Clinical research
Validation of the Polish version of the Hospital Anxiety and Depression Scale in three populations of gynecologic patients
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Submission date: 2013-02-07
Final revision date: 2013-03-30
Acceptance date: 2013-04-19
Online publication date: 2014-02-04
Publication date: 2014-06-30
Arch Med Sci 2014;10(3):517–524
Introduction: We analyzed the psychometric properties of the Polish version of the Hospital Anxiety and Depression Scale (HADS) in gynecologic patients.
Material and methods: A total of 252 patients, consisting of three subgroups – endocrinologic gynecology (n = 67), high-risk pregnancy (n = 124), and outpatient gynecologic clinic (n = 61) – responded to the HADS, the 12-item Well-being Questionnaire (W-BQ12), the Spielberger State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory-II (BDI-II), and the Hamilton Depression Scale (HAMD). Socio-demographic data were obtained by self-report and interviews.
Results: The HADS presented good internal consistency with Cronbach’s  at 0.84 and 0.78 for depression and anxiety subscales, respectively, and 0.88 for the whole questionnaire. The principal component analysis with Eigenvalues > 1 revealed a three-factor structure. Factors 1 (“depression”), and 2 (“anxiety”), as well as the separate Factor 3, explained 23.48%, 21.42%, and 12.07% of the variance, respectively. The items with shared loadings were A1, A3, and A6. The HADS scores correlated strongly with other depression and well-being scales, but not with STAI-X1/X2.
Conclusions: The Polish HADS revealed a three-factor structure, and 3/7 HADS-A items showed ambiguous factor loadings. All other psychometric properties were satisfactory. The HADS seems to be suitable for use in gynecologic patients, preferentially as an indicator for global psychological distress.