Psychometric properties of Spanish Version of Hospital Anxiety and Depression Scale in cancer patients

Background: The Hospital Anxiety and Depression Scale (HADS) despite being widely studied in various populations, there is still no consensus on its factor structure. Our study aims to evaluate the psychometric properties of HADS in people with cancer.
Methods: Our study was cross-sectional and non-probabilistic. It involved 467 patients diagnosed with cancer, over 18 years old, and were treated in a public institution specialized in cancer. The Hospital Anxiety and Depression Scale, the Beck Anxiety Inventory and the Beck Depression Inventory were used. Internal structure, measurement invariance, relationship with other variables and reliability were evaluated.
Results: It was found that HADS is best suited to a bifactorial structure where there is one general factor (emotional distress) and two specific factors (anxiety and depression). HADS proves to be invariant according to sex and years of education. It is moderately related to Beck Anxiety Inventory and Beck Depression Inventory. Also, it presents acceptable levels of reliability and relationship with instruments used in the diagnosis of anxiety and depression.
Conclusion: HADS is best suited to a bifactorial structure in a cancer population, comparisons can be made for both men and women and according to years of education. Its brevity, versatility, hospital-focused design and extensive study make HADS a very important instrument in the detection of anxiety and depression in cancer patients.