The translation and evaluation of an Urdu version of the Hospital Anxiety and Depression Scale.

The translation of the Hospital Anxiety and Depression Scale (HADS) into Urdu was undertaken by the authors in committee. After examining initial drafts by 6 independent translators, an agreed Urdu text was given to 6 back-translators, and subsequently modified further. The evaluation of the new translation was performed in 3 stages: evaluation of linguistic equivalence of items in a bilingual population; evaluation of conceptual equivalence by examining item-subscale correlations: and evaluation of scale equivalence by 2-way classification of high and low scorers. Satisfactory results at each stage suggest that the Urdu version is a reliable and valid translation of the HADS for use in Pakistan.