Psychometric Properties of the Hospital Anxiety and Depression Scale (HADS) in Previously Hospitalized COVID-19 Patients

Fernández‐de‐las‐Peñas, César; Rodríguez‐Jiménez, Jorge; Palacios‐Ceña, María; de-la-Llave-Rincón, Ana I; Fuensalida‐Novo, Stella; Ambite-Quesada, Silvia; Ortega‐Santiago, Ricardo; Arias-Buría, José Luis; Liew, Bernard X. W.; Hernández‐Barrera, Valentín; Cigarán‐Méndez, Margarita

doi:10.3390/ijerph19159273

Cited by 40 publications

(33 citation statements)

References 40 publications

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“… 18 Both the HADS anxiety (HADS-A; 7 items; range, 0-21 points) and HADS depressive (HADS-D; 7 items; range, 0-21 points) scales were used. 19 A cutoff score of 12 points or more for the HADS-A was indicative of anxiety symptoms, and a cutoff score of 10 points or more for the HADS-D was indicative of depressive symptoms. 20 The PSQI (range, 0-21 points) was used to assess sleep quality during the previous month, in which a cutoff of 8.0 points or more was considered indicative of poor sleep quality.…”

Section: Methodsmentioning

confidence: 99%

Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients

Fernández‐de‐las‐Peñas

Rodríguez‐Jiménez

Cancela-Cilleruelo

et al. 2022

JAMA Netw Open

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ImportanceIdentification of long-term post–COVID-19 symptoms among hospitalized and nonhospitalized patients is needed.ObjectiveTo compare the presence of post–COVID-19 symptoms 2 years after acute SARS-CoV-2 infection between hospitalized and nonhospitalized patients.Design, Setting, and ParticipantsA cross-sectional cohort study was conducted at 2 urban hospitals and general practitioner centers from March 20 to April 30, 2020, among 360 hospitalized patients and 308 nonhospitalized patients with acute SARS-CoV-2 infection during the first wave of the pandemic. Follow-up was conducted 2 years later.Main Outcomes and MeasuresParticipants were scheduled for a telephone interview 2 years after acute infection. The presence of post–COVID-19 symptoms was systematically assessed, with particular attention to symptoms starting after infection. Hospitalization and clinical data were collected from medical records. Between-group comparisons and multivariate logistic regressions were conducted.ResultsA total of 360 hospitalized patients (162 women [45.0%]; mean [SD] age, 60.7 [16.1] years) and 308 nonhospitalized patients (183 women [59.4%]; mean [SD] age, 56.7 [14.7] years) were included. Dyspnea was more prevalent at the onset of illness among hospitalized than among nonhospitalized patients (112 [31.1%] vs 36 [11.7%]; P &lt; .001), whereas anosmia was more prevalent among nonhospitalized than among hospitalized patients (66 [21.4%] vs 36 [10.0%]; P = .003). Hospitalized patients were assessed at a mean (SD) of 23.8 (0.6) months after hospital discharge, and nonhospitalized patients were assessed at a mean (SD) of 23.4 (0.7) months after the onset of symptoms. The number of patients who exhibited at least 1 post–COVID-19 symptom 2 years after infection was 215 (59.7%) among hospitalized patients and 208 (67.5%) among nonhospitalized patients (P = .01). Among hospitalized and nonhospitalized patients, fatigue (161 [44.7%] vs 147 [47.7%]), pain (129 [35.8%] vs 92 [29.9%]), and memory loss (72 [20.0%] vs 49 [15.9%]) were the most prevalent post–COVID-19 symptoms 2 years after SARS-CoV-2 infection. No significant differences in post–COVID-19 symptoms were observed between hospitalized and nonhospitalized patients. The number of preexisting medical comorbidities was associated with post–COVID-19 fatigue (odds ratio [OR], 1.93; 95% CI, 1.09-3.42; P = .02) and dyspnea (OR, 1.91; 95% CI, 1.04-3.48; P = .03) among hospitalized patients. The number of preexisting medical comorbidities (OR, 3.75; 95% CI, 1.67-8.42; P = .001) and the number of symptoms at the onset of illness (OR, 3.84; 95% CI, 1.33-11.05; P = .01) were associated with post–COVID-19 fatigue among nonhospitalized patients.Conclusions and RelevanceThis cross-sectional study suggested the presence of at least 1 post–COVID-19 symptom in 59.7% of hospitalized patients and 67.5% of nonhospitalized patients 2 years after infection. Small differences in symptoms at onset of COVID-19 were identified between hospitalized and nonhospitalized patients. Post–COVID-19 symptoms were similar between hospitalized and nonhospitalized patients; however, lack of inclusion of uninfected controls limits the ability to assess the association of SARS-CoV-2 infection with overall and specific post–COVID-19 symptoms 2 years after acute infection. Future studies should include uninfected control populations.

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Section: Methodsmentioning

confidence: 99%

Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients

Fernández‐de‐las‐Peñas

Rodríguez‐Jiménez

Cancela-Cilleruelo

et al. 2022

JAMA Netw Open

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“…Anxiety and depressive symptoms were assessed with the Hospital Anxiety and Depression Scale (HADS) [ 40 ]. Each scale includes 7 items evaluating anxiety (HADS-A) or depressive (HADS-D) symptoms on a 4-point Likert scale (0–3).…”

Section: Methodsmentioning

confidence: 99%

“…The score of each subscale ranges from 0 to 21 points, where ≥12 points on the HADS-A are indicative of anxiety symptoms and ≥10 points on the HADS-D indicate of depressive symptoms [ 41 ]. A recent study has revealed that both scales of the HADS exhibit good internal consistency in people with the post-COVID-19 condition [ 40 ].…”

Section: Methodsmentioning

confidence: 99%

Sleep Quality Mediates the Effect of Sensitization-Associated Symptoms, Anxiety, and Depression on Quality of Life in Individuals with Post-COVID-19 Pain

Hernández

Fernández‐de‐las‐Peñas

Fuensalida‐Novo

et al. 2022

Brain Sciences

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A better understanding of biological and emotional variables associated with health-related quality of life in people with long-COVID is needed. Our aim was to identify potential direct and indirect effects on the relationships between sensitization-associated symptoms, mood disorders such as anxiety/depressive levels, and sleep quality on health-related quality of life in people suffering from post-COVID-19 pain. One hundred and forty-six individuals who were hospitalized due to COVID-19 during the first wave of the pandemic and suffering from long-term post-COVID-19 pain completed different patient-reported outcome measures (PROMs), including clinical features, symptoms associated with sensitization of the central nervous system (Central Sensitization Inventory), mood disorders (Hospital Anxiety and Depressive Scale), sleep quality (Pittsburgh Sleep Quality Index), and health-related quality of life (paper-based five-level version of EuroQol-5D) in a face-to-face interview conducted at 18.8 (SD 1.8) months after hospitalization. Different mediation models were conducted to assess the direct and indirect effects of the associations among the different variables. The mediation models revealed that sensitization-associated symptoms and depressive levels directly affected health-related quality of life; however, these effects were not statistically significant when sleep quality was included. In fact, the effect of sensitization-associated symptomatology on quality of life (β = −0.10, 95% CI −0.1736, −0.0373), the effect of depressive levels on quality of life (β= −0.09, 95% CI −0.1789, −0.0314), and the effect of anxiety levels on quality of life (β = −0.09, 95% CI −0.1648, −0.0337) were all indirectly mediated by sleep quality. This study revealed that sleep quality mediates the relationship between sensitization-associated symptoms and mood disorders (depressive/anxiety levels) with health-related quality of life in individuals who were hospitalized with COVID-19 at the first wave of the pandemic and reporting post-COVID-19 pain. Longitudinal studies will help to determine the clinical implications of these findings.

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“…This scale has been used owing to the fact that it has proven to be psychometric valid and reliable which makes it a useful and easily applicable tool to screen for anxiety and depression in clinical practice [ 21 – 25 ].…”

Section: Methodsmentioning

confidence: 99%

The psychological impact of the COVID-19 pandemic on the Sudanese healthcare workers in quarantine centers: a cross-sectional study 2020–2021

Idrees

Bashir

2023

Middle East Curr Psychiatry

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Background After its emergence in Wuhan in December 2019, the COVID-19 virus disseminated around the globe creating an incredible panic and outweighing the healthcare system’s capacities. As a result of this hazardous situation, healthcare workers were placed at an unprecedented challenge making them vulnerable to a wide spectrum of mental health issues including anxiety and depression. This was a cross-sectional health facility-based study aiming to explore the psychological impact of the COVID-19 pandemic on Sudanese healthcare workers in COVID-19 treatment centers. Convenience sampling was applied. And two-part self-administered online questionnaire was used: the first part consisted of the demographic data and concerns related to COVID-19, and the second part consisted of the Hospital Anxiety and Depression Scale (HADS) standardized questionnaire. Ethical clearance was obtained from the Ministry of Health. Results One-hundred thirty-three healthcare workers of different job titles were enrolled in this study. A total of 54% were females, and 46% were males. Most of the participants had borderline depression (44%) or anxiety scores (47%). Females had significantly a higher mean anxiety score than males. There was no significant difference between participants with and without chronic disease on both anxiety and depression scores. Conclusions Healthcare workers at the forefront of the fight against COVID-19 pandemic are facing critical mental health challenges. An immediate intervention from the decision-makers is needed to mitigate this deleterious impact and to strengthen the healthcare system’s capacity in the face of healthcare emergencies in general.

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Psychometric Properties of the Hospital Anxiety and Depression Scale (HADS) in Previously Hospitalized COVID-19 Patients

Cited by 40 publications

References 40 publications

Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients

Post–COVID-19 Symptoms 2 Years After SARS-CoV-2 Infection Among Hospitalized vs Nonhospitalized Patients

Sleep Quality Mediates the Effect of Sensitization-Associated Symptoms, Anxiety, and Depression on Quality of Life in Individuals with Post-COVID-19 Pain

The psychological impact of the COVID-19 pandemic on the Sudanese healthcare workers in quarantine centers: a cross-sectional study 2020–2021

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