Using Hospital Anxiety and Depression Scale (HADS) on patients with epilepsy: Confirmatory factor analysis and Rasch models. (February 2017)

• Record Type: Journal Article
• Authors: Lin, Chung-Ying; Pakpour, Amir H.
• Is Part Of: Seizure. Volume 45(2017)
• Page Start: 42
• Page End: 46
• Publication Date: 2017-02
• Subjects: HADS Hospital Anxiety and Depression Scale -- CFI confirmatory factor analysis -- RMSEA root mean square error of approximation -- SRMR standardized root mean square residual -- SEM structural equation model -- TLI Tucker–Lewis index -- infit information-weighted fit statistic -- MnSq mean square -- outfit outlier-sensitive fit statistic; Anxiety -- Confirmatory factor analysis -- Depression -- Epilepsy -- Rasch; Epilepsy -- Periodicals; Epilepsy -- Periodicals; Seizures -- Periodicals; Épilepsie -- Périodiques; Electronic journals; Electronic journals; 616.853
• DOI: 10.1016/j.seizure.2016.11.019
• Languages: English
• ISSNs: 1059-1311

Abstract

Highlights: Hospital Anxiety and Depression Scale (HADS) showed good psychometric properties. The additive score in the HADS was supported for people with epilepsy. Male and female people with epilepsy interpret the HADS in the same way. The HADS was interpreted similarly across two people with types of epilepsy. Abstract: Purpose: The problems of mood disorders are critical in people with epilepsy. Therefore, there is a need to validate a useful tool for the population. The Hospital Anxiety and Depression Scale (HADS) has been used on the population, and showed that it is a satisfactory screening tool. However, more evidence on its construct validity is needed. Method: A total of 1041 people with epilepsy were recruited in this study, and each completed the HADS. Confirmatory factor analysis (CFA) and Rasch analysis were used to understand the construct validity of the HADS. In addition, internal consistency was tested using Cronbachs' α, person separation reliability, and item separation reliability. Ordering of the response descriptors and the differential item functioning (DIF) were examined using the Rasch models. Results: The HADS showed that 55.3% of our participants had anxiety; 56.0% had depression based on its cutoffs. CFA and Rasch analyses both showed the satisfactory construct validity of the HADS; the internal consistency was also acceptable ( α = 0.82 in anxiety and 0.79 in depression; person separation reliability = 0.82 in anxiety and 0.73 in depression; item separation reliability = 0.98 in anxiety and 0.91 in depression). The difficulties of the four-point Likert scale used in the HADS were monotonically increased, which indicates no disordering response categories. No DIF items across male and female patients and across types of epilepsy were displayed in the HADS. Conclusions: The HADS has promising psychometric properties on construct validity in people with epilepsy. Moreover, the additive item score is supported for calculating the cutoff.