Evidence map›Paper›PMID 28978356›Full record

ArticleHealth and quality of life outcomes2017

Is the Hospital Anxiety and Depression Scale (HADS) a valid measure in a general population 65-80 years old? A psychometric evaluation study.

Ingrid Djukanovic, Jörg Carlsson, Kristofer Årestedt

2 registry-linked trialsOpen access · goldAbstract readValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in Health and quality of life outcomes, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 159 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
159citing papers in PubMed, 5 pooled it
34.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05214937 narecruitingnot on this mapstarted 2022, after this paper: background citation

A Distance-based, Randomized Controlled Trial for Reducing Sedentary Behaviour Among Prostate Cancer Survivors

TypeinterventionalSponsorUniversity of TorontoRan2022 to 2026Enrolled120ConditionsSedentary Behavior, Cancer of ProstateArmsIntervention, FitBit Only
NCT07450950 recruitingnot on this mapstarted 2025, after this paper: background citation

Evaluating Health Literacy, Expectations and Regrets in Patients Undergoing Major Abdominal Surgery for Malignant Disease

TypeobservationalSponsorRigshospitalet, DenmarkRan2025 to 2026Enrolled90ConditionsSurgery, Major Pancreatic, Surgery, Major Hepatic, Large Bowel/Sarcoma Resections, Surgery, Major Esophageal or Stomach
3 · Its place in the literature

Who cites it

159 citing papers in PubMed, 5 syntheses or guidelines pooled it, 330 citations in OpenAlex.

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  4. The Use of Music to Manage Burnout in Nurses: A Systematic Review.American journal of health promotion : AJHP · 2022
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99 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors at 2 institutions in 1 country.

Ingrid DjukanovicFaculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, SE, Sweden. ingrid.djukanovic@lnu.se.ORCID http://orcid.org/0000-0001-6157-3644
Jörg CarlssonFaculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, SE, Sweden.
Kristofer ÅrestedtFaculty of Health and Life Sciences, Linnaeus University, 391 82, Kalmar, SE, Sweden.
Linnaeus University · SELinköping University · SE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe HADS (Hospital Anxiety and Depression Scale) aims to measure symptoms of anxiety (HADS Anxiety) and depression (HADS Depression). The HADS is widely used but has shown ambiguous results both regarding the factor structure and sex differences in the prevalence of depressive symptoms. There is also a lack of psychometric evaluations of the HADS in non-clinical samples of older people. The aim of the study was to evaluate the factor structure of the HADS in a general population 65-80 years old and to exam possible presence of differential item functioning (DIF) with respect to sex.

methodsThis study was based on data from a Swedish sample, randomized from the total population in the age group 65-80 years (n = 6659). Confirmatory factor analyses (CFA) were performed to examine the factor structure. Ordinal regression analyses were conducted to detect DIF for sex. Reliability was examined by both ordinal as well as traditional Cronbach's alpha.

resultsThe CFA showed a two-factor model with cross-loadings for two items (7 and 8) had excellent model fit. Internal consistency was good in both subscales, measured with ordinal and traditional alpha. Floor effects were presented for all items. No indication for meaningful DIF regarding sex was found for any of the subscales.

conclusionsHADS Anxiety and HADS Depression are unidimensional measures with acceptable internal consistency and are invariant with regard to sex. Despite pronounced ceiling effects and cross-loadings for item 7 and 8, the hypothesized two-factor model of HADS can be recommended to assess psychological distress among a general population 65-80 years old.

Indexed as

Quality of LifeSurveys and QuestionnairesAgedAged, 80 and overAnxietyCross-Sectional StudiesDepressionFactor Analysis, StatisticalFemaleHumansMalePrevalencePsychometricsReproducibility of ResultsSex FactorsAnxietyDepressionElderlyPsychometricValidation

Identifiers

PMID28978356
PMCPMC5628437
OpenAlexW2761367352

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.