Screening of depression in cardiac patients: Is the HADS an effective tool?

Tesio, Valentina; Molinaro, Stefano; Castelli, Lorys; Andriani, Monica; Fanelli, Antonella; Marra, Sebastiano; Torta, Riccardo

doi:10.1016/j.ijcard.2013.12.308

Cited by 10 publications

(7 citation statements)

References 11 publications

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“…What is more, routine screening in the hospital care setting is still under-performed, also because of conflicting and confused findings regarding the optimal tool [4,6,7]. A recent systematic review analysed the diagnostic accuracy of different screening tools, including the "Hospital Anxiety and Depression Scale" (HADS), in detecting MDD in CHD patients [4].…”

Section: Introductionmentioning

confidence: 99%

Screening of depression in cardiology: A study on 617 cardiovascular patients

Tesio

Marra

Molinaro

et al. 2017

International Journal of Cardiology

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BackgroundDepression screening in the cardiovascular disease (CVD) care setting is under-performed, also because the issue of the optimal screening tools cut-off is still open. We analysed which HADS (Hospital Anxiety and Depression Scale) total score cut-off value shows the best properties in two groups of 357 Acute Coronary Syndrome (ACS) and 260 Chronic Coronary Artery Disease (CAD) hospitalized patients. MethodsA Receiver Operating Characteristics (ROC) curve was plotted for both groups using the Montgomery-Asberg Depression Rating Scale (MADRS) as the criterion. Accuracy, positive (PPV) and negative (NPV) predictive values were computed for different cut-off scores. ResultsThe ROC curves confirmed the excellent/very good accuracy of the HADS in both groups, with an area under the curve of .911 for the ACS and .893 for the CAD patients. The cut-off of 14 showed the best compromise between high sensitivity and good specificity in both groups, with high negative predicted values (95.5% and 92.4%, respectively). ConclusionUsing a cut-off value of 14, the HADS could be considered a good screening tool to identify hospitalized CAD and ACS patients requiring a more accurate depression assessment, in order to promptly plan the most appropriate treatment strategies and prevent the negative effects of depression in CVD patients.3

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Section: Introductionmentioning

confidence: 99%

Screening of depression in cardiology: A study on 617 cardiovascular patients

Tesio

Marra

Molinaro

et al. 2017

International Journal of Cardiology

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“…For the HADS depression scale, alternative cutoff scores have been proposed for cardiac populations. The cutoff scores that should be used for screening purposes seem to vary depending on the type of cardiac disease [42]. Whether this is the case for the anxiety subscale is still unknown.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of anxiety in patients with an implantable cardioverter defibrillator: measurement equivalence of the HADS-A and the STAI-S

2019

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PurposeThe Hospital Anxiety and Depression Scale (HADS-A) and State-Trait Anxiety Inventory (STAI-S) are popular instruments for assessing anxiety and are considered interchangeable, although little is known about their equivalence. Hence, we examined whether the two instruments are (i) equivalent with respect to determining the prevalence of probable clinical anxiety levels and (ii) reflect variation on a common anxiety attribute.MethodsScore and construct concordance were evaluated using equipercentile equating and bifactor modeling, respectively. Secondary data from the WEBCARE trial and the MIDAS study were used for the current study, where patients implanted with a first-time implantable cardioverter defibrillator completed both the HADS-A and the STAI-S within 10 days post implant.ResultsData from 710 patients were included in the analyses. Results showed that the STAI-S produced a higher prevalence rate than the HADS-A (39% vs. 23%). A crosswalk table was generated with equivalent scores and cutoffs for the HADS-A and STAI-S, respectively. Bifactoring suggested that HADS-A and STAI-S largely tapped into the same generic anxiety attributes.ConclusionsSTAI-S and HADS-A reflect a common anxiety attribute, but using the recommended cutoff scores on the respective measures show very different prevalence rates and would classify patients as anxious with the STAI-S who would not be identified as such with the HADS-A. Clinicians and researchers should be aware of the inequivalence when using these measures for screening and determining the prevalence of probable clinical anxiety levels.

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“…The HADS is a widely used measure and has shown good internal consistency for both subscales (Cronbach's alpha for anxiety = 0.85 and 0.80 for depression) and for the total scale (Cronbach's alpha = 0.89) (Roberts et al, 2001). The HADS is used in CR services as part of routine assessment in the UK (Stafford et al, 2007; Tesio et al, 2014, 2017; British Heart Foundation, 2018). The Cronbach alpha values for the present sample were as follows: 0.81 for anxiety, 0.76 for depression, and 0.84 for the total score.…”

Section: Methodsmentioning

confidence: 99%

Measuring the Cognitive Attentional Syndrome in Cardiac Patients With Anxiety and Depression Symptoms: Psychometric Properties of the CAS-1R

et al. 2019

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Metacognitive Therapy (MCT) is a recent treatment with established efficacy in mental health settings. MCT is grounded in the Self-Regulatory Executive Function (S-REF) model of emotional disorders and treats a negative perseverative style of thinking called the cognitive attentional syndrome (CAS), thought to maintain psychological disorders, such as anxiety and depression. The evaluation of effective psychological therapies for anxiety and depression in chronic physical illness is a priority and research in this area depends on the suitability and validity of measures assessing key psychological constructs. The present study examined the psychometric performance of a ten-item scale measuring the CAS, the CAS-1R, in a sample of cardiac rehabilitation patients experiencing mild to severe symptoms of anxiety and/or depression (N = 440). Participants completed the CAS scale, the Hospital Anxiety and Depression Scale and the Metacognitions Questionnaire 30 (MCQ-30). The latent structure of the CAS-1R was assessed using confirmatory factor analyses (CFA). In addition, the validity of the measure in explaining anxiety and depression was assessed using hierarchical regression. CFA supported a three-factor solution (i.e., coping strategies, negative metacognitive beliefs and positive metacognitive beliefs). CFA demonstrated a good fit, with a CFI = 0.988 and an RMSEA = 0.041 (90% CI = 0.017–0.063). Internal consistency was acceptable for the first two factors but low for the third, though all three demonstrated construct validity and the measure accounted for additional variance in anxiety and depression beyond age and gender. Results support the multi-factorial assessment of the CAS using this instrument, and demonstrate suitability for use in cardiac patients who are psychologically distressed.

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Screening of depression in cardiac patients: Is the HADS an effective tool?

Cited by 10 publications

References 11 publications

Screening of depression in cardiology: A study on 617 cardiovascular patients

Screening of depression in cardiology: A study on 617 cardiovascular patients

Prevalence of anxiety in patients with an implantable cardioverter defibrillator: measurement equivalence of the HADS-A and the STAI-S

Measuring the Cognitive Attentional Syndrome in Cardiac Patients With Anxiety and Depression Symptoms: Psychometric Properties of the CAS-1R

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