A psychometric evaluation of the Hospital Anxiety and Depression Scale in coronary care patients following acute myocardial infarction

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Abstract
The utility of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for coronary care patients following acute myocardial infarction (MI) was investigated. A maximum likelihood factor analysis was conducted on the HADS to determine its psychometric properties and utility in 194 patients. Though internal reliability estimations of the anxiety and depression sub-scales were found to be acceptable, the expected two-factor solution failed to emerge from the data set. The three-factor solution that emerged isolated dimensions representing depression and distinct factors of trait anxiety and state anxiety. The utility of the HADS in the routine assessment of the affective state of patients following acute MI may be extended by the use of the instrument in predicting mortality and morbidity.