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Hospital Anxiety and Depression Scale

HADS
health sciencespsychologyLicensed: permission required

Permission: Licensed: permission required. Obtain permission from the copyright holder before using it in a study.

A 14-item screening scale for anxiety and depression in medically ill and general-hospital populations, deliberately excluding somatic symptoms that confound physical illness.

Items
14
Response format
4-point scale (0-3), item-specific wording
Version
1.0
Subscales
2

Ready-to-cite methods sentence

Anxiety and depression were screened with the Hospital Anxiety and Depression Scale (HADS; Zigmond & Snaith, 1983), whose two 7-item subscales show good internal consistency across studies (mean α = .83 for anxiety and .82 for depression; Bjelland et al., 2002); subscale scores of 8 or more indicate possible cases.

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Permission required

Importing HADS into a Surveyor study is disabled: Folio holds the instrument’s metadata, not a license to pass on its wording. The citation, scoring and reliability details on this page are free to use and cite.

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Reliability & validation

Source
Bjelland et al., 2002
Validation population
General medical outpatients (Zigmond & Snaith, 1983; Bjelland et al., 2002)
Cronbach's α
0.82–0.83

Subscales

Anxiety (HADS-A)Depression (HADS-D)

Known limitations

Licensed: permission is required from the publisher. A screening instrument, not diagnostic, and its two-factor structure has been widely questioned, with evidence it largely captures general distress.

Original citation

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370.

https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

This instrument is licensed. Folio does not distribute its item wording. Obtain permission from the copyright holder before using it in your study.

Questions researchers ask

What does the HADS measure?

A 14-item screening scale for anxiety and depression in medically ill and general-hospital populations, deliberately excluding somatic symptoms that confound physical illness.

How many items does the HADS have?

The Hospital Anxiety and Depression Scale (HADS) has 14 items across 2 subscales: Anxiety (HADS-A), Depression (HADS-D).

Is the HADS free to use?

The HADS is licensed. You must obtain permission from the copyright holder before using it in a study. Folio does not distribute its item wording without that permission.

Is the HADS reliable?

Validation studies report Cronbach's α of 0.82–0.83 (Bjelland et al., 2002). See the reliability section for the population studied and full statistics.

Who developed the HADS, and how do I cite it?

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. https://doi.org/10.1111/j.1600-0447.1983.tb09716.x

Or track new research mentioning HADS as it publishes

Related scales

DASS-21Depression Anxiety Stress Scales-21BAIBeck Anxiety InventoryBDI-IIBeck Depression Inventory-IICES-DCenter for Epidemiologic Studies Depression ScaleEPDSEdinburgh Postnatal Depression ScaleGAD-7Generalized Anxiety Disorder-7

Library entry verified September 2026. Metadata is provided for reference; item wording is available inside Folio Surveyor, subject to each instrument's licensing.