title: Normative data for the Hospital Anxiety and Depression Scale.
abstract: OBJECTIVE
  The Hospital Anxiety and Depression Scale (HADS) is widely used in both research and clinical contexts. However, UK normative data from HADS remain limited. In our recent review of the literature, only six reports from four studies were identified as reporting UK normative data and all had limitations. The aim of our study was to use a large population-based dataset to address this.
  
  
  METHODS
  The Epidemiology of Functional Disorders Study is a large longitudinal population-based study carried out in Northwest England. All adults aged between 25 and 65 years registered with three general practices were sent a self-completion questionnaire which contained the HADS and other health-related instruments. Scores were calculated for participants completing all items on each sub-scale (anxiety 6,189 participants and depression 6,198 participants). Scores are presented by gender and by 5-year age groups. Percentile scores were also generated.
  
  
  RESULTS
  The median anxiety score was higher in women [6, interquartile range (IQR) 4-9] than in men (5, IQR 2-8) and increased with age in both groups. The median depression score for both women and men was 3 (IQR 1-6).
  
  
  CONCLUSIONS
  Our study is the largest population-based study providing UK normative data from the HADS. While our data confirm some of the normative data reported previously, subtle and important differences emerged, particularly at the upper end of the percentile scores. Due to the nature of our study design and the number of participants sampled, we believe that our data are likely to be more representative of the UK population than existing published normative values.
authors: Health Services Research Unit, Division of Applied Health Sciences, University of Aberdeen, Health Sciences Building, Foresterhill, Aberdeen, AB25 2ZD, UK, s.breeman@abdn.ac.uk.
authors: Suzanne
authors: S
authors: Breeman
authors: Seonaidh
authors: S
authors: Cotton
authors: Shona
authors: S
authors: Fielding
authors: Gareth T
authors: GT
authors: Jones
mesh_terms: D000328:Adult; D001007:Anxiety / Q000453:epidemiology*; D003863:Depression / Q000453:epidemiology*; D004739:England / Q000453:epidemiology; D005260:Female; D006760:Hospitalization; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012016:Reference Values; D011795:Surveys and Questionnaires