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Hospital Anxiety and Depression Scale

self-report mood disorder questionnaire

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General referenceInterpretive dossier study · Crown Archives visual atlas
Record originEnglish Wikipedia
Text licenseCC BY-SA 4.0
Source revisionFeb 24, 2026
Entity authorityQ17027611 ↗
Source-derived summary

Hospital Anxiety and Depression Scale (HADS) was originally developed by Zigmond and Snaith (1983) and is commonly used by doctors to determine the levels of anxiety and depression that a person is experiencing. The HADS is a 14-item scale, with seven items relating to anxiety and seven relating to depression. Zigmond and Snaith created this outcome measure specifically to avoid reliance on aspects of these conditions that are also common somatic symptoms of illness, for example fatigue and insomnia or hypersomnia. This, it was hoped, would create a tool for the detection of anxiety and depression in people with physical health problems.

Items on the questionnaire

The items on the questionnaire that relate to anxiety are

I feel tense or wound up

I get a sort of frightened feeling as if something awful is about to happen

Worrying thoughts go through my mind

I can sit at ease and feel relaxed

I get a sort of frightened feeling like 'butterflies' in the stomach

I feel restless as I have to be on the move

I get sudden feelings of panic

The items that relate to depression are:

I still enjoy the things I used to enjoy

I can laugh and see the funny side of things

I feel cheerful

I feel as if I am slowed down

I have lost interest in my appearance

I look forward with enjoyment to things

I can enjoy a good book or radio or TV program

Scoring the questionnaire

Each item on the questionnaire is scored from 0-3 and this means that a person can score between 0 and 21 for either anxiety or depression.

Caseness of anxiety and depression

A number of researchers have explored HADS data to establish the cut-off points for caseness of anxiety or depression. Bjelland et al (2002) through a literature review of a large number of studies identified a cut-off point of 8/21 for anxiety or depression. For anxiety (HADS-A) this gave a specificity of 0.78 and a sensitivity of 0.9. For depression (HADS-D) this gave a specificity of 0.79 and a sensitivity of 0.83.

Factor structure

There are a large number of studies that have explored the underlying factor structure of the HADS. Many support the two-factor structure but there are others that suggest a three or four factor structure.

Editorial summary

“Hospital Anxiety and Depression Scale” enters the record as self-report mood disorder questionnaire. Crown Archives preserves that source wording while asking what Hospital, Anxiety and Depression can confirm, complicate or overturn.

Editorial reviewA concise reference frame for defining the subject, testing terminology and identifying the institution closest to the evidence. The current lead gives the account dated anchors—1983, 2002—that can be checked directly. The selected authority fields contribute no independent date. Its strongest next move is a source search built around Hospital, Anxiety and Depression.
Editorial analysis

Why this record matters

“Hospital Anxiety and Depression Scale” is worth following because a concise public description often conceals a longer documentary argument. Here, Hospital, Anxiety and Depression provides the most credible route into that argument.

Evidence profile

Named sources, stable identifiers and responsible institutions provide the strongest route from overview to verifiable evidence. The source revision retrieved here is dated Feb 24, 2026. The linked authority identifier is Q17027611. None of the 0 selected statements returned an explicit reference. The first chronological checks are 1983 and 2002.

Critical limits

The absence of detail may reflect summary conventions rather than a lack of surviving documentation. The lead is largely declarative, so disagreement and counter-evidence require a deliberate search beyond the opening account. Authority statements aid reconciliation but still require their own references, qualifiers and ranks to be checked.

How to read it

Use the entry as an orientation point, then follow its citations and revision history. Names, dates and institutional relationships should be checked against the original record.

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  • Locating named sources
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The closest primary source, responsible institution and strongest cited specialist reference.

Three-step research path

  1. Establish the record: confirm the title “Hospital Anxiety and Depression Scale”, its source revision and the description used here.
  2. Expand the search: follow Hospital Anxiety and Depression Scale primary sources, Hospital Anxiety and Depression Scale archive and Hospital research across catalogues and specialist indexes.
  3. Test the account: compare the strongest cited source with the responsible institution’s current record and note any disagreement.

Questions for further research

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Source & attribution

This entry incorporates text from “Hospital Anxiety and Depression Scale” on English Wikipedia. Contributors are listed in the page history. Text is available under the Creative Commons Attribution-ShareAlike 4.0 License. Selected authority identifiers and statements are retrieved from Wikidata under CC0; their references and qualifiers remain part of the verification path.