The factor structure of a Polish language version of the hospital anxiety depression scale (HADS)

The Hospital Anxiety Depression Scale (HADS) is widely used as a screening measure for psychological distress. Nevertheless, there is disagreement among researchers about the extent to which the HADS provides separate measures of anxiety and depression or a single measure of affectively based distress, and the present study was designed to contribute to this discussion. Participants (n = 951) who were psychologically distressed, but not hospitalized, completed a Polish language version of the HADS. A confirmatory factor analysis of participants' responses confirmed a model with two correlated factors with one cross-loaded item. The estimated correlation between the factors was .68. These results suggest that the Polish version of the HADS consists of two correlated measures of affectively focused distress, depression and anxiety. Nevertheless, analysts and practitioners need to be cautious and take into account the possibility that the discriminant validity of these two scales may be somewhat limited given the correlation between the subscales and the possible cross-loadings of items.