD) scale in primary health care.,
Soc Psychiatry Psychiatr Epidemiol 30: 1, 26-31, Jan, 1995. |
| Abstract |
| The Arabic version of the Hospital Anxiety and Depression
(HAD) scale was retested and cut-off points determined in a sample of 217
patients attending a primary health care centre in Al Ain, United Arab
Emirates (U.A.E.). Subjects were screened using the HAD scale and all patients
were then interviewed by a single consultant psychiatrist. The scale scores
were assessed against the psychiatrist's clinical evaluations. The study
furnished evidence that the Arabic version of the HAD scale is a valid
instrument for detecting anxiety and depressive disorders in primary health
care settings. Spearman rank correlations of all items of the scale were
significantly above zero. The butterflies item of the anxiety subscale
had the lowest correlation coefficients. The overall Cronbach alpha measures
of internal consistency were 0.7836 and 0.8760 for anxiety and depression,
respectively. The cut-off points that produced a balanced combination of
sensitivity and specificity appropriate for referral to a psychiatric facility
by the general practitioner were 6/7 for anxiety and 3/4 for depression.
Almost all other similar studies have determined a single cut-off point
for both subscales of the HAD. This study also indicated that the HAD depression
subscale is more consistent and more predictive than the HAD anxiety subscale.
Moreover some of the problems arising from applying psychiatric research
instruments across cultures are highlighted by this study. |
| Citation: |
Silverstone PH, Poor efficacy of the Hospital Anxiety and Depression
Scale in the diagnosis of major depressive disorder in both medical and
psychiatric patients., J Psychosom Res 38: 5, 441-50, Jul, 1994.
|
| Abstract |
| The Hospital Anxiety and Depression scale (HAD) is a brief
questionnaire which was designed to indicate the likely presence of a depressive
disorder in medically ill patients. However, more recently it has been
used in several research studies to determine the presence of depression
in both medical and psychiatric patients. The aim of the present study
was to validate the usefulness of the HAD when used in this way. The HAD
was compared to DSM-III-R diagnoses of major depressive disorder in 153
medical inpatients and 147 psychiatric out-patients. In both groups the
sensitivity of the HAD was between 80 and "100%" using the cut-off point
of 8. However, the positive predictive value (PPV) of the HAD was only
17% in medical patients and 29% in psychiatric patients. Changing the cut-off
point for depression or using the total HAD score did not significantly
improve the PPV. These findings suggest that the HAD does not accurately
determine the presence of DSM-III-R major depressive disorder in medical
or psychiatric patients, and should not be used as a research instrument
for this purpose. Nonetheless, the HAD should still be used for its original
purpose, namely as a clinical indicator as to the possibility of a depressive
disorder. |
| Citation: |
Maher EJ, Mackenzie C, Young T, Marks D, The use of the Hospital
Anxiety and Depression Scale (HADS) and the EORTC QLQ-C30 questionnaires
to screen for treatable unmet needs in patients attending routinely for
radiotherapy., Cancer Treat Rev 22 Suppl A: 123-9, Jan, 1996.
|
| Citation: |
Javed MA, Psychiatric morbidity among male students., JPMA J
Pak Med Assoc 44: 4, 85-6, Apr, 1994. |
| Abstract |
| An epidemiological study was conducted to assess the mental
health problems of first year male students studying in two educational
institutions. Based on the findings of general health questionnaire and
hospital anxiety and depression scale, the estimated prevalence of psychological
disturbance was found to be 33% for the whole sample. Present findings
are discussed in terms of early identification and provision of better
health facilities for the students population. |
| Citation: |
Paterson AJ, Lamb AB, Clifford TJ, Lamey PJ, Burning mouth syndrome:
the relationship between the HAD scale and parafunctional habits.,
J Oral Pathol Med 24: 7, 289-92, Aug, 1995. |
| Abstract |
| This study investigated 84 patients with burning mouth syndrome
(BMS), who were asked to complete a hospital anxiety and depression (HAD)
scale questionnaire. A control group of 69 patients was also included.
All patients were interviewed regarding parafunctional habits and were
subjectively examined for signs of occlusal wear of the natural teeth or
dentures. The results demonstrated that parafunctional habits were present
in 61% of patients with BMS. There was a statistically significantly relationship
between parafunctional habits and anxiety as indicated by the HAD scale,
but not with depression. |
| Citation: |
Clark DA, Steer RA, Use of nonsomatic symptoms to differentiate
clinically depressed and nondepressed hospitalized patients with chronic
medical illnesses., Psychol Rep 75: 3 Pt 1, 1089-90, Dec, 1994.
|
| Abstract |
| The differential sensitivity of the Depression subscale scores
of the Hospital Anxiety and Depression Scale and the Cognitive-Affective
subscale scores of the revised Beck Depression Inventory were compared
for 21 chronic medically ill hospitalized patients with DSM-III--R unipolar
depressive disorders and 54 hospitalized medically ill patients without
a comorbid psychiatric disorder. Both subscales significantly differentiated
these two types of patients beyond the .001 level and yielded comparable
effect sizes. The Cognitive-Affective subscale detected clinical depression
as well as a specialized self-report measure. |
| Citation: |
Psychological factors associated with oral lichen planus., J
Oral Pathol Med 273-5, Jul, 1995. |
| Abstract |
| 50 patients with oral lichen planus (LP) were investigated
for current anxiety and depression and for related personality factors.
Anxiety levels, as measured on the Hospital Anxiety and Depression (HAD)
Scale, were elevated in 50% of cases while depression scores, measured
on the same scale, were low in all but a few. The sample profile showed
a slight tendency towards anxiety, as measured by the Cattell 16 PF Questionnaire,
but did not confirm previous reports of high intelligence and intellectual
orientation. There were no statistically significant associations between
erosive oral LP and either anxiety or depression, as measured on the HAD
Scale, or anxiety as measured by the Cattell 16 PF Questionnaire. |
| Citation: |
McCartan BE, 24: 6, |
| Citation: |
Farooq S, Gahir MS, Okyere E, Sheikh AJ, Oyebode F, Somatization:
a transcultural study., J Psychosom Res 39: 7, 883-8, Oct, 1995.
|
| Abstract |
| The primary aim of this study was to investigate the comparative
rates of somatic complaints between Asian and Caucasian patients in a primary
care setting and to characterize the factors associated with increased
rates of somatization. One hundred and ninety-five individuals aged between
16 and 65 yr were interviewed with the Bradford Somatic Inventory (BSI)
and the Hospital Anxiety and Depression Scale (HAD) respectively. The main
finding was that the Asian patients reported significantly more somatic
and depressive symptoms than the Caucasian patients. Ethnicity was the
most important variable determining this result. |
| Citation: |
Velikova G, Selby PJ, Snaith PR, Kirby PG, The relationship of cancer
pain to anxiety., Psychother Psychosom 63: 3-4, 181-4, , 1995.
|
| Abstract |
| The interaction between pain and anxiety in the setting of
somatic illness is a widely recognised association. More accurate knowledge
about the association and also about the means of assessing anxiety in
a clinical setting are of use to the clinician. The present study used
the Hospital Anxiety and Depression Scale for assessment of anxiety, and
the set of linear analogue scales for detecting the presence and severity
of anxiety and pain in an oncology clinic, where patients were undergoing
active treatment for cancer. The relationship between pain and anxiety
was found to be significant, even when the possible mediating effect of
the variables of illness severity and age were removed. The need for detecting
anxiety in order to plan treatment strategy is emphasised. |
| Citation: |
Caplan RP, Stress, anxiety, and depression in hospital consultants,
general practitioners, and senior health service managers [see comments],
BMJ 309: 6964, 1261-3, Nov 12, 1994. |
| Abstract |
| OBJECTIVE--To study stress, anxiety, and depression in a
group of senior health service staff.
DESIGN--Postal survey.
SUBJECTS--81 hospital consultants, 322 general practitioners, and 121
senior hospital managers (total 524). MAIN OUTCOME MEASURES--Scores on
the general health questionnaire and the hospital anxiety and depression
scale.
RESULTS--Sixty five ("80%") consultants, 257 ("80%") general practitioners,
and 67 (56%) managers replied. Of all 389 subjects, 183 (47%) scored positively
on the general health questionnaire, indicating high levels of stress.
From scores on the hospital anxiety and depression scale only 178 (46%)
would be regarded as free from anxiety, with 100 (25%) scoring as borderline
cases and 111 (29%) likely to be experiencing clinically measurable symptoms.
The findings for depression were also of some concern, especially for general
practitioners, with 69 (27%) scoring as borderline or likely to be depressed.
General practitioners were more likely to be depressed than managers (69
(27%) v 4 (6%) scored > or = 8 on hospital anxiety and depression scale-D;
P = 0.004) with no significant difference between general practitioners
and consultants. General practitioners were significantly more likely to
show suicidal thinking than were consultants (36 (14%) v 3 (5%); P = 0.04)
but not managers (9 (13%)). No significant difference could be found between
the three groups on any other measure.
CONCLUSIONS--The levels of stress, anxiety, and depression in senior
doctors and managers in the NHS seem to be high and perhaps higher than
expected.
|
| Citation: |
Pergami A, Catalan J, Hulme N, Burgess A, Gazzard B, How should
a positive HIV result be given? The patients' view., AIDS Care 6:
1, 21-7, , 1994. |
| Abstract |
| The study aimed at obtaining information about the experience
of how the diagnosis of HIV infection was given. Thirty asymptomatic HIV
seropositive subjects completed a self-report questionnaire enquiring about
their views of the process of communication of a positive test result.
Subjects' current mood was assessed with the Hospital Anxiety and Depression
Scale (HAD). Only about one-third of subjects were definitely satisfied
with the way they were told the diagnosis. Satisfaction was associated
with perceived reassurance and sympathy, and with the quality of the information
given. The views of patients, as reported in this study, should be taken
into account when training staff in the notification of HIV test results.
|
| Citation: |
Bottomley A, The development of the Bottomley Cancer Social Support
Scale., Eur J Cancer Care (Engl) 4: 3, 127-32, Sep, 1995. |
| Abstract |
| At present, no social support scale exists that is cancer-specific.
The objective of the study was to develop a cancer-specific scale that
not only had validity in reflecting the experiences of cancer patients,
but also one that was quick and easy to use in a busy clinical environment.
Sixty patients with a primary diagnosis of cancer were selected from oncology
wards and out-patient clinics, and they were administered the Bottomley
Social Support Scale and the Hospital Anxiety and Depression Scale. The
results indicate a valid and reliable social support scale that could be
used in conjunction with other measures in a clinical setting. The clinical
implications of the measure are that it will allow medical and support
staff to assess the levels of social support and implement any appropriate
social support interventions. |
| Citation: |
von Essen L, Burstrom L, Sjoden PO, Perceptions of caring behaviors
and patient anxiety and depression in cancer patient-staff dyads.,
Scand J Caring Sci 8: 4, 205-12, , 1994. |
| Abstract |
| Cancer patient and staff perceptions of the importance of
caring behaviors (Caring Assessment Instrument, CARE-Q) and patient levels
of anxiety and depression (Hospital Anxiety and Depression Scale, HADS)
were determined in 19 matched patient-staff dyads. Both groups perceived
comforting and anticipating behaviors to be among the most important ones.
Patients considered behaviors focused on staff explaining and facilitating
to be more important than did staff, whereas staff rated behaviors concerning
accessibility as more important than did patients. Patient and staff perceptions
of the importance of comforting behaviors were negatively associated. No
significant mean value difference or correlation was found on the HADS
anxiety or depression subscales. Members of matched patient-staff dyads
did not agree strongly on the importance of caring behaviors and patient
levels of anxiety and depression. |
| Citation: |
Kurer JR, Watts TL, Weinman J, Gower DB, Psychological mood of regular
dental attenders in relation to oral hygiene behaviour and gingival health.,
J Clin Periodontol 22: 1, 52-5, Jan, 1995. |
| Abstract |
| This study examined the relationship between psychological
mood, stress and oral hygiene behaviour in a group of 51 regular dental
attenders. Subjects brought a saliva sample for cortisol radioimmunoassay,
completed the Hospital Anxiety and Depression (HAD) Scale, were assessed
for plaque and gingivitis, and were then instructed in toothbrushing. 5
weeks later, 47 subjects were given a full repeat examination. There was
a slight reduction in plaque and gingivitis scores, but no change in mood
as assessed by HAD Scale and salivary cortisol concentration. Mean anxiety
scores were associated with gingivitis level, and mean depression scores
with plaque. Neither mood nor cortisol were predictors of subsequent change
in plaque or gingivitis. |
| Citation: |
Canney PA, Hatton MQ, The prevalence of menopausal symptoms in patients
treated for breast cancer., Clin Oncol (R Coll Radiol) 6: 5,
297-9, , 1994. |
| Abstract |
| A survey has been performed to discover the prevalence of
menopausal symptoms in 108 patients successfully treated for breast cancer.
Patients were assessed by them answering a custom designed questionnaire,
and the use of the Hospital Anxiety and Depression (HAD) scale and the
Greene Climacteric Scale. During the first year after treatment 70% of
women suffered such symptoms; overall 60% of women surveyed were affected.
Adjuvant hormonal treatment was the largest contributing factor in the
development of symptoms. There was a relationship with borderline cases
of anxiety, but not with definite cases of anxiety, as measured by the
HAD scale. The high proportion of women shown to be affected means that
treatment of menopausal symptoms should be incorporated into randomized
trials of adjuvant therapy. |
| Citation: |
Millar K, Jelicic M, Bonke B, Asbury AJ, Assessment of preoperative
anxiety: comparison of measures in patients awaiting surgery for breast
cancer., Br J Anaesth 74: 2, 180-3, Feb, 1995. |
| Abstract |
| We have compared three measurements of anxiety to determine
their equivalence in assessing anxiety before surgery. Forty-four patients
awaiting breast cancer surgery completed the state scale of the state-trait
anxiety inventory (STAI), the hospital anxiety and depression scale (HAD)
and a 100-mm visual analogue scale (VAS). Analysis restricted to correlations
between the scales gave the misleading impression that VAS scores were
inconsistent with those of the HAD and STAI. However, when scores were
considered in relation to normative cut-off values to categorize anxiety
levels, the three scales showed good agreement. We conclude that the scales
were equivalent in their assessment of anxiety before surgery, but that
reference to normative data was important in establishing such equivalence
and in determining the patient's state. |
| Citation: |
Pattison HM, Robertson CE, The effect of ward design on the well-being
of post-operative patients., J Adv Nurs 23: 4, 820-6, Apr, 1996.
|
| Abstract |
| Changes in the design of hospital wards have usually been
determined by architects and members of the nursing and medical professions;
the views and preferences of patients have seldom been sought directly.
The Hospital Anxiety and Depression scale and the Disturbance Due to Hospital
Noise questionnaire were administered to 64 female patients on bay and
Nightingale wards together with a questionnaire designed for this study.
Perceptions of social and physical factors of ward design were examined,
and their relationship to psychological well-being and sleep patterns.
The results show that the bay ward seemed to offer a more favourable environment
for patients but some of the disadvantages of bay wards are balanced by
better staffing levels and better and more modern facilities. Visibility
to nurses was lower on the bay ward. The Nightingale ward was perceived
as significantly noisier than the bay ward and noise levels were significantly
correlated to anxiety scores. Paradoxically the increase in noise levels
appeared to improve the perceived level of privacy on the Nightingale ward.
Seventy-five per cent of patients were found to prefer the bay ward design,
and since neither design appears to have major disadvantages their continued
introduction should be encouraged. However, recommendations are made concerning
the optimizing of patients' well-being within the bay ward setting. |
| Citation: |
Pattison HM, Robertson CE, The effect of ward design on the well-being
of post-operative patients., J Adv Nurs 23: 4, 820-6, Apr, 1996.
|
| Abstract |
| Changes in the design of hospital wards have usually been
determined by architects and members of the nursing and medical professions;
the views and preferences of patients have seldom been sought directly.
The Hospital Anxiety and Depression scale and the Disturbance Due to Hospital
Noise questionnaire were administered to 64 female patients on bay and
Nightingale wards together with a questionnaire designed for this study.
Perceptions of social and physical factors of ward design were examined,
and their relationship to psychological well-being and sleep patterns.
The results show that the bay ward seemed to offer a more favourable environment
for patients but some of the disadvantages of bay wards are balanced by
better staffing levels and better and more modern facilities. Visibility
to nurses was lower on the bay ward. The Nightingale ward was perceived
as significantly noisier than the bay ward and noise levels were significantly
correlated to anxiety scores. Paradoxically the increase in noise levels
appeared to improve the perceived level of privacy on the Nightingale ward.
Seventy-five per cent of patients were found to prefer the bay ward design,
and since neither design appears to have major disadvantages their continued
introduction should be encouraged. However, recommendations are made concerning
the optimizing of patients' well-being within the bay ward setting. |
| Citation: |
Jenkins PL, Lester H, Alexander J, Whittaker J, A prospective study
of psychosocial morbidity in adult bone marrow transplant recipients.,
Psychosomatics 35: 4, 361-7, Jul-Aug, 1994. |
| Abstract |
| Forty recipients of bone marrow transplantation were recruited
prospectively and assessed pretransplant, at 1 month postdischarge, and
at 6 months postdischarge between 1989 and 1990. Assessments included a
psychiatric interview, a variety of standardized questionnaires (Hospital
Anxiety and Depression Scale, Mental Attitude to Cancer Scale, Psychosocial
Adjustment to Illness Scale), and a standardized diagnostic interview.
The influence of factors such as depression and anxiety upon length of
stay, survival, psychosocial adjustment, and negative prognostic attitudes
were examined. In contrast to other studies, little influence was found
for psychiatric illness on physical outcome variables, but they did affect
psychosocial outcome. The implications of these findings are discussed.
|
| Citation: |
Jadresic D, Riccio M, Hawkins DA, Wilson B, Shanson DC, Thompson C,
Long-term impact of HIV diagnosis on mood and substance use--St Stephen's
cohort study., Int J STD AIDS 5: 4, 248-52, Jul-Aug, 1994. |
| Abstract |
| Twenty HIV positive and 68 HIV negative subjects were assessed
by the Hospital Anxiety and Depression Scale and by the Alcohol and Drugs
Frequency Schedule immediately prior to notification of their HIV serostatus
and 6 months after serodiagnosis. The 2 groups did not differ significantly
in levels of anxiety or depression at baseline or follow-up. There were
borderline levels of pathological anxiety prior to notification of HIV
serostatus in both groups. The drop to normal levels of anxiety which had
occurred by follow-up was significant in the HIV positive group. About
a third of subjects in both groups were regularly making use of alcohol
and/or drugs, both at baseline and follow-up. Mean levels of weekly alcohol
intake for both groups ranged from about 20 to 30 units per week. The drugs
most commonly used (in any frequency) were nitrates ('poppers') and cannabis.
|
| Citation: |
Pritchard CW, Depression and smoking in pregnancy in Scotland.,
J Epidemiol Community Health 48: 4, 377-82, Aug, 1994. |
| Abstract |
| OBJECTIVE--The aim was to examine the association between
depressive symptoms and smoking in pregnancy and to investigate the part
played by social and psychosocial factors. SETTING--A single Glasgow hospital.
DESIGN--Prospective survey by postal questionnaires at 20 and 30 weeks'
gestation. PARTICIPANTS--A total of 395 women (69% of the 572 eligible)
parity 1 who booked for delivery between November 1988 and February 1990
took part. MEASUREMENTS--Depressive symptoms were measured using the Hospital
Anxiety and Depression Scale. Smoking was self reported. The Life Events
Inventory and measures of role specific strain and stress in domestic roles
were used to assess psychosocial well being. MAIN
RESULTS--Smokers were more likely than non-smokers to experience depressive
symptoms at 20 and 30 weeks' gestation and on both occasions. The excess
risk remained substantial and significant after adjustment for social and
psychosocial factors.
CONCLUSIONS--Smoking is a significant risk factor for depression in
pregnancy. The association of smoking with depression and psychosocial
difficulty represents a major problem for interventions intended to reduce
smoking in pregnancy.
|
| Citation: |
Johnson G, Burvill PW, Anderson CS, Jamrozik K, Stewart-Wynne EG, Chakera
TM, Screening instruments for depression and anxiety following stroke:
experience in the Perth community stroke study., Acta Psychiatr Scand
91: 4, 252-7, Apr, 1995. |
| Abstract |
| Evaluation of the relative efficacy of three screening instruments
for depression and anxiety in a group of stroke patients was undertaken
as part of the Perth community stroke study. Data are presented on the
sensitivity and specificity of the Hospital Anxiety and Depression Scale
(HAPS), the Geriatric Depression Scale and the General Health Questionnaire
(GHQ) (28-item version) in screening patients 4 months after stroke for
depressive and anxiety disorders diagnosed according to DSM-III criteria.
The GHQ-28 and GDS but not the HADS depression, were shown to be satisfactory
screening instruments for depression, with the GHQ-28 having an overall
superiority. The performance of all 3 scales for screening post-stroke
anxiety disorders was less satisfactory. The HADS anxiety had the best
level of sensitivity, but the specificity and positive predictive values
were low and the misclassification rate high. |
| Citation: |
Malasi TH, Mirza IA, el-Islam MF, Validation of the Hospital Anxiety
and Depression Scale in Arab patients., Acta Psychiatr Scand 84:
4, 323-6, Oct, 1991. |
| Abstract |
| The Hospital Anxiety and Depression Scale (HADS) was administered
to psychiatric out-patients with various diagnoses to assess its validity.
The study was also designed to find out whether HADS can differentiate
between diagnostic groups based on depression and anxiety symptoms. HADS
was able to discriminate patients from controls at a sensitivity of 79%
and specificity of 87%. HADS was much less sensitive, specific and diagnostically
accurate in identifying anxiety and depressive disorders in the experimental
group at a cut-off point of 13 and 10 respectively for both conditions.
Possible psychological, social and psychiatric reasons for the results
are discussed. |
| Citation: |
Mumford DB, Tareen IA, Bajwa MA, Bhatti MR, Karim R, The translation
and evaluation of an Urdu version of the Hospital Anxiety and Depression
Scale., Acta Psychiatr Scand 83: 2, 81-5, Feb, 1991. |
| Abstract |
| The translation of the Hospital Anxiety and Depression Scale
(HADS) into Urdu was undertaken by the authors in committee. After examining
initial drafts by 6 independent translators, an agreed Urdu text was given
to 6 back-translators, and subsequently modified further. The evaluation
of the new translation was performed in 3 stages: evaluation of linguistic
equivalence of items in a bilingual population; evaluation of conceptual
equivalence by examining item-subscale correlations: and evaluation of
scale equivalence by 2-way classification of high and low scorers. Satisfactory
results at each stage suggest that the Urdu version is a reliable and valid
translation of the HADS for use in Pakistan. |
| Citation: |
Upadhyaya AK, Stanley I, Hospital anxiety depression scale [letter],
Br J Gen Pract 43: 373, 349-50, Aug, 1993. |
| Citation: |
Carroll BT, Kathol RG, Noyes R Jr, Wald TG, Clamon GH, Screening
for depression and anxiety in cancer patients using the Hospital Anxiety
and Depression Scale., Gen Hosp Psychiatry 15: 2, 69-74, Mar,
1993. |
| Abstract |
| Nine hundred and thirty inpatients and out-patients with cancer
were approached to complete the Hospital Anxiety and Depression Scale (HADS).
Eight hundred and nine (86.9%) of those approached participated in this
screening. Using the suggested cutoff score of 8 for the anxiety and depression
subscales, we found that 47.6% of this population would warrant further
psychiatric evaluation. Twenty-three percent (23.1%) had scores 11 or greater
and would be the most likely to have had anxiety (17.7%) or depressive
(9.9%) disorders based on DSM-III-R criteria. Patients with active malignant
disease and inpatient status were more likely to have higher depression
scores. The HADS was an easily administered tool that identified a large
proportion of cancer patients as having high levels of anxiety or depression.
However, clinical psychiatric interviews were not performed, so it is not
possible to determine what proportion of patients would benefit from treatment.
|
| Citation: |
Snaith RP, The hospital anxiety and depression scale [letter; comment],
Br J Gen Pract 40: 336, 305, Jul, 1990. |
| Citation: |
Mumford DB, Hospital anxiety and depression scale [letter; comment],
Br J Psychiatry 159: 729, Nov, 1991. |
| Citation: |
Thapar AK, Thapar A, Psychological sequelae of miscarriage: a controlled
study using the general health questionnaire and the hospital anxiety and
depression scale., Br J Gen Pract 42: 356, 94-6, Mar, 1992.
|
| Abstract |
| This study was carried out to assess whether psychiatric
morbidity after a miscarriage is higher than that associated with early
pregnancy. A total of 60 consecutive women admitted to a Swansea hospital
with a miscarriage were compared with 62 consecutive women who attended
an antenatal clinic at the same hospital, using the 28-item general health
questionnaire and the hospital anxiety and depression scale. These were
completed both at initial contact and six weeks later. Women who had had
a miscarriage were found to be significantly more anxious and scored higher
on the subscale for severe depression than the pregnant women, both at
initial assessment and six weeks later. At the six week assessment more
somatic symptoms were also experienced by the group who had had a miscarriage.
This study highlights the psychological disturbance associated with miscarriage.
The primary health care team and hospital staff need to take this into
consideration when organizing follow up for women who have had a miscarriage.
|
| Citation: |
Dowell AC, Biran LA, Problems in using the hospital anxiety and
depression scale for screening patients in general practice [see comments],
Br J Gen Pract 40: 330, 27-8, Jan, 1990. |
| Abstract |
| A study was made of the feasibility of screening general
practice patients for anxiety and depression using the hospital anxiety
and depression scale. A group of consecutive patients aged 18 years and
over completed the questionnaire at the surgery and an age and sex matched
sample were sent questionnaires by post; 94 patients (84%) returned the
postal questionnaire. A further group of 170 consecutive patients coming
for consultation were recruited. Using a threshold score of eight and over,
51% of patients screened by post were probable 'cases' of psychiatric disorder
and using a score of 11 and over, 28% were 'cases'. These proportions were
similar for patients screened when attending the surgery. The findings
are discussed in the context of well-person screening, and a strategy for
follow-up of probable cases is put forward. |
| Citation: |
Snaith RP, Availability of the hospital anxiety and depression (HAD)
scale [letter; comment], Br J Psychiatry 161: 422, Sep, 1992.
|
| Citation: |
Lewis G, Wessely S, Comparison of the General Health Questionnaire
and the Hospital Anxiety and Depression Scale [see comments], Br J
Psychiatry 157: 860-4, Dec, 1990. |
| Abstract |
| The specificity and sensitivity of the HAD, 12-item GHQ and
CIS were calculated by comparing the scores of dermatological patients
on these tests with a criterion measure of disorder. Since psychiatry,
along with many other branches of medicine, does not have an error-free
criterion, it was assumed that the criterion was an underlying latent construct
which was measured by all of the tests and could be derived by factor analysis
from the scores on them. No differences were found between the two questionnaires
(HAD and GHQ) in their ability to detect cases of minor psychiatric disorder
although they were somewhat less reliable than the CIS. |
| Citation: |
Nayani S, The evaluation of psychiatric illness in Asian patients
by the Hospital Anxiety Depression Scale [see comments], Br J Psychiatry
155: 545-7, Oct, 1989. |
| Abstract |
| Twenty Asian psychiatric patients suffering from neurotic
illness completed the Urdu version of the HAD Scale. The results were compared
with the Clinical Interview Schedule. Somatic symptoms were significantly
related to various measures of anxiety but not to those of depression.
This finding contradicts the previously held view of linking somatic symptoms
with the presentation of depression. |
| Citation: |
Hamer D, Sanjeev D, Butterworth E, Barczak P, Using the Hospital
Anxiety and Depression Scale to screen for psychiatric disorders in people
presenting with deliberate self-harm., Br J Psychiatry 158:
782-4, Jun, 1991. |
| Abstract |
| In-patients referred to a deliberate self-harm team were
asked to complete the HAD questionnaire and diagnoses were made using the
SCID. The total prevalence of psychiatric disorder by DSM-III criteria
was 54%. The HAD performed well as a screening instrument; a threshold
score of eight gave a sensitivity of 88% and a positive predictive value
of "80%"; its use by non-psychiatrists to detect depressive disorder in patients
presenting with deliberate self-harm is to be recommended. |
| Citation: |
Moorey S, Greer S, Watson M, Gorman C, Rowden L, Tunmore R, Robertson
B, Bliss J, The factor structure and factor stability of the hospital
anxiety and depression scale in patients with cancer [see comments],
Br J Psychiatry 158: 255-9, Feb, 1991. |
| Abstract |
| An exploratory factor analysis of the HAD was carried out
in 568 cancer patients. Two distinct, but correlated, factors emerged which
corresponded to the questionnaire's anxiety and depression subscales. The
factor structure proved stable when subsamples of the total sample were
investigated. The internal consistency of the two subscales was also high.
These results provide support for the use of the separate subscales of
the HAD in studies of emotional disturbance in cancer patients. |
| Citation: |
Herrmann C, Scholz KH, Kreuzer H, [Psychologic screening of patients
of a cardiologic acute care clinic with the German version of the Hospital
Anxiety and Depression Scale], Psychother Psychosom Med Psychol 41:
2, 83-92, Feb, 1991. |
| Abstract |
| A German version of the HAD-scale which had originally been
developed by Zigmond and Snaith for assessing psychological morbidity in
medical patients was tested in 136 medical students, 18 psychiatric and
531 cardiologic patients. Its validity, reliability and acceptance were
found to be satisfactory, its integration into medical routine did not
raise any problems. Among 203 patients with suspected coronary heart disease
(137 men, 66 women; mean age 54 +/- 10 years) the sub-group with high (vs.
normal) HAD anxiety scores showed a significantly higher number of negative
exercise tests (p less than .05) and coronary angiograms (p = .01; n =
60). Hence, the German HAD version seems to be suitable for a psychological
screening of cardiologic patients. In patients with suspected coronary
heart disease it improves the non-invasive differentiation between organic
and functional causes of chest pain. |
| Citation: |
Jelicic M, Bonke B, Millar K, Clinical note on the use of denial
in patients undergoing surgery for breast cancer., Psychol Rep 72:
3 Pt 1, 952-4, Jun, 1993. |
| Abstract |
| 44 patients awaiting surgery for breast cancer completed
the Hospital Anxiety and Depression Scale. Thirteen patients had anxiety
scores within the normal range, and five of them even scored extremely
low in anxiety. These five and possibly all 13 patients were probably using
denial as a defense against the stress of major surgery. |
| Citation: |
Ali B, Saud Anwar M, Mohammad SN, Lobo M, Midhet F, Ali SA, Saud M
[corrected to Saud Anwar M], Psychiatric morbidity: prevalence, associated
factors and significance [published erratum appears in JPMA J Pak Med Assoc
1994 Apr;44(4):102], JPMA J Pak Med Assoc 43: 4, 69-70, Apr,
1993. |
| Abstract |
| A cross-sectional observational systematic study was carried
out on ambulatory patients at a tertiary care hospital to determine the
probable prevalence, associated factors and significance of psychiatric
morbidity by using an Urdu translation of the hospital anxiety and depression
(HAD) scale over a period of 6 days in a week. Results showed a prevalence
of 38.4% which is slightly higher than what has been generally reported
(30%). Two variables, i.e., female sex and being a housewife were significantly
related with the outcome. An attempt has been made to identify the probable
reasons for this and some suggestions laid down for further work. |
| Citation: |
Zakrzewska JM, Feinmann C, A standard way to measure pain and psychological
morbidity in dental practice., Br Dent J 169: 10, 337-9, Nov
24, 1990. |
| Abstract |
| Dental surgeons are continually faced with patients in pain.
In complicated cases, a measure of pain and its psychological consequences
are essential. The McGill Pain Questionnaire measures pain using 78 descriptors
and is useful not only in diagnosis but in monitoring treatment outcome.
The Hospital Anxiety and Depression Scale is a simple way of assessing
anxiety and depression in non psychiatric out-patient clinics. These two
scales are compared with other measures that can be used. |
| Citation: |
Hopwood P, Howell A, Maguire P, Screening for psychiatric morbidity
in patients with advanced breast cancer: validation of two self-report
questionnaires., Br J Cancer 64: 2, 353-6, Aug, 1991. |
| Abstract |
| Eighty-one patients with advanced breast cancer completed
the Hospital Anxiety and Depression Scale (HADS) and Rotterdam Symptom
Checklist (RSCL) to determine how well these questionnaires identified
patients suffering from an anxiety state or depressive illness, compared
with an independent interview by a psychiatrist who used the Clinical Interview
Schedule. A threshold score was defined for each questionnaire which gave
the optimal sensitivity and specificity. Seventy-five per cent of patients
were correctly identified as suffering from an affective disorder by both
the Rotterdam Symptom Checklist and by the Hospital Anxiety and Depression
Scale. Twenty-one per cent of 'normal' patients were misclassified by the
Rotterdam Checklist and 26% by the Hospital Anxiety and Depression Scale.
When the HADs anxiety and depression subscales were analysed separately,
the performance of the anxiety items was superior to that of the depression
items. Both questionnaires were found to have good predictive value and
could be used in patients with advanced cancer to help screen out those
with an affective disorder. |
| Citation: |
Silverstone PH, Low self-esteem in eating disordered patients in
the absence of depression., Psychol Rep 67: 1, 276-8, Aug, 1990.
|
| Abstract |
| Both low self-esteem and depression are well recognised as
occurring in patients with eating disorders. 43 patients with eating disorders
were studied to assess whether this low self-esteem occurred as part of
an affective disorder or was independent of this. The patients, 23 with
anorexia nervosa and 20 with bulimia nervosa, were assessed for low self-esteem,
using the Rosenberg Self-esteem Questionnaire, and for depression, using
the Hospital Anxiety and Depression Scale. The patients had low self-esteem,
despite only a minority (33%) being depressed. This study demonstrates
that low self-esteem occurs in patients with eating disorders in the absence
of depression. |
| Citation: |
Thompson DR, Meddis R, A prospective evaluation of in-hospital counselling
for first time myocardial infarction men., J Psychosom Res 34:
3, 237-48, , 1990. |
| Abstract |
| Self-ratings of anxiety and depression were studied over
six months in 60 male patients, under 66 yr of age, who were admitted to
a coronary care unit with a first time acute myocardial infarction. Patients
were randomly assigned to either a treatment group, where they received
a simple programme of in-hospital counselling in addition to routine care,
or to a control group, where they received routine care only. All patients
completed the Hospital Anxiety and Depression scale and a battery of visual
analogue scales measuring anxiety on a range of topics related to recovery
from a myocardial infarction. Patients who received in-hospital counselling
reported statistically significantly less anxiety and depression than those
who received routine care alone. This effect was sustained for six months
after leaving hospital. It is concluded that a simple programme of in-hospital
counselling, provided by a coronary care nurse, is efficacious and should
be routinely offered to first myocardial infarction patients in hospital.
|
| Citation: |
Thompson DR, Meddis R, Wives' responses to counselling early after
myocardial infarction., J Psychosom Res 34: 3, 249-58, , 1990.
|
| Abstract |
| Self-ratings of anxiety and depression were studied over
six months in 60 wives of first time myocardial infarction patients. Couples
were randomly assigned to either a treatment group, where they received
a simple programme of education and psychological support in addition to
routine care, or to a control group, where they received routine care only.
All wives completed the Hospital Anxiety and Depression scale and a battery
of visual analogue scales measuring anxiety on a range of topics related
to recovery from a heart attack. Wives in the treatment group reported
statistically significantly less anxiety than controls. This effect was
sustained for six months after the counselling. It is concluded that a
simple programme of in hospital counselling is efficacious and should be
routinely offered to the wives of coronary patients. |
| Citation: |
Wands K, Merskey H, Hachinski VC, Fisman M, Fox H, Boniferro M, A
questionnaire investigation of anxiety and depression in early dementia.,
J Am Geriatr Soc 38: 5, 535-8, May, 1990. |
| Abstract |
| We report findings on a study of anxiety and depression by
questionnaire in 50 patients with mild dementia and 134 control subjects
using the Hospital Anxiety and Depression Scale. Thirty-eight percent of
patients and 9% of controls had a possible or probable diagnosis of an
anxiety disorder. Possible or probable depression was found in 28% of the
patients and 3% of the controls. These rates for the patients were above
those in normal populations. All patients and control subjects were tested
with the Extended Scale for Dementia (ESD). Neither group showed a significant
relationship between depression and ESD scores. In the control subjects
there was a negative correlation (P less than .006) between anxiety and
cognitive scores, one that was not found in the patients. |
| Citation: |
Lewin B, Robertson IH, Cay EL, Irving JB, Campbell M, Effects of
self-help post-myocardial-infarction rehabilitation on psychological adjustment
and use of health services., Lancet 339: 8800, 1036-40, Apr
25, 1992. |
| Abstract |
| A home-based exercise programme has been found to be as useful
as a hospital-based one in improving cardiovascular fitness after an acute
myocardial infarction. To find out whether a comprehensive home-based programme
would reduce psychological distress, 176 patients with an acute myocardial
infarction were randomly allocated to a self-help rehabilitation programme
based on a heart manual or to receive standard care plus a placebo package
of information and informal counselling. Psychological adjustment, as assessed
by the Hospital Anxiety and Depression Scale, was better in the rehabilitation
group at 1 year. They also had significantly less contact with their general
practitioners during the following year and significantly fewer were readmitted
to hospital in the first 6 months. The improvement was greatest among patients
who were clinically anxious or depressed at discharge from hospital. The
cost-effectiveness of the home-based programme has yet to be compared with
that of a hospital-based programme, but the findings of this study indicate
that it might be worth offering such a package to all patients with acute
myocardial infarction. |
| Citation: |
Rosenqvist S, Berglund G, Bolund C, Fornander T, Rutqvist LE, Skoog
L, Wilking N, Lack of correlation between anxiety parameters and oestrogen
receptor status in early breast cancer., Eur J Cancer 29A: 9,
1325-6, , 1993. |
| Abstract |
| Correlation between anxiety parameters and oestrogen receptor
levels (ER) were investigated in 89 patients with primary breast cancer.
Patients were divided into two groups, ER poor (< 0.05 fmol/microgram
DNA) and ER rich (> 0.05 fmol/microgram DNA). No differences were found
between anxiety levels, determined by a modified Hospital Anxiety and Depression
(HAD) scale, in the two groups. This report does not support the findings
from other studies, claiming an association between psychological parameters
and oestrogen receptor status, which is believed to be a prognostic predictor.
|
| Citation: |
Greenough CG, Fraser RD, Comparison of eight psychometric instruments
in unselected patients with back pain., Spine 16: 9, 1068-74,
Sep, 1991. |
| Abstract |
| A comparative evaluation of eight psychometric instruments
was made in 274 patients who were currently suffering or previously had
suffered from low-back pain. The specificity and sensitivity values for
detection of psychological disturbance were calculated and optimum cutoff
scores determined for each test. The influence of current pain, social
group, compensation, migrant status, and unemployment on the accuracy of
each test were evaluated. The Pain Drawing, the Inappropriate Symptoms,
the Inappropriate Signs, and the Illness Behavior Questionnaire were found
to be least discriminating. The Modified Somatic Perception Questionnaire,
the Hospital Anxiety Scale, the Hospital Depression Scale, and the Zung
Depression Scale were the most accurate and least affected by the factors
examined. The combination of the Modified Somatic Perception Questionnaire
and the Zung Depression Scale yielded specificities and sensitivities of
91% and 84% for men and 96% and 85% for women, respectively. This combination
is recommended for the assessment of psychological disturbance in patients
with low-back pain. |
| Citation: |
Barczak P, Kane N, Andrews S, Congdon AM, Clay JC, Betts T, Patterns
of psychiatric morbidity in a genito-urinary clinic. A validation of the
Hospital Anxiety Depression scale (HAD)., Br J Psychiatry 152:
698-700, May, 1988. |
| Abstract |
| The prevalence of psychiatric disorder (by DSM-III criteria)
in a population attending a genito-urinary clinic was found to be 31%.
The performance of the Hospital Anxiety Depression (HAD) scale as a screening
questionnaire for psychiatric disorder was assessed. Case definition by
a score of 8 or more on either of the anxiety or depressive subscales produced
optimal results, giving sensitivities of 82% and 70%, and specificities
of 94% and 68%, for depressive and anxiety disorders respectively. |
| Citation: |
Huston GJ, The Hospital Anxiety and Depression Scale [letter],
J Rheumatol 14: 3, 644, Jun, 1987. |
| Citation: |
Snaith RP, Zigmond AS, The hospital anxiety and depression scale
[letter], Br Med J (Clin Res Ed) 292: 6516, 344, Feb 1, 1986.
|
| Citation: |
el-Rufaie OE, Absood G, Validity study of the Hospital Anxiety and
Depression Scale among a group of Saudi patients., Br J Psychiatry
151: 687-8, Nov, 1987. |
| Abstract |
| The Arabic version of the HAD scale was validated in a sample
of 50 Saudi patients. The scale scores were assessed against the principal
author's clinical evaluations. Spearman correlations of all items of the
scale, except for one, were statistically significant. The non-significance
of one item was probably related to the way it was translated into Arabic.
The study furnished evidence that the Arabic version was a reliable instrument
for detecting states of anxiety and depression in Saudi patients in a primary
health care setting. |
| Citation: |
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 38: 312, 311-3, Jul, 1988.
|
| Citation: |
Lamey PJ, Lamb AB, The usefulness of the HAD scale in assessing
anxiety and depression in patients with burning mouth syndrome., Oral
Surg Oral Med Oral Pathol 67: 4, 390-2, Apr, 1989. |
| Abstract |
| A recent index of anxiety and depression (Hospital Anxiety
and Depression Scale) was applied to 74 patients with burning mouth syndrome.
The scale pointed to anxiety, more than depression, being a feature of
burning mouth syndrome. The validity and clinical application of this scale
to assess anxiety and depression in such patients are discussed. |
| Citation: |
Aylard PR, Gooding JH, McKenna PJ, Snaith RP, A validation study
of three anxiety and depression self-assessment scales., J Psychosom
Res 31: 2, 261-8, , 1987. |
| Abstract |
| All measuring instruments require further validation both
in the setting for which they were designed and in other fields. The Hospital
Anxiety and Depression Scale was designed for detection and assessment
of those mood disorders in the setting of hospital medical and surgical
clinics. Reasons are given for supposing it has advantages over other similar
scales. The present study undertakes a further validation of the scale
in a general hospital setting. The opportunity is taken to assess the usefulness,
in this setting of the Irritability Depression and Anxiety Scale and also
of two subscales of the General Health Questionnaire, the one relating
to the concept of depression and the other to the concept of anxiety. Score
ranges of the latter two subscales are suggested and will require replication
for confirmation of their usefulness. |
| Citation: |
Snaith RP, Taylor CM, Rating scales for depression and anxiety:
a current perspective., Br J Clin Pharmacol 19 Suppl 1: 17S-20S,
, 1985. |
| Abstract |
| Research now requires instruments capable of a better distinction
between depressive and anxiety disorders. The study is concerned with two
relatively recent clinician-rated scales, the Montgomery-Asberg Depression
Rating Scale and the Clinical Anxiety Scale together with two recent self-assessment
scales, the Irritability-Depression-Anxiety Scale and the Hospital Anxiety
and Depression Scale. The concurrent validity of these scales as measures
of the separate concepts of anxiety and depression is examined. |
| Citation: |
Thompson DR, A randomized controlled trial of in-hospital nursing
support for first time myocardial infarction patients and their partners:
effects on anxiety and depression., J Adv Nurs 14: 4, 291-7,
Apr, 1989. |
| Abstract |
| This study monitored and compared levels of anxiety and depression
reported by first myocardial infarction (MI) male patients and their partners,
throughout the patients' hospital stay. An independent variable of a programme
of supportive-educative counselling provided by a coronary care nurse was
introduced to determine whether it significantly affected reactions. Sixty
couples were randomly assigned to one of two groups: (a) the treatment
group (in which they received the systematic programme of nursing support
in addition to routine care), or (b) the control group (in which they received
routine care but no other intervention). Anxiety and depression were measured
by the Hospital Anxiety and Depression (HAD) scale at 24 hours and 5 days
after the patient's admission to hospital. At 5 days there were statistically
significant differences between both groups with respect to the HAD scale
mean scores. These findings strongly suggest that a simple programme of
in-hospital couple counselling, provided by a coronary care nurse, statistically
significantly reduces anxiety and depression in first MI male patients
and anxiety in their partners. |
| Citation: |
Identifying anxiety and depressive disorders among primary care
patients: a pilot study., Acta Psychiatr Scand 280-2, Mar, 1988. |
| Abstract |
| One stage case-identification method, using the Arabic Version
of the Hospital Anxiety and Depression Scale (HAD) was applied in a pilot
study for estimating the prevalence of depressive and anxiety disorders
among a group of Saudi primary care attenders. The validity of the Arabic
Version of the HAD scale was previously tested and found valid with high
sensitivity and specificity. The total prevalence rate of depression was
17% and that of anxiety was 16%. Seven percent of the sample suffered both
depression and anxiety i.e. the total percentage of patients with depression,
anxiety or both was 26%. Higher morbidity of depression was recorded among
females and a higher morbidity of anxiety among male patients. |
| Citation: |
el-Rufaie OE, Albar AA, Al-Dabal BK, 77: 3, |
| Citation: |
The Scottish First Episode Schizophrenia Study. III. Cognitive performance.
The Scottish Schizophrenia Research Group., Br J Psychiatry 150:
338-40, Mar, 1987. |
| Abstract |
| Cognitive performance in 46 first episode schizophrenics
was assessed within 1 week of admission to hospital by Progressive Matrices,
Mill Hill Vocabulary Scale, Block Design and Similarities subtests of the
Wechsler Adult Intelligence Scale, and Digit Copying Test. Patients' intellectual
performance was at a dull normal level, just within one standard deviation
from the mean. There was an association between the presence of anxiety
and depression and lower scores on psychological tests. Patients assessed
by the Present State Examination as belonging to the 'uncertain psychosis'
category performed more poorly. |
| Citation: |
Hicks JA, Jenkins JG, The measurement of preoperative anxiety.,
J R Soc Med 81: 9, 517-9, Sep, 1988. |
| Abstract |
| Preoperative anxiety was assessed using the hospital anxiety
and depression (HAD) scale, multiple affect adjective check list (MAACL)
and linear analogue anxiety scale (LAAS) in 100 consecutive day case patients
undergoing termination of pregnancy. The HAD scale, a recently introduced
self assessment scale comprising 7 multiple choice questions, was readily
accepted and easily understood by patients. There was a high degree of
correlation between the HAD scale and both the MAACL (correlation coefficient
0.74) and the LAAS (correlation coefficient 0.67). There was only a moderate
degree of correlation between the HAD scale and the anaesthetist's assessment
of anxiety (correlation coefficient 0.46). The HAD scale is a useful method
of subjective measurement of preoperative anxiety. |
| Citation: |
Hashimoto F, Kellner R, Kapsner CO, Upper respiratory tract infections
increase self-rated hostility and distress., Int J Psychiatry Med 17:
1, 41-7, , 1987. |
| Abstract |
| The authors administered a personality inventory, the Eysenck
Personality Inventory and a distress scale, the Symptom Questionnaire,
to all patients in a walk-in clinic of a general hospital during an influenza
epidemic. Hostility, depression, anxiety and somatic symptoms were significantly
higher in patients with upper respiratory tract infections (p less than
.005); the majority scored in the range of psychiatric patients, regardless
of whether patients had clinically classical influenza or merely symptoms
and signs of another respiratory tract infection. There were no differences
in the personality traits of extraversion or neuroticism between any of
the groups, suggesting that hostility and distress were consequences of
the viral infections and were largely unaffected by preexisting personality
traits. |
| Citation: |
Cundall DB, Children and mothers at clinics: who is disturbed?,
Arch Dis Child 62: 8, 820-4, Aug, 1987. |
| Abstract |
| One hundred and eighty one white children aged 6 to 11 years
who were attending medical out-patient clinics with their mothers were studied
to assess the prevalence of psychological disturbance in the children,
and anxiety and depression in the mothers. Teachers were also asked to
assess the children independently using the Rutter scales. Mothers assessed
70 (39%) of the children as being disturbed, 20 of whom were also assessed
as being disturbed by their teachers. A further 15 children were assessed
as being disturbed by their teachers but not by their mothers. Thirty five
(19%) of the mothers assessed themselves as anxious and two as depressed
using the hospital anxiety and depression scale. Anxious and depressed
mothers were significantly more likely to assess their child as being disturbed.
In contrast, the teachers' assessments of the children were not affected
by the mental state of the mothers. These findings confirm that mothers'
perceptions of their children are modified by their own moods. |
| Citation: |
Robertson DA, Ray J, Diamond I, Edwards JG, Personality profile
and affective state of patients with inflammatory bowel disease., Gut
30: 5, 623-6, May, 1989. |
| Abstract |
| The Eysenck Personality Inventory and Hospital Anxiety and
Depression scale were administered to 80 patients undergoing medical treatment
for long standing inflammatory bowel disease: 22 patients were studied
before the diagnosis was established and 40 patients with diabetes mellitus
served as controls. High neuroticism and introversion scores were more
prevalent in the patients with inflammatory bowel disease than controls
(p less than 0.05) and these characteristics were as prominent in patients
before diagnosis as in established cases. Introversion scores increased
with the duration of disease (r = 0.51). Depression was uncommon, occurring
only in patients with active chronic disease. Patients believed there was
a close link between personality, stress and disease activity. Fifty six
of the patients recognised factors that initiated the disease and in 42
this was thought to be a stressful life event or a 'nervous personality'.
|
| Citation: |
Marsh DT, Stile SA, Stoughton NL, Trout-Landen BL, Psychopathology
of opiate addiction: comparative data from the MMPI and MCMI., Am J
Drug Alcohol Abuse 14: 1, 17-27, , 1988. |
| Abstract |
| The MMPI and MCMI were administered to 163 former opiate
addicts who were being maintained in a methadone program affiliated with
an urban hospital. Highest group mean MMPI scores were found for Psychopathic
Deviate, Depression, Hypomania, and Hysteria. For the MCMI, highest group
mean clinical syndrome scores were found for Drug Abuse, Alcohol Abuse,
Anxiety, and Dysthymia; highest personality disorder scores were found
for Antisocial, Narcissistic, Histrionic, and Paranoid. The MCMI Drug Abuse
Scale identified only 49% of subjects as having a recurrent or recent history
of drug abuse. Frequency and factor analyses documented the heterogeneity
of the population with respect to clinical syndromes, as well as the prevalence
of personality disorders (86% had elevations on MCMI Personality Scales).
Factor and correlational analyses did not provide strong evidence of similar
factor structure or convergent validity of the MMPI and MCMI with this
population. |
| Citation: |
Ryde-Brandt B, Mothers of primary school children with Down's syndrome.
How do they experience their situation?, Acta Psychiatr Scand 78:
1, 102-8, Jul, 1988. |
| Abstract |
| The occurrence of anxiety or depression, experience of social
support and feelings about the family situation were evaluated in 13 mothers
of children of primary school age with Down's syndrome (DS). The results
were compared with those obtained in a group of 13 females engaged in taking
care of these children and assisting their families. Questionnaires were
used to assess feelings of depression or anxiety (Hospital Anxiety and
Depression Scale), to evaluate social support (Interview Schedule for Social
Interaction) and the family situation (Family Adaptability and Cohesion
Evaluation Scale). A semi-structured interview with the mothers was also
conducted. The results indicated that negative feelings at the birth of
a child with DS had almost invariably changed in a positive direction.
Experience of depression or anxiety was uncommon. Social and emotional
contacts were quantitatively normal, although more empathy was often desired.
The families were relatively often described as enmeshed and controlled,
but the experience of the family situation was generally positive. |
| Citation: |
Smith J, Carr V, Morris H, Gilliland J, The dexamethasone suppression
test in relation to symptomatology: preliminary findings controlling for
serum dexamethasone concentrations., Psychiatry Res 25: 2, 123-33,
Aug, 1988. |
| Abstract |
| A diagnostically heterogeneous sample of psychiatric inpatients
(n = 52) was administered the 1 mg dexamethasone suppression test (DST)
shortly after hospital admission. Each was also assessed using the Hamilton
Rating Scale for Depression (HRSD) and selected items of the Present State
Examination (PSE) representing psychomotor retardation and anxiety. A potent
determinant of postdexamethasone serum cortisol concentrations was found
to be the level of serum dexamethasone concentration achieved following
the oral dose. No relationship was found between postdexamethasone cortisol
concentration and the scores on either the HRSD or an anxiety scale derived
from selected PSE items. However, symptoms of psychomotor retardation were
significantly related to postdexamethasone serum cortisol concentration,
particularly when the serum dexamethasone concentrations were taken into
account. It may be that DST nonsuppression in psychiatric patients is in
part a reflection of the presence of psychomotor retardation, a phenomenon
that cuts across diagnostic categories. |
| Citation: |
Malt U, The long-term psychiatric consequences of accidental injury.
A longitudinal study of 107 adults., Br J Psychiatry 153: 810-8,
Dec, 1988. |
| Abstract |
| One hundred and seven accidentally injured adults were studied
while in hospital and assessed prospectively twice more in a mean period
of 28 months. The patients were studied by means of taped clinical interviews,
including the Comprehensive Psychopathological Rating Scale (which includes
the Montgomery-Asberg Depression Rating Scale), and several self-report
measures of distress (Schedule of Recent Life Events, General Health Questionnaire,
Impact of Event Scale and State Anxiety Inventory) at the three assessments.
The total incidence of psychiatric disorders considered to be caused by
the accident during the follow-up period was 22.4%. The incidence of non-organic
psychiatric disorders caused by the accident was 16.8% at the first follow-up
and 9.3% at the final follow-up. Depressive disorders of different severity
were most often seen. Only one patient suffered from a post-traumatic stress
disorder during the follow-up, and none at the final follow-up (DSM-III).
Organic mental disorders were diagnosed in 9.3% of the patients. In 5.6%
of the patients this was the only disorder. |
| Citation: |
Chandarana PC, Eals M, Steingart AB, Bellamy N, Allen S, The detection
of psychiatric morbidity and associated factors in patients with rheumatoid
arthritis., Can J Psychiatry 32: 5, 356-61, Jun, 1987. |
| Abstract |
| Eighty-six patients with a confirmed diagnosis of rheumatoid
arthritis were surveyed to assess the extent of psychiatric morbidity as
indicated by two screening questionnaires, the General Health Questionnaire
and the Hospital Anxiety and Depression Scale. In addition to an investigation
of the concordance of the screening questionnaires, a description of demographic
characteristics and measures of disability were taken. Disability due to
arthritis was indicated by measures of years of chronicity, pain, duration
of morning stiffness, functional level, active treatment involvement, and
presence of coexisting medical problems. The relationship of physical symptoms
to level of psychiatric distress was investigated. Psychiatric cases were
identified using recommended cut off scores on results of the screening
questionnaires. GHQ cut off scores of 6/7 identified as "cases"
31.8% of the sample. HADS subscale cut off scores of 8/9 identified 21.4%
of subjects with "anxiety" and 19.0% with "depression"
scores in the morbid range. Nineteen percent of patients were found to
have scores on both tests concurrently in the pathological range. |
| Citation: |
Overall JE, Rhoades HM, Moreschi E, The Nurses Evaluation Rating
Scale (NERS)., J Clin Psychol 42: 3, 454-66, May, 1986. |
| Abstract |
| The Nurses Evaluation Rating Scale (NERS) consists of 16
items designed to capture salient dimensions of psychopathology and nursing
care requirements for psychiatric patients. Reliability and validity of
the NERS were evaluated by using a total of 3,052 sets of ratings accomplished
by 19 staff nurses on a total of 235 adult psychiatric inpatients. All
items of the NERS were utilized in describing psychopathology in this sample
of patients, although no patient was positive on all items. Factor analysis
revealed four distinct clusters of items, which represented higher-order
constructs of thinking disturbance, depression, anxiety, and psychomotor
retardation. Test-retest reliability was found to be comparable to the
reliability of most other clinical assessments of psychopathology. Scoring
for the four factors was defined, and analysis of change during first 10
days of hospital stay revealed statistically significant improvement. The
NERS appears to be a promising instrument for longitudinal, daily evaluations
of inpatient psychopathology as seen in the routine clinical practice of
psychiatric nurses. |
| Citation: |
Berrios GE, Ryley JP, Garvey TP, Moffat DA, Psychiatric morbidity
in subjects with inner ear disease., Clin Otolaryngol 13: 4,
259-66, Aug, 1988. |
| Abstract |
| A prospective assessment of psychiatric morbidity in a sample
of 207 patients with inner ear disorders, attending an ENT clinic, was
carried out. As a group, they were found to have higher psychiatric morbidity
on the general health questionnaire (GHQ) than either normal samples or
samples affected by other forms of physical disease. Within the sample
tinnitus patients scored the highest, and presbyacusis patients the lowest.
High GHQ scores predicted an exaggerated self-rating of symptom severity
in a visual analogue scale. Past psychiatric history did not play a role
in the development of psychiatric morbidity. Elderly subjects complained
more often of fear of collapsing in the street but this was not related,
as has been suggested, to the subsequent development of agoraphobic symptoms.
Factor analysis of GHQ items for the 'cases' yielded 'depression', 'anxiety'
and 'personality' factors. No correlation was found between these factors
and the rest of the clinical variables. It is concluded that tinnitus shows
the clearest association with psychiatric morbidity and hence merits detailed
psychological analysis. Such a study has been started at Addenbrooke's
Hospital. |
| Citation: |
Neuling SJ, Winefield HR, Social support and recovery after surgery
for breast cancer: frequency and correlates of supportive behaviours by
family, friends and surgeon., Soc Sci Med 27: 4, 385-92, , 1988.
|
| Abstract |
| In a longitudinal study of recovery after surgery for breast
cancer, subjects reported the frequency of, and their satisfaction with,
various supportive behaviours on the part of family members, close friends
and medical professionals. The reliability of the Multi-Dimensional Support
Scale (MDSS) devised for this purpose is described. Measures of psychological,
social and physical adjustment approached normality by 3 months post-operation.
Frequency of support from all sources decreased as time from surgery passed,
whilst satisfaction with support varied with the type of support given
and the source from which it was received. Quite different patterns emerged
in support needs from professional and non-professional sources, with empathic
support being required from all sources, whilst informational support was
desired from surgeons, rather than from family and friends. Further, subjects
were more discriminating in the amounts of support required from family
and friends, such that it was more likely for these sources to give unwanted
support than it was for professional sources, from whom many subjects reported
inadequate support. Satisfaction with social support was matched with measures
of adjustment, and it was found that those satisfied with support from
family members were significantly less anxious and depressed in hospital
than were those who were not satisfied with support from this source. However,
at 1 month post-operation, anxiety and depression levels were significantly
related to satisfaction with support from surgeons; and at 3 months post-operation,
anxiety and depression measures were significantly related to satisfaction
with support from both family members and surgeons.(ABSTRACT TRUNCATED
AT 250 WORDS) |
| Citation: |
Buckelew SP, DeGood DE, Schwartz DP, Kerler RM, Cognitive and somatic
item response pattern of pain patients, psychiatric patients, and hospital
employees., J Clin Psychol 42: 6, 852-60, Nov, 1986. |
| Abstract |
| Standard psychological tests generally provide a single global
score that reflects multidimensional constructs, such as depression and
anxiety. This single score, however, integrates a range of item contents,
including cognitive/affective, somatic, and behavioral characteristics
of these multidimensional constructs. The present study was designed to
compare the pattern of item endorsement among chronic pain patients (N
= 50), psychiatric inpatients (N = 50), and hospital employees (N = 50)
on the SCL-90-R (Derogatis, Rickels, & Rock, 1976). Pain patients reported
the highest SCL-90 scale level of Somatization, while the psychiatric inpatients
reported the highest level of Anxiety and Depression. Additionally, the
within-scale pattern of item responses on the Anxiety and Depression scales
differed among groups. Although psychiatric inpatients endorsed equivalent
levels of somatic and cognitive items, the pain patients' reports of psychological
distress were limited primarily to somatic signs of anxiety and depression.
Thus, the interpretation of pain patients' psychological profiles and subsequent
treatment recommendations may be inappropriate if based on normative data
obtained from psychiatric and/or normal populations. |
| Citation: |
Miles MS, Emotional symptoms and physical health in bereaved parents.,
Nurs Res 34: 2, 76-81, Mar-Apr, 1985. |
| Abstract |
| The purpose of this study was to compare the emotional symptoms
and physical health of parents whose children had died suddenly in an accident,
parents whose children had died following a chronic disease, and nonbereaved
parents. Data for this retrospective survey were collected by mailed questionnaires:
the Hopkins Symptom Checklist (HSCL), Bereavement Health Assessment Scale,
Review of Life Experiences Scale, and a personal-situation questionnaire.
Subjects were 30 bereaved parents who had experienced the death of a child
following a chronic disease; 31 bereaved parents whose children died in
an accident; and 81 nonbereaved parents. Findings indicated significant
differences between the bereaved groups and the control group on the total
scale score of the HSCL and on the subscales measuring Depression, Anxiety,
Somatization, Obsession-Compulsion, and Interpersonal Sensitivity. However,
there were no differences on these variables between the two bereaved groups.
Bereaved parents with higher concurrent life stresses and parents from
a lower socioeconomic background were at higher risk for emotional symptomatology.
There were no significant differences among the three groups on the number
of physician/nurse visits, number of hospital admissions, number of new
or recurrent illnesses, or drug usage. Bereaved parents, however, more
frequently reported appetite and sleep problems. |
| Citation: |
Zigmond AS, Snaith RP, The hospital anxiety and depression scale.,
Acta Psychiatr Scand 67: 6, 361-70, Jun, 1983. |
| Abstract |
| A self-assessment scale has been developed and found to be
a reliable instrument for detecting states of depression and anxiety in
the setting of an hospital medical out-patient clinic. The anxiety and depressive
subscales are also valid measures of severity of the emotional disorder.
It is suggested that the introduction of the scales into general hospital
practice would facilitate the large task of detection and management of
emotional disorder in patients under investigation and treatment in medical
and surgical departments. |
| Citation: |
Magni G, Messina C, De Leo D, Mosconi A, Carli M, Psychological
distress in parents of children with acute lymphatic leukemia., Acta
Psychiatr Scand 68: 4, 297-300, Oct, 1983. |
| Abstract |
| Psychological distress in parents of children with acute
lymphatic leukemia was evaluated by means of the Symptom Distress Checklist.
This scale was administered twice: within a few days after the child's
admission to hospital and 8 months later. Twenty-five consecutive, unselected
subjects were compared with controls matched for age, sex, marital status
and social class. At the first evaluation the sample presented higher mean
scores than the controls for anxiety (P less than 0.005), depression (P
less than 0.005), sleep disturbances (P less than 0.005) and obsessions
(P less than 0.05). An 8 months' follow-up confirmed the persistence of
anxiety (P less than 0.05), sleep disturbances (P less than 0.05) and above
all depression (P less than 0.005). |
| Citation: |
Matson JL, Kazdin AE, Senatore V, Psychometric properties of the
psychopathology instrument for mentally retarded adults., Appl Res
Ment Retard 5: 1, 81-9, , 1984. |
| Abstract |
| One hundred and ten adults, from borderline to severe levels
of mental retardation, were assessed through the out-patient clinic of a
university-affiliated mental health center and a large state psychiatric
hospital. These patients were included only after they had demonstrated
the ability to respond to questions of similar difficulty to those presented
in the Psychopathology Instrument for Mentally Retarded Adults. This measure
was designed by the authors based on DSM III criteria, and covered seven
types of psychopathology including schizophrenia, depression, psychosexual
disorders, adjustment disorder, anxiety, somatoform disorders, and personality
problems. In the present study the psychometric properties of the scale
were reviewed and/or evaluated including internal consistency of items
and test-retest reliability, and factor analysis. |
| Citation: |
Moore NC, Medazepam and the driving ability of anxious patients.,
Psychopharmacology (Berl) 52: 1, 103-6, Mar 23, 1977. |
| Abstract |
| A double-blind crossover trial of Medazepam was carried out
in 14 anxious hospital patients. The mean self-adjusted dosage was 16.5
mg daily. The active drug was no more effective than placebo in relieving
anxiety, which was rated both clinically and by the Middlesex Health Questionnaire
(M.H.Q.) (Crown and Crisp, 1970). This may have been because the dose was
relatively low for chronically anxious hospital patients. Even this dosage
caused significantly higher scores on the M.H.Q. scale for depression.
Braking and driving simulator tests were not adversely affected by Medazepam.
In real driving conditions those taking the drug made significantly more
technical, but not dangerous, errors. Pulse and blood pressure also were
not affected. |
| Citation: |
Schiller E, Baker J, Return to work after a myocardial infarction:
evaluation of planned rehabilitation and of a predictive rating scale.,
Med J Aust 1: 23, 859-62, Jun 5, 1976. |
| Abstract |
| This paper reports the first recorded controlled trial of
cardiac rehabilitation after myocardial infarction in men of working age,
viewed as a team intervention effort to facilitate the patient's return
to normal work. Our results show that this intervention is helpful in returning
to jobs which they can handle successfully men who would otherwise be at
risk of remaining unemployed. A previously developed rating scale for predicting
return to work after myocardial infarction was used and reevaluated. Employment
and occupational level at admission to hospital, work history, availability
of the previous job, educational level, family and social stability, age
at which regular cigarette smoking commenced, and level of anxiety and
depression on a personality scale proved highly predictive. |
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