Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations
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Factor structure of the Hospital Anxiety and Depression Scale in Japanese psychiatric outpatient and student populations Tomomi Matsudaira*†1, Hiromi Igarashi†1, Hiroyoshi Kikuchi†2, Rikihachiro Kano†2, Hiroshi Mitoma†3, Kiyoshi Ohuchi†4 and Toshinori Kitamura†1 Address: 1Department of Clinical Behavioural Sciences (Psychological Medicine), Kumamoto University, Graduate School of Medical Sciences, 11-1 Honjo, Kumamoto, Kumamoto, Japan 860-8556, 2Graduate School of Clinical Psychology, Tokyo International University, 2-6-1 Nishiwaseda, Shijuku, Tokyo, Japan 169-0051, 3Mitoma Clinic, 2-5-12 Shin-ohe, Kumamoto, Kumamoto, Japan 862-0972 and 4Heartful Clinic, 5-10-23 Hotakubo, Kumamoto, Kumamoto, Japan 862-0926 Email: Tomomi Matsudaira* - [email protected]; Hiromi Igarashi - [email protected]; Hiroyoshi Kikuchi - [email protected]; Rikihachiro Kano - [email protected]; Hiroshi Mitoma - [email protected]; Kiyoshi Ohuchi - [email protected]; Toshinori Kitamura - [email protected] * Corresponding author †Equal contributors
Published: 17 May 2009 Health and Quality of Life Outcomes 2009, 7:42
doi:10.1186/1477-7525-7-42
Received: 16 February 2009 Accepted: 17 May 2009
This article is available from: http://www.hqlo.com/content/7/1/42 © 2009 Matsudaira et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: The Hospital Anxiety and Depression Scale (HADS) is a common screening instrument excluding somatic symptoms of depression and anxiety, but previous studies have reported inconsistencies of its factor structure. The construct validity of the Japanese version of the HADS has yet to be reported. To examine the factor structure of the HADS in a Japanese population is needed. Methods: Exploratory and confirmatory factor analyses were conducted in the combined data of 408 psychiatric outpatients and 1069 undergraduate students. The data pool was randomly split in half for a cross validation. An exploratory factor analysis was performed on one half of the data, and the fitness of the plausible model was examined in the other half of the data using a confirmatory factor analysis. Simultaneous multi-group analyses between the subgroups (outpatients vs. students, and men vs. women) were subsequently conducted. Results: A two-factor model where items 6 and 7 had dual loadings was supported. These factors were interpreted as reflecting anxiety and depression. Item 10 showed low contributions to both of the factors. Simultaneous multi-group analyses indicated a factor pattern stability across the subgroups. Conclusion: The Japanese version of HADS indicated good factorial validity in our samples. However, ambiguous wording of item 7 should be clarified in future revisions.
Background The Hospita
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