Usefulness of the Hospital Anxiety and Depression Scale for screening for psychiatric morbidity in Chinese patients with Graves' ophthalmopathy.

OBJECTIVE: To examine the usefulness of the Hospital Anxiety and Depression Scale (HADS) for screening psychiatric morbidity in Chinese patients with Graves' ophthalmopathy.
METHODS: A cross-sectional study was conducted from 1 January 2010 to 31 December 2010 at the specialist eye outpatient clinic at Pamela Youde Nethersole Eastern Hospital. All euthyroid patients diagnosed with Graves' ophthalmopathy were recruited. They were interviewed with the Chinese version of the HADS and the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition Axis I. Demographic data and clinical background information were collected from the patients and their hospital records were reviewed.
RESULTS: In all, 124 patients were recruited into the study. Current prevalence of psychiatric disorders was 32%, of which 19% were current depressive disorders and 19% were current anxiety disorders. The HADS provided the best discriminating power for screening for psychiatric morbidity at a cut-off threshold of 10/11. For screening of depressive and anxiety disorders, the cut-off thresholds were 4/5 and 6/7 respectively.
CONCLUSION: Depression and anxiety disorders were common in the local population of patients with Graves' ophthalmopathy. Recognising the predictors for psychiatric morbidity could assist clinicians to identify those patients with a predisposition to developing psychiatric complications, and refer them for appropriate treatment. The HADS can be considered as a screening tool for psychiatric morbidity in patients with Graves' ophthalmopathy.