Validation of the Hungarian Translation of Hospital Anxiety and Depression Scale

Abstract

Objectives: The Hospital Anxiety and Depression Scale (HADS) is a widely used screening instrument. The purpose of this study was to evaluate reliability and validity of the Hungarian translation. Methods: The English version of the HADS was translated using the ‘forward–backward’ procedure. The questionnaire was used in a large scale study of 715 Hungarian cancer patients along with other screening measures of psychological state and description of illness. Results: Translated items of the HADS questionnaire showed high internal consistency: Cronbach’s α values for the subscales were 0.81 (anxiety) and 0.83 (depression). Factor analysis of the Hungarian version yielded an identical two-factor model to the English and German versions. Results of the known groups comparison showed that both subscales of the HADS discriminates well between sub-groups: decreasing performance status and more advanced disease stage showed significantly higher levels of anxiety and depression. Sufficient concurrent validity of the HADS depression subscale was found using five items from the Symptom List and the Hungarian version of the Beck Depression Scale. Conclusions: Based on a detailed analysis of results we found the translated version of the HADS a reliable and valid self-assessment screening tool in medical practice.