This is legacy information provided for the convenience of researchers. I no longer use HADS. Academic refs are provided below.

The HAD scale is a questionnaire commonly used by Doctors and Therapists to assess levels of Anxiety and Depression.

The HADS comprises statements which the patient rates based on their experience over the past week. The 14 statements are relevant to either generalised anxiety (7 statements) or 'depression' (again 7), the latter being largely (but not entirely) composed of reflections of the state of anhedonia (inability to enjoy oneself or take pleasure in everyday things enjoyed normally).

Even-numbered questions relate to depression and odd-numbered questions relate to anxiety. Each question has 4 possible responses. Responses are scored on a scale from 3 to 0. The maximum score is therefore 21 for depression and 21 for anxiety. A score of 11 or higher indicates the probable presence of the mood disorder with a score of 8 to 10 being just suggestive of the presence of the respective state. The two subscales, anxiety and depression, have been found to be independent measures. In its current form the HADS is now divided into four ranges: normal (0-7), mild (8-10), moderate (11-15) and severe (16-21).

A self-scoring electronic version of the HADS appeared on this website until I was asked to remove it by the copyright owners. I can't tell you where to find it, but it is still easy to Google for it and find paper versions that can be downloaded from the web in either PDF or Microsoft Word format.

PLEASE NOTE: I didn't invent the HADS. I was just a simple user. I have no special expertise on its use or interpretation. Because of the problems mentioned above, I now (like thousands of other therapists around the world) use CORE-OM. This is free to use and has excellent evidence of effectiveness. See CORE (www.coreims.co.uk)

If you require further help or assistance with a research project, or with training, I have over 20 years experience in conducting research in psychotherapy, social care and commercial settings. I welcome enquiries about fee-based projects. Contact me using the email address below or telephone me on 01484 847246 (From outside the UK dial +44 1484 847246) Alan Priest

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Academic References

The HADS was developed in the early 80s. The original article reporting on the development and evaluation of the scale can be found as follows: Zigmond AS, Snaith RP: The Hospital Anxiety And Depression Scale. Acta Psychiatr Scand 1983, 67:361-70.

It has been reviewed in various studies over the years and these studies have consistently validated its effectiveness, for example ...

Herrmann C: International experience with the Hospital Anxiety and Depression Scale A review of validation data and clinical results. J Psychosom Res 1997, 42:17-41 (Dr. Christoph Herrmann, Abteilung Psychosomatik und Psychotherapie, Universität Göttingen, von-Siebold-Str. 5, D-37075 , Göttingen, , Germany. Tel: +49-551-396722; Fax: +49-551-394592).

Bjelland I, Dahl AA, Haug TT, Neckelmann D: The validity of the Hospital Anxiety and Depression Scale; an updated review. J Psychiat Res 2002, 52:69-77.

Its effectiveness in helping to understand patients' experience of suffering in the setting of medical practice has also been reported by one of the original designers, see for example;