Hospital Anxiety and Depression Scale
HADSA 14-item screening scale for anxiety and depression in medically ill and general-hospital populations, deliberately excluding somatic symptoms that confound physical illness.
Ready-to-cite methods sentence
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Reliability & validation
Subscales
Known limitations
Licensed — permission 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.xThis 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. 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
Permission required
Importing HADSinto 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.
Related scales
Library entry verified July 2026. Metadata is provided for reference; item wording is available inside Folio Surveyor, subject to each instrument's licensing.