Comparison of Two Versions of the Hospital Anxiety and Depression Scale in Assessing Depression in a Neurologic Setting
Bibliographic record
Abstract
BACKGROUND: The Hospital Anxiety and Depression Scale-Depression Subscale (HADS-D) is widely used to assess depression in people with multiple sclerosis (MS). Developed specifically for use in a medical setting, the scale has one item, "I feel as if I am slowed down," that might represent a significant somatic confounder, possibly biasing the assessment. OBJECTIVE: We sought to determine whether inclusion or exclusion of the "slowed down" item in the HADS-D affects the detection of depression and the scale's associations with impaired cognition, fatigue, and employment status. METHODS: A sample of 193 people with confirmed MS completed the HADS. To identify depressed participants, we used previously established cutoff scores for the HADS-D with (≥8) and without (≥6) the "slowed down" item. Linear and logistic regression models were used to determine predictors of cognition and employment status. RESULTS: The HADS-D with and without the "slowed down" item detected similar rates of depression: 30.6% and 31.6%, respectively. Both versions of the HADS-D predicted processing speed and executive functioning, but not memory. Neither version predicted employment status. CONCLUSIONS: The HADS-D is an easy-to-use and clinically relevant self-report psychometric scale for detecting depression in MS. Removing the "slowed down" item from the HADS-D does not influence its internal consistency, and both versions have similar associations with clinical outcomes.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".