Sensitivity of the hospital anxiety and depression scale HADS in stroke patients

Introduction. The validated Hospital Anxiety and Depression Scale HADS is recommended for screening symptoms of anxiety and depression in the routine practice of somatic doctors; it is also recommended by experts for use in rehabilitation medicine and frequently used in scientific research to assess the emotional state of stroke patients. At the same time, the literature provides various contradictory data on the sensitivity of this scale for stroke patients. Aim. To evaluate the detectability of emotional disorders in stroke patients using the HADS scale in comparison with the author’s computer program for studying the actual emotional state of the patient. Materials and methods. 60 stroke patients underwent inpatient rehabilitation in the National Medical Research Center for Rehabilitation and Balneology were randomly divided into 2 groups. 30 patients of Group 1 received a basic rehabilitation complex (aimed at correcting motor disorders); 30 patients of Group 2 received a basic rehabilitation complex in combination with a course of cognitive behavioral psychotherapy (CBT). To assess the emotional state at the beginning and at the end of rehabilitation, the HADS scale and the author’s computer program were used to study the actual emotional state of the patient. Statistical analysis was carried out using the Statistica-10 program. Results. The study groups were comparable in gender, age and clinical parameters. Initially, in patients of both groups, the median values of anxiety and depression on the HADS Scale corresponded to the norm, while the median values of the author’s methodology corresponded to a low level of comfort, the presence of fatigue, high levels of anxiety and depression. At the end of rehabilitation, according to the HADS Scale, significant positive dynamics was revealed in both groups, both for depression and anxiety (p 0.05), without significant intergroup differences. Whereas with the help of the author’s methodology, significant intergroup differences (p 0.05) were revealed, indicating a better positive dynamics of the emotional state in group 2, additionally receiving CBT. Conclusion. In comparison with the author’s program in stroke patients, the HADS scale is significantly less sensitive in the diagnosis of anxiety and depression, and does not reflect the established intergroup difference in the dynamics of emotional state after the use of the basic complex and its combination with CBT.