title: Can the Hospital Anxiety and Depression Scale be used in patients with schizophrenia?
abstract: RATIONALE, AIMS, OBJECTIVES: The Hospital Anxiety and Depression Scale (HADS) was developed explicitly for use in non-psychotic populations, yet is routinely used for screening patients with psychotic illness. The utility of the HADS as a screening instrument for use in patients with schizophrenia was investigated.
  
  
  METHODS
  Exploratory factor analysis and confirmatory factor analysis were conducted on the HADS to determine its psychometric properties in 100 patients with a primary ICD-10 diagnosis of schizophrenia.
  
  
  RESULTS
  Three distinct factors were identified within the HADS. Support was found for the clinical use of the HADS anxiety subscale to assess anxiety in patients with schizophrenia; however, evidence was also found that the HADS depression subscale may not be a unidimensional measure of depression in this clinical group.
  
  
  CONCLUSIONS
  Caution should be used when using the HADS depression subscale in this clinical group. The direction of future research in this area is indicated, in particular comparison of HADS anxiety and depression measures to determine further the validity or otherwise of these subscale domains.
authors.affiliation: Abdale House, Craven, Harrogate, England, UK.
authors.forename: Richard
authors.initials: R
authors.lastname: Allan
authors.forename: Colin R
authors.initials: CR
authors.lastname: Martin
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis*; D005163:Factor Analysis, Statistical; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000295:instrumentation*; D008875:Middle Aged; D012565:Schizophrenic Psychology; D055815:Young Adult