Discriminant validity of the Hospital Anxiety and Depression Scale, Beck Depression Inventory (II) and Beck Anxiety Inventory to confirmed clinical diagnosis of depression and anxiety in patients with chronic obstructive pulmonary disease
Tina Phan, Edith Cowan UniversityFollow
Owen Carter, Edith Cowan UniversityFollow
Claire Adams, Edith Cowan UniversityFollow
Li Ping Chung
Cobie Rudd, Edith Cowan UniversityFollow
Mel R. Ziman, Edith Cowan UniversityFollow
Natalie Strobel, Edith Cowan UniversityFollow
Place of Publication
School of Medical and Health Sciences
Government of Western Australia, Department of Health (Grant number G1000794)
The objective of this study was to investigate the discriminant validity of commonly used depresson and anxiety screening tools in order to determine the most suitable tool for patients with chronic obstructive pulmonary disease (COPD). COPD patients (n = 56) completed the Hospital Anxiety and Depression Scale (HADS), Beck Depression Inventory (BDI-II) and Beck Anxiety Inventory (BAI). These scores were compared to confirmed clinical diagnosis of depression and anxiety using the Mini Neuropsychiatric Interview. HADS depression subscale (HADS-D) sensitivity/specificity was 78/81 %; BDI-II 89/77 %; HADS anxiety subscale (HADS-A) 71/81 %; and BAI 89/62 %. HADS-D sensitivity/specificity was improved (100/83%) with the removal of Q4 'I feel as if I am slowed down' and adjusted cut-off ( ≥. 5). Removal of BDI-II Q21 'Loss of interest in sex' with adjusted cut-off ≥ 12 resulted in similar improvement (100/79 %). No problematic items were identified for HADS-A or BAI. Previously reported low sensitivity/specificity of the HADS for COPD patients was not replicated. Furthermore, simple modifications of the HADS-D markedly improved sensitivity/specificity for depression. BDI-II, HADS-A and BAI produced acceptable sensitivity/specificity unmodified. Pending further research for COPD patients we recommend continued use of the HADS-A with standard cut-off ( ≥ 8) and removal of Q4 of the HADS-D with lower cut-off ≥ 5.
Phan, T. (2018). Breathing New Life: Investigating ways to improve the mental health of people living with chronic obstructive pulmonary disease in Western Australia. Retrieved from http://ro.ecu.edu.au/theses/2071
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Phan, T., Carter, O., Adams, C., Waterer, G., Chung, L., Hawkins, M., ... Strobel, N. (2016). Discriminant validity of the Hospital Anxiety and Depression Scale, Beck Depression Inventory (II) and Beck Anxiety Inventory to confirmed clinical diagnosis of depression and anxiety in patients with chronic obstructive pulmonary disease. Chronic Respiratory Disease, 13(3), 220-228.