Factor structure of the Hospital Anxiety and Depression Scale in adolescent patients with chronic disease

Abstract

Introduction. The Hospital Anxiety and Depression Scale (HADS) is a screening instrument that assesses emotional symptoms in different populations and medical conditions. This study analyzes the psychometric properties and factor structure of the HADS in adolescents with chronic disease and the differences based on their medical condition. Method. The HADS was administered to a sample of 302 adolescents with chronic disease. Exploratory factor analyses were done in a subsample of 100 adolescents, while confirmatory factor analyses were performed in the rest of participants (202) to examine the validity and reliability of the HADS (14 items); an analysis of variance for a single factor was also done to study differences among diseases. Results. Patients were aged 12-16 years, with a similar sex ratio; 43 % had respiratory diseases and 47 %, endocrine disorders. The original twofactor structure (anxiety and depression) showed adequate fit indices and incorporated a secondorder factor (emotional distress). Three of the original items were removed, thus obtaining a new 11-item version. This showed adequate psychometric properties, and differences were observed between patients with type 1 diabetes mellitus and those with respiratory disease, but not in terms of short stature, in the depression factor. Conclusions. The HADS displays an adequate reliability and validity in pediatric patients with chronic disease and is useful for the early detection of anxiety and depression in the health care setting. Key words: factor structure, patient health questionnaire in the anxiety and depression scale, type 1 diabetes mellitus, chronic respiratory diseases, short stature.

Primary ciliary dyskinesia and psychological well-being in adolescence

“…Scores between 0-6 represent no anxiety, 7-9 anxiety possible, over 10 anxiety probable. In depression, 0-5.4 represent no depression, 5.5-7.5 depression possible, over 7.5 depression probable and for emotional distress, below 15.5 no emotional distress, and over 15.5 emotional distress probable [33].…”

Factors associated with stress when caring for a child with a short stature

“…"I feel as if I am slowed down"), and a total score for emotional distress can be obtained. It has a Likert scale format (0 to 3) and has shown adequate internal consistency (0.68 to 0.93) in other studies (Quintana et al, 2003;Valero-Moreno et al, 2019) and in this (α anxiety =0.75; α depression =0.66; α emotional distress =0.89).…”

Psychosocial Factors and Chronic Illness as Predictors for Anxiety and Depression in Adolescence

“…An overall score for emotional distress is obtained by adding the anxiety and depression scales. The questionnaire has been used in adolescents and young people (Saez-Flores et al, 2018) (from 10 to 23 years old), and validated for pediatric samples (Valero-Moreno et al, 2019) obtaining adequate psychometric properties (Mihalca and Pilecka, 2015;Valero-Moreno et al, 2019). Scores between 0 and 6 represent no anxiety, 7-9 possible anxiety, and scores of over 10 probable anxiety.…”

“…Scores between 0 and 6 represent no anxiety, 7-9 possible anxiety, and scores of over 10 probable anxiety. In depression, 0-5.4 represents no depression, 5.5-7.5 possible depression, over 7.5 probable depression and for emotional distress, below 15.5 is no emotional distress, and over 15.5 emotional is probable distress (Valero-Moreno et al, 2019). The psychometric properties in the present study seem to be adequate: χ 2 (df) = 98.76(40); S-Bχ 2 (df) = 81.21(40); S-Bχ 2 /df = 2.03; CFI = 0.97; IFI = 0.97; RMSEA = 0.04 (IC = 0.03-0.05); α = 0.78 for anxiety, α = 0.68 for depression and α = 0.82 for emotional distress.…”