The factor structure of the Hospital Anxiety and Depression Scale in acquired brain injury

PRIMARY OBJECTIVE: To evaluate the factor structure of the Hospital Anxiety and Depression Scale (HADS) as a mood assessment in a sample of individuals with acquired brain injury (ABI). RESEARCH DESIGN: Cohort study. METHODS AND PROCEDURES: HADS data from 140 people with ABI was subjected to principle components analysis (PCA). EXPERIMENTAL INTERVENTIONS: None. MAIN OUTCOMES AND RESULTS: A three-factor solution emerged. Items loading on the first two factors map on to the anxiety and depression scales. However, two items from the depression sub-scale did not load significantly on either of these two main factors. Possible reasons are discussed. CONCLUSIONS: This study suggests that the HADS is a useful tool for examining depression and anxiety in a brain injured population, but interpretation of responses to some items should be cautious.