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Family Practice Vol. 12, No. 2, 149-154
© Oxford University Press 1995

research-article

Can the Hospital Anxiety and Depression (HAD) Scale be used on Chinese elderly in general practice?

Cindy LK Lam, Pey-Chyou Pan1, Aylwin WT Chan2, Sai-Yin Chan3 and Clarke Munro4

General Practice Unit, The University of Hong Kong Hong Kong
1Medical Health Services, Western Bay Health Tauranga, New Zealand
2Nethersole Hospital, The University of Hong Kong Hong Kong
3Castle Peak Hospital, The University of Hong Kong Hong Kong
4General Practice Unit, The University of Hong Kong Hong Kong

Address for correspondence: General Practice Unit, The University of Hong Kong, 3/F, Ap Lei Chau Clinic, 161, Main Street. Ap Lei Chau, Hong Kong

A study was carried out in a general practice in Hong Kong to find out if the Hospital Anxiety and Depression (HAD) Scale could be used to detect psychological problems in Chinese elderly. The HAD Scale was translated into Cantonese and administered by an interviewer to 298 Chinese aged 60 or above before their doctor consultations. The acceptance rate of the Scale was 96% and each interview took only 5–10 min to complete. All 298 elderly understood and completed the HAD Scale. Validation of the results of the HAD Scale by the Clinical Interview Schedule (CIS) was done on a random sample of 100 elderly. Relative operating characteristic (ROC) analysis showed that the optimal cut-off points of the HAD Scale was a depression score of 6 and an anxiety score of 3. The sensitivity was 80%, specificity was 90%, OMR (overall misclassification rate) was 12%, positive predictive value was 67% and negative predictive value was 95%. Thirty-six per cent of the elderly had scores above these cut-off points. More females than males had high anxiety scores. Nearly half of those with positive HAD scores were not known to have any psychological illness. The HAD Scale has great potential to be used as a screening instrument for psychological illnesses in Cantonese-speaking Chinese elderly all over the world.


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