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Preliminary Psychometric Evaluation of the Romanian Version of the Hospital Anxiety and Depression Scale in
Lilia Böckels1,2, Vitalie Lisnic3, Daniel Alexa1,2
1Neurology Department, Rehabilitation Hospital, 700661 Iași, Romania.
Abstract:
Background/Objectives: Relapsing-remitting multiple sclerosis (RRMS) is frequently associated with anxiety and depressive symptoms, which significantly impact quality of life and clinical outcomes. The Hospital Anxiety and Depression Scale (HADS) is widely used to screen for psychological distress in medical populations. To perform a preliminary psychometric evaluation of the Romanian version of HADS in patients with RRMS, focusing on internal consistency and construct-related associations. Methods: This cross-sectional study included 60 RRMS patients. Internal consistency was assessed using Cronbach's alpha and corrected item-total correlations. Construct-related evidence was explored through correlations with Expanded Disability Status Scale (EDSS) scores and disease duration, as well as known-groups comparisons based on disability level. Results: HADS demonstrated acceptable internal consistency (HADS-A α = 0.834; HADS-D α = 0.767). Depressive symptoms showed a moderate association with neurological disability (ρ = 0.456, p < 0.001), whereas no significant association was observed between anxiety symptoms and EDSS. Patients with higher disability had significantly higher HADS-D scores (p = 0.001), while HADS-A scores did not differ between groups. Conclusions: The Romanian version of HADS provides preliminary evidence of acceptable internal consistency and construct-related validity in RRMS. These findings support its potential use as a screening tool for psychological distress while highlighting the need for larger studies including factor analysis and test-retest reliability.