Validation of the Chinese-Cantonese version of the Hospital Anxiety and Depression Scale and comparison with the Hamilton Rating Scale of Depression

Objective: The aim of this study was to validate the Chinese-Cantonese version of the Hospital Anxiety and Depression Scale (HADS) and to compare it with the Hamilton Rating Scale of Depression (HRSD) as a screening tool for depressive disorders in general hospital in-patients. Method: The Chinese-Cantonese version of the HADS was administered to general hospital in-patients seen on a consultation basis, and psychiatric diagnoses were made according to DSM-III-R. The subjects were further rated independently with the HRSD. Results: The Chinese-Cantonese version of the HADS was found to have good internal consistency and external validity, with favourable sensitivity and specificity for screening for psychiatric disorders. However, its performance nas marginally inferior to that of the HRSD. The scale also performed poorly in identifying major depression. Conclusion: The HADS has limitations with regard to identification of depressive disorders. However, despite its shortcomings, it remains one of the best paper-and-pencil tests for screening psychiatric disorders in the medically ill.