Evaluating anxiety and depression in HIV-infected patients

Because there is a large overlap between HIV manifestations and somatic sym ptoms of anxiety and depression, it is crucial to use measures that do not contain somatic items to validly and reliably assess these psychological st ates in HIV-infected patients. The purpose of this study was to assess the psychometric properties of the Hospital Anxiety and Depression Scale (HADS) , a questionnaire that does not include any somatic items, in HIV-seroposit ive individuals. Because the study was conducted among French Canadian indi viduals, the quality of the translation was Ist subjectively and empiricall y assessed. Then, the psychometric properties of the HADS were evaluated in 162 HIV-seropositive patients, who, in addition to the HADS, also complete d the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory . The French Canadian version used was found to be subjectively and empiric ally equivalent to the original English version. Moreover, results of this study demonstrated a bifactorial structure with factors corresponding to th e HADS subscales, an excellent internal consistency and test-retest reliabi lity, a very good convergent validity, and an acceptable discriminant valid ity. Strikingly, in contrast to the BDI, HADS scores were found to be uncon founded by the presence of HIV symptomatology. The HADS appears to represen t the best currently available self-report scale to reliably and validly as sess anxiety and depression in HI;V-infected patients. The HADS is simple a nd brief to administer (14 items) and may therefore be easily implemented i n routine HIV care.