The Hospital Anxiety and Depression Scale. Homogeneity of the subscales

The H.A.D.-scale was originally used as a screening test for assessing the presence of clinically significant degrees of anxiety and depression. It has also been used as a measuring instrument outside hospital care. The main questions in this study are: l) Do the test items fit a sample of nonclinical persons? 2) Are the two subscales of Depression and Anxiety homogeneous? In total 163 persons answered the questionnaire. Two factor analyses are reviewed, a two factor solution and a four factor solution. The two factor solution did not split the items in the way originally intended. A four factor analysis with three interpreted factors gave a better solution. The analysis leads us to recommend great caution when interpreting the H.A.D.-scale, especially when used in a population outside of hospital care.