The Brief Anxiety and Depression Scale (BADS): a new instrument for detecting anxiety and depression in long-term care residents.

BACKGROUND

Depression and anxiety are common among long-term care residents, yet both appear to be under-recognized and under-treated. In our survey of 164 geriatric health care professionals from 34 U.S. states, 96% of respondents reported that a new instrument that rapidly assesses both depression and anxiety is needed. The Brief Anxiety and Depression Scale (BADS) is a new screening tool that can identify possible major depressive episodes (MDE) and generalized anxiety disorders (GAD) in long-term care residents.

METHODS

The psychometric properties of the BADS were investigated in a sample of 224 U.S. long-term care residents (aged 80.52 ± 9.07). Participants completed a battery of several individually administered mood and cognitive tests, including the BADS. MDE and GAD were diagnosed based on the DSM-IV-TR criteria.

RESULTS

Adequate internal consistency and construct validity were found. A principle component analysis (PCA) revealed an Anxiety Factor and a Depression Factor, which explained 50.26% of the total variance. The Anxiety Factor had a sensitivity of 0.73 and specificity of 0.81 for identifying GAD (PPV = 0.69, NPV = 0.84). The Depression Factor had a sensitivity of 0.76 and a specificity of 0.73 for identifying MDE (PPV = 0.77, NPV = 0.72).

CONCLUSIONS

The BADS appears to be a reliable and valid screening instrument for MDE and GAD in long-term residents. The BADS can be rapidly administered, is sensitive to mood diagnoses in both patients without dementia and with dementia, and produces separate depression and anxiety factor scores that can be used clinically to identify probable mood diagnoses.