Normative values for the Hospital Anxiety and Depression Scale (HADS) in the general German population

Objective: The aim of this study was to present normative values for the Hospital Anxiety and Depression Scale (HADS). Methods: A representative sample of the German general population (N=4410) was tested with the HADS. Results: Females are more anxious than males, and older subjects are more depressed than younger subjects. The mean scores for anxiety / depression are 4.4 / 4.8 (males) and 5.0 / 4.7 (females). Using the cut-off 8+, the percentages of elevated anxiety and depression in the total sample are 21 % and 23 %, respectively. Regression analyses proved a linear but not a curvilinear age trend of anxiety and depression. Percentile rank norms are given for anxiety, depression, and the HADS total score. Conclusion: The regression coefficients allow the calculation of expected mean scores for each age and gender distribution of any sample of patients. HADS mean scores are better suited to describe the degree of anxiety and depression in patient samples compared to percentages of subjects with elevated values. (C) 2011 Elsevier Inc. All rights reserved.