Comparison of the Short Form 36 and the Hospital Anxiety and Depression Scale measuring emotional distress in patients admitted for elective coronary angiography


      Anxiety and depression are frequently observed in patients with coronary artery disease. Because emotional distress is of prognostic importance in these patients, screening is recommended.


      We compared the Short Form 36 (SF-36) and the Hospital Anxiety and Depression Scale (HADS) in measuring emotional distress in patients admitted for elective coronary angiography.


      A total of 587 patients were consecutively included (mean age 62 years, 75% were male). Gender-specific partial correlations were calculated for the associations between their SF-36 and HADS scores, whereas subgroup differences were evaluated using t tests or analysis of variance.


      In both genders, the HADS subscales for anxiety and depression were significantly related to all SF-36 subscales and most strongly related to the Mental Health subscale. Both HADS and the Mental Health subscale demonstrated a high occurrence of emotional distress and discriminated significantly between patients with and without severe angina. The HADS, but not the SF-36, demonstrated high levels of emotional distress (anxiety) among men without verified coronary artery disease.


      Both instruments seem appropriate as screening instruments for emotional distress in patients with suspected coronary artery disease. Although the Mental Health subscale has the advantage of being shorter, we recommend the HADS because it shows anxiety more specifically.
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