how to calculate A & D

Appendix 8

HAD Scale Questionnaire

No.	Statement	Response	Points
1.	I feel tense or "wound up"	a. most of the time	3 [H]*
		b. a lot of the time	2
		c. from time to time, occasionally	1
		d. not at all	0
2.	I still enjoy the things I used to enjoy	a. definitely as much	0 [D]#
		b. not quite as much	1
		c. only a little	2
		d. hardly at all	3
3.	I get a sort of frightened feeling as if something awful is about to happen	a. very definitely and quite badly	3 [ H ]*
		b. yes, but not too badly	2
		c. a little, but it doesn't worry me	1
		d. not at all	0
4.	I can laugh and see the funny side things:	a. as much as I always could	0 [D]#
		b. not quite so much now	1
		c. definitely not so much now	2
		d. not at all	3
5.	Worrying thoughts go through my mind	a. a great deal of the time	3 [ H ]*
		b. a lot of the time	2
		c. from time to time but not too often	1
		d. only occasionally	0
6.	I feel cheerful	a. not at all	3 [D]#
		b. not often	2
		c. sometimes	1
		d. most of the time	0
7.	I can sit at ease and feel relaxed	a. definetly	0 [ H ]*
		b. usually	1
		c. not often	2
		d. not at all	3
8.	I feel as if I am slowed down:	a. nearly all the time	3 [D]#
		b. very often	2
		c. sometimes	1
		d. not at all	0
9.	I get a sort of frightened feeling, like "butterflies" in the staomach	a. not at all	0 [ H ]*
		b. occasionally	1
		c. quite often	2
		d. very often	3
10.	I have lost interest in my appearance	a. definitely	3 [D]#
		b. I don't take so much care as I sould	2
		c. I may not take quite as much care	1
		d. I take just as much care as ever	0
11.	I feel restless as if I have to be on the move	a. very much indeed	3 [ H ]*
		b. quite a lot	2
		c. not very much	1
		d. not at all	0
12.	I look forward with enjoyment to things	a. as much as ever I did	0 [D]#
		b. rather less than I used to	1
		c. definitely less than I used to	2
		d. hardly at all	3
13.	I get sudden feeling of panic	a. very often indeed	3 [ H ]*
		b. quite often	2
		c. not very often	1
		d. not at all	0
14.	I can enjoy a good book or radio or TV programme	a. often	0 [D]#
		b. sometimes	1
		c. not often	2
		d. very seldom	3

* H: Hospital Anexity.

^# D: Depression.

 

The emotional status was assessed using a validated Arabic translation of the Hospital Anxiety and Depression (HAD) Scale outlined by Zigmond and Snaith (1983)
(Appendices 8 and 9), which is a self-assessment instrument for detecting anxiety and depression in medical outpatients (Zigmond and Snaith, 1983). The HAD scale consists of 14 statements (7 for anxiety and 7 for depression) with 4 responses for each statement. Each response will have score from 0-4 points. Anxiety subscore was obtained by summation of points for the 7 anxiety statements and depression subscore was obtained by summation of points for the 7 depression statements. Minimum subsocre for each category is zero and the maximum subscore is 21. Interpretation of anxiety and depression subscores is outlined in Table 3.1.

 

 

 

 

 

 

Table 3.1: Interpretation of HAD Subscores

 

Subscore	Anxiety or depression
≤ 7	Not present
8-10	Doubtful
≥ 11*	Definite

* 11-15 moderate anxiety or depression while 16-21 severe anxiety or depression