Helvik Anne-Sofie, Engedal Knut, Skancke Randi H, Selbæk Geir
Department of Public Health and General Practice, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Nord J Psychiatry. 2011 Oct;65(5):338-44. doi: 10.3109/08039488.2011.560684. Epub 2011 Feb 22.
Few psychometric studies of the Hospital Anxiety and Depression Scale (HADS) scale have been performed with clinical samples of elderly individuals.
The participants were 484 elderly (65-101 years, 241 men) patients in an acute medical unit. The HADS, the Montgomery-Aasberg Depression Rating Scale (MADRS) and questionnaires assessing quality of life, functional impairment, and cognitive function were used. The psychometric evaluation of the HADS included the following analyses: 1) the internal construct validity by means of principal component analysis followed by an oblique rotation and corrected item-total correlation; 2) the internal consistency reliability by means of the alpha coefficient (Cronbach's) and 3) concurrent validity by means of Spearman's rho.
We found a two-factor solution explaining 45% of the variance. Six of seven items loaded adequately (≥0.40) on the HADS-A subscale (item 7 did not) and five of seven items loaded adequately on the HADS-D subscale (items 8 and 10 did not). Cronbach's alpha for the HADS-A and HADS-D subscale was 0.78 and 0.71, respectively. The correlation between HADS-D and the MADRS, a measure of the concurrent validity, was 0.51.
The HADS appears to differentiate well between depression and anxiety. The internal consistency of the HADS in a sample of elderly persons was as satisfactory as it is in samples with younger persons. In contrast to younger samples, item 8 ("I feel as if I have slowed down") did not load adequately on the HADS-D subscale. This may be attributed to the way elderly people experience and describe their symptoms.
针对老年临床样本，很少有对医院焦虑抑郁量表（HADS）进行的心理测量学研究。
参与者为急性内科病房的484名老年患者（65 - 101岁，241名男性）。使用了HADS、蒙哥马利 - 阿斯伯格抑郁评定量表（MADRS）以及评估生活质量、功能损害和认知功能的问卷。HADS的心理测量学评估包括以下分析：1）通过主成分分析及斜交旋转和校正的项目 - 总分相关来分析内部结构效度；2）通过α系数（克朗巴哈系数）分析内部一致性信度；3）通过斯皮尔曼等级相关系数分析同时效度。
我们发现了一个解释45%方差的两因素解决方案。HADS - A分量表上七个项目中的六个负荷良好（≥0.40）（项目7除外），HADS - D分量表上七个项目中的五个负荷良好（项目8和10除外）。HADS - A和HADS - D分量表的克朗巴哈α系数分别为0.78和0.71。作为同时效度指标，HADS - D与MADRS之间的相关性为0.51。
HADS似乎能很好地区分抑郁和焦虑。HADS在老年样本中的内部一致性与在年轻样本中一样令人满意。与年轻样本不同的是，项目8（“我感觉自己好像变慢了”）在HADS - D分量表上的负荷不足。这可能归因于老年人体验和描述其症状的方式。
