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Factor Structure of Hospital Anxiety and Depression Scale in Malaysian patients with coronary artery disease

Satpal Kaur1, Nor Zuraida Zainal2, Wah Yun Low2

  • 1University of Malaya, Kuala Lumpur, Malaysia s_kaur76@yahoo.com.

Asia-Pacific Journal of Public Health
|May 9, 2014
PubMed

Insights

The Hospital Anxiety and Depression Scale (HADS) is a valid tool for assessing psychological distress in Malaysian coronary artery disease (CAD) patients. Findings suggest reevaluating HADS cutoff scores for better screening of anxiety and depression in this population.

Area of Science:

  • Psychiatry
  • Cardiology
  • Psychometrics

Background:

  • The Hospital Anxiety and Depression Scale (HADS) is widely used for screening psychological distress.
  • Its utility in patients with coronary artery disease (CAD) is established, but factor structure may vary across populations.
  • Understanding the HADS factor structure in diverse ethnic and cultural groups, such as Malaysians with CAD, is crucial.

Purpose of the Study:

  • To determine the factor structure of the HADS in a Malaysian sample of 189 patients with CAD.
  • To validate the HADS as a measure of psychological distress within this specific patient group.
  • To explore the dimensionality of anxiety and depression symptoms in CAD patients in Malaysia.

Main Methods:

  • Factor analysis, including principal component analysis with varimax rotation, was employed to identify underlying factors of the HADS.
  • Confirmatory factor analysis was used to support the proposed factor structure.
  • Internal consistency and validity of the HADS were assessed in the Malaysian CAD sample.

Main Results:

  • Factor analysis revealed a 3-factor structure for the HADS in Malaysian CAD patients.
  • Confirmatory factor analysis supported these three dimensions: anxiety, anhedonia, and psychomotor retardation.
  • The HADS demonstrated good internal consistency and validity for measuring psychological distress in this cohort.

Conclusions:

  • The HADS is a valid and reliable instrument for assessing psychological distress, specifically anxiety, anhedonia, and psychomotor retardation, in Malaysian patients with CAD.
  • Low mean scores suggest a need to reevaluate the recommended cutoff scores for screening psychological distress in this population.
  • Further research is recommended to confirm the generalizability and consistency of the tridimensional HADS structure in Malaysia.

Keywords:
Hospital Anxiety and Depression Scalecoronary artery diseasedimensionalityfactor structurevalidity

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