Abstract
Background
The purposes of this study were: 1) to explore the psychometric properties of the HAD Scale in the working population, 2) to determine the prevalence of anxiety and depression on two severity levels among employees, and 3) to examine whether psychosocial work–related determinants for both categories of mental health problems may differ.
Methods
Data were taken from 7482 employees participating in the epidemiological Maastricht Cohort Study on Fatigue at Work. Anxiety and depression were measured with the easy to administer self–report Hospital Anxiety and Depression (HAD) Scale, while several questionnaires and self–formulated questions were used to measure psychosocial work–related characteristics.
Results
A principal component analysis indicated that the HAD Scale enables measuring anxiety and depression as separate constructs among employees. On a subclinical level, prevalences of anxiety and depression were both considerable: anxiety prevalences were 8.2 % for males and 10 % for females, and depression prevalences were 7.1% for males and 6.2% for females. Regarding self–reported psychosocial work characteristics, in multivariate regression analyses partly differential cross–sectional associations were found for anxiety and depression.
Conclusions
The results indicate that subclinical anxiety and depression are considerable in the working population and provide suggestive evidence that diagnosing, preventing or managing anxiety and depression among employees may require focusing on different aspects of their psychosocial work environment.
Similar content being viewed by others
References
APA (1994) Diagnostic and statistical manual of mental disorders (DSM-IV).Washington, D.C.: American Psychiatric Association
Bildt C, Michelsen H (2002) Gender differences in the effects of working conditions on mental health: a 4-year follow-up. Int Arch Occup Environ Health 75:252–258
Bjelland I, Dahl AA, Haug TT, et al. (2002) The validity of the Hospital Anxiety and Depression Scale; an updated literature review. J Psychosom Res 52:69–77
Broadbent DE (1985) The clinical impact of job design. Br J Clinical Psychol 24:33–44
Broadhead WE, Blazer DG, George LK, et al. (1990) Depression, disability days, and days lost from work in a prospective epidemiological survey. JAMA 264:2524–2528
Bültmann U, Kant IJ, Kasl SV, et al. (2002) Fatigue and psychological distress in the working population: psychometrics, prevalence and correlates. J Psychosom Res 52:445–452
Chevalier A, Bonenfant S, Picot MC, et al. (1996) Occupational factors of anxiety and depressive disorders in the French National Electricity and Gas Company. J Occup Environ Med 38:1098–1107
Conti DJ, Burton WN (1994) The economic impact of depression in a workplace. J Occup Med 36:983–988
Dewa C, Lin E (2000) Chronic physical illness, psychiatric disorder and disability in the workplace. Soc Sci Med 51:41–50
Gorman JM (1996) Comorbid depression and anxiety spectrum disorders. Depress Anxiety 4:160–168
Gründemann RWM, Smulders PWG, De Winter CR (1993) Handleiding Vragenlijst Arbeid en Gezondheid (Manual, Questionnaire on work and health). Lisse: Swets & Zeitlinger
Houtman I (1995) Reliability and validity of the Dutch version of the Karasek Job Content Questionnaire. APA/NIOSH conference on Work, Stress and Health, Washington, D.C.
Houtman I (1999) Feiten en fabels op een rij. Werkdruk in cijfers (Work pace in numbers). Arbeidsomstandigheden 75:2–5
Jenkins R (1993) Mental health at work – why is it so under-researched? J Occup Med 43:65–67
Jimenez CJ, Perez TA, Prieto FS, et al. (1989) Behavioural habits and affective disorders in old people. J Adv Nurs 14:356–364
Kant IJ, Bültmann U, Schröer CAP, et al. (2003) An epidemiological approach to study fatigue in the working population: The Maastricht Cohort Study. Occup Environ Med 60(Suppl 1):i32–i39
Karasek RA (1979) Job demands, job decision latitude, and mental strain: implications for job design. Administrative Science Quarterly 24:285–309
Karasek RA (1985) Job Content Questionnaire and Users Guide. Los Angeles (CA): University of Southern California: Department of Industrial and Systems Engineering
Karasek RA, Theorell T (1990) Healthy work: stress,productivity and the reconstruction of working life. New York (NY): Basic Books
Kessler RC, Frank RG (1997) The impact of psychiatric disorders on work loss days. Psychol Med 27:861–873
Laitinen-Krispijn S, Bijl R (2002) Werk, psyche en ziekteverzuim; aard en omvang van psychische stoornissen, ziekteverzuim en zorggebruik in de beroepsbevolking (Work, psyche and sickness absence; nature and magnitude of mental health problems, sickness absence and use of health care in the working population). Utrecht: Trimbos Instituut
Laitinen-Krispijn S, Bijl RV (2000) Mental disorder and employee sickness absence: the NEMESIS study. Soc Psychiatry Psychiatr Epidemiol 35:71–77
Lisspers J, Nygren A, Soderman E (1997) Hospital Anxiety and Depression Scale (HAD): some psychometric data for a Swedish sample. Acta Psychiatr Scand 96:281–286
Martin JK, Blum TC, Beach SR, et al. (1996) Subclinical depression and performance at work. Soc Psychiatry Psychiatr Epidemiol 31:3–9
Nisenson LG, Pepper CM, Schwenk TL, et al. (1998) The nature and prevalence of anxiety disorders in primary care. Gen Hosp Psychiatry 20:21–28
Ormel J, Oldehinkel AJ, Goldberg DP, et al. (1995) The structure of common psychiatric symptoms: How many dimensions of neurosis? Psychol Med 25:521–530
Regier DA, Rae DS, Narrow WE, et al. (1998) Prevalence of anxiety disorders and their comorbidity with mood and addictive disorders. Br J Psychiatry Suppl 34:24–28
Schröer C (1997) De toename van arbeidsongeschiktheid wegens psychische aandoeningen (the increase of work disability due to mental disorders). Tijdschrift voor Bedrijfs- en verzekeringsgeneeskunde 5:16–23
Spinhoven P, Ormel J, Sloekers PP, et al. (1997) A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 27:363–370
Stansfeld S (2002) Work, personality and mental health (editorial). Br J Psychiatry 181:96–98
Stansfeld S, Feeney A, Head J, et al. (1995) Sickness absence for psychiatric illness: the Whitehall II study. Soc Sci Med 40:189–197
Stansfeld SA, Fuhrer R, Shipley M, et al. (1999) Work characteristics predict psychiatric disorder: prospective results from the Whitehall II study. Occup Environ Med 56:302–307
Stein MB (1995) Mixed anxiety-depression in a primary care clinic. J Affect Disord 34:79–84
Thiebaut R, Martin C, Grabot D, et al. (1999) Prevalence and occupational covariates of mood, anxiety disorders, and alcohol dependence in a French ancillary staff population. Eur Psychiatry 14:210–216
Van Amelsvoort LGPM, Beurskens AJHM, Kant IJ, et al. (2004) The effect of non-random loss to follow-up on group mean estimates in a longitudinal study. Eur J Epidemiol 19:15–23
Veldhoven M, Meijman T (1994) Het meten van psychosociale arbeidsbelasting met een vragenlijst. De vragenlijst beleving en beoordeling van de arbeid (VBBA) (Questionnaire on Perception and Judgement of Work). Amsterdam: NIA (Nederlands Instituut voor Arbeidsomstandigheden) (Dutch Institute for Working Conditions)
Warr PB (1990) Decision latitude, job demands, and employee well being. Work and Stress 4:285–294
Zigmond AS, Snaith RP (1983) The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 67:361–370
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Andrea, H., Bültmann, U., Beurskens, A.J.H.M. et al. Anxiety and depression in the working population using the HAD Scale. Soc Psychiatry Psychiatr Epidemiol 39, 637–646 (2004). https://doi.org/10.1007/s00127-004-0797-6
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/s00127-004-0797-6