Abiodun O A
Faculty of Health Sciences, University of Ilorin, Kwara State, Nigeria.
Br J Psychiatry. 1994 Nov;165(5):669-72. doi: 10.1192/bjp.165.5.669.
The utility of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for anxiety and depressive disorders in non-psychiatric units (medical & surgical wards; gynaecology & antenatal clinics of a teaching hospital) and a community sample in Nigeria was investigated.
A two-stage screening procedure was employed. This involved the use of GHQ-12/GHQ-30 and HADS against the criteria of a standardised (PSE schedule) psychiatric interview, with psychiatric diagnosis assigned in accordance with ICD-9 criteria.
Sensitivity for the anxiety sub-scale ranged from 85.0% in the medical and surgical wards to 92.9% in the ante-natal clinic, while sensitivity for the depression sub-scale ranged from 89.5% in the community sample to 92.1% in the gynaecology clinic. Specificity for the anxiety sub-scale ranged from 86.5% in the gynaecology clinic to 90.6% in the community sample, while specificity for the depression sub-scale ranged from 86.6% in the medical and surgical wards to 91.1% in the ante-natal clinic and community sample. Misclassification rates ranged from 9.9% in the community sample to 13.2% in the medical and surgical wards. Relative Operating Characteristic (ROC) analyses showed the HADS and the GHQ-12 to be quite similar in ability to discriminate between cases (anxiety and depression) and non-cases.
The HADS is valid for use as a screening instrument in non-psychiatric units and although initially developed for use in hospital settings, it could be usefully employed in community settings of developing countries to screen for mental morbidity.
对医院焦虑抑郁量表（HADS）作为尼日利亚一家教学医院非精神科科室（内科与外科病房、妇科及产前诊所）以及社区样本中焦虑和抑郁障碍筛查工具的效用进行了调查。
采用两阶段筛查程序。这包括使用一般健康问卷-12（GHQ-12）/一般健康问卷-30（GHQ-30）和HADS，对照标准化的（PSE程序）精神科访谈标准，依据国际疾病分类第九版（ICD-9）标准进行精神科诊断。
焦虑分量表的敏感性在内科与外科病房为85.0%，在产前诊所为92.9%，而抑郁分量表的敏感性在社区样本中为89.5%，在妇科诊所为92.1%。焦虑分量表的特异性在妇科诊所为86.5%，在社区样本中为90.6%，而抑郁分量表的特异性在内科与外科病房为86.6%，在产前诊所和社区样本中为91.1%。错误分类率在社区样本中为9.9%，在内科与外科病房中为13.2%。相对操作特征（ROC）分析表明，HADS和GHQ-12在区分病例（焦虑和抑郁）与非病例的能力上相当相似。
HADS作为非精神科科室的筛查工具是有效的，尽管它最初是为医院环境开发的，但在发展中国家的社区环境中也可有效地用于筛查精神疾病。
