Carlos Arturo Cassiani-Miranda1, Orlando Scoppetta2, Diego Fernando Cabanzo-Arenas3. 1. University of Santander, Faculty of Health Sciences, Medicine Program, UDES Neuroscience Research Group, Bucaramanga, Colombia. Electronic address: ca.cassiani@mail.udes.edu.co. 2. Catholic University of Colombia, Faculty of Psychology, GAEM Research Group (Research methods applied to behavioral science), Bogotá, Colombia. Electronic address: oscoppetta18@ucatolica.edu.co. 3. University of Santander, Faculty of Health Sciences, Medicine Program, Positive Psychiatry Research Incubator, UDES Neuroscience Research Group, Bucaramanga, Colombia.
Abstract
OBJECTIVE: To assess the validity of the Hospital Anxiety and Depression Scale (HADS) for depression and anxiety screening in primary care patients in Colombia. METHODS: A criterion validity study was conducted with 243 adults that had completed the HADS and were later assessed using the MINI as a gold standard. Cronbach's alpha, McDonald's omega and factor structure were applied through confirmatory factor analysis (CFA). ROC curve analysis and Youden's statistic were used to determine the cut-off point. RESULTS: Cronbach's α was reported to be 0.85 and 0.82 for McDonalds' ω. CFA supported a two-factor solution demonstrating satisfactory fit. Root mean square error of approximation = 0.04, Comparative Fix Index (CFI) and Tucker-Lewis Index (TLI) = 0.97. For HADS-A, the cut-off point was determined as 6 associated with a sensitivity of 0.76, a specificity of 0.72 and Youden's index of 0.50. The ABC was 0.81. For HADS-D, the cut-off point was determined as 4 associated with a sensitivity of 0.78, a specificity of 0.74 and Youden's index of 0.53. The ABC was 0.82. CONCLUSION: The HADS is a valid and reliable instrument for anxiety and depression screening in adult patients of primary healthcare services in Colombia.
OBJECTIVE: To assess the validity of the Hospital Anxiety and Depression Scale (HADS) for depression and anxiety screening in primary care patients in Colombia. METHODS: A criterion validity study was conducted with 243 adults that had completed the HADS and were later assessed using the MINI as a gold standard. Cronbach's alpha, McDonald's omega and factor structure were applied through confirmatory factor analysis (CFA). ROC curve analysis and Youden's statistic were used to determine the cut-off point. RESULTS: Cronbach's α was reported to be 0.85 and 0.82 for McDonalds' ω. CFA supported a two-factor solution demonstrating satisfactory fit. Root mean square error of approximation = 0.04, Comparative Fix Index (CFI) and Tucker-Lewis Index (TLI) = 0.97. For HADS-A, the cut-off point was determined as 6 associated with a sensitivity of 0.76, a specificity of 0.72 and Youden's index of 0.50. The ABC was 0.81. For HADS-D, the cut-off point was determined as 4 associated with a sensitivity of 0.78, a specificity of 0.74 and Youden's index of 0.53. The ABC was 0.82. CONCLUSION: The HADS is a valid and reliable instrument for anxiety and depression screening in adult patients of primary healthcare services in Colombia.