Validation of Hospital Anxiety and Depression Rating Scale among HIV/ AIDS Patients in Aminu Kano Teaching Hospital, Kano, North-Western Nigeria
DOI:
https://doi.org/10.12970/2309-0529.2014.02.02.2Keywords:
Depression, HAD scale, CIDI, HIV AIDS, Nigeria.Abstract
Background: The Hospital Anxiety and Depression (HAD) scale is an instrument used for the screening of depression and anxiety. The scale has not been validated for use among HIV/ AIDS patients in Northwestern Nigeria. Aim: The study aimed to validate HAD scale for screening of depression in HIV/AIDS patients in Kano, Northwestern Nigeria. Methods: It was a cross-sectional study carried out at Aminu Kano Teaching Hospital (AKTH), Kano in which 250 HIV/AIDS patients were recruited. The depression component of HAD scale was administered to them. Respondents who scored 8 and above on HAD scale were further assessed for depression using the depression module of Composite International Diagnostic Inventory (CIDI). The data was analyzed using SPSS 17.0. Results: Of the patients recruited, 90(36%) had depression using HAD scale while 87 (34.8%) were confirmed using CIDI. HAD scale had sensitivity of 100%, specificity of 98.2%, positive predictive value of 96.7% and negative predictive value of 100%, and accuracy of 98.8%. Conclusion: The HAD scale is a reliable screening tool with high level of precision and validity, and could be reliably used to detect depression among HIV/AIDS patients.References
[1] Centers for Disease Control and Prevention. Incorporating HIV prevention into the medical care of persons living with HIV: Recommendations of CDC, the Health Resources and Services Administration, the National Institutes of Health, and the HIV Medicine Association of the Infectious Diseases Society of America. MMWR Morb Mortal Wkly Rep 2003; 52: 1-24.
[2] Song JY, Lee JS, Seo YB, et al. Depression among HIVinfected patients in Korea: assessment of clinical significance and risk factors. Infect Chemother 2013; 45: 211-6. http://dx.doi.org/10.3947/ic.2013.45.2.211
[3] Su X, Lau JT, Mak WW, et al. Prevalence and associated factors of depression among people living with HIV in two cities in China. J Affect Disord 2013; 149: 108-15. http://dx.doi.org/10.1016/j.jad.2013.01.011
[4] Elliot A. Depression and HIV in the Era of HAART. STEP Perspective 2003; 2: 4-10.
[5] Springer SA, Dushaj A, Azar MM. The impact of DSM-IV mental disorders on adherence to combination antiretroviral therapy among adult persons living with HIV/AIDS: a systematic review. AIDS Behav 2012; 16: 2119-43. http://dx.doi.org/10.1007/s10461-012-0212-3
[6] Hahn D, Reuter K, Härter M. Screening for affective and anxiety disorders in medical patients: comparison of HADS, GHQ-12 and Brief-PHQ. GMS Psychosoc Med 2006; 3: Doc09.
[7] Oche M, Adamu H. Determinants of patient waiting time in the general outpatient department of a tertiary health institution in North Western Nigeria. Ann Med Health Sci Res 2013; 3: 588-92. http://dx.doi.org/10.4103/2141-9248.122123
[8] Pence BW, Gaynes BN, Atashili J, et al. Validity of an interviewer-administered patient health questionnaire-9 to screen for depression in HIV-infected patients in Cameroon. J Affect Disord 2012; 143: 208-13. http://dx.doi.org/10.1016/j.jad.2012.05.056
[9] Herrmann C. International experiences with the Hospital Anxiety and Depression Scale--a review of validation data and clinical results. J Psychosom Res 1997; 42: 17-41. http://dx.doi.org/10.1016/S0022-3999(96)00216-4
[10] Pallant JF, Bailey CM. Assessment of the structure of the Hospital Anxiety and Depression Scale in musculoskeletal patients. Health Qual Life Out 2005; 3: 82. http://dx.doi.org/10.1186/1477-7525-3-82
[11] Abiodun OA. A validity study of the Hospital Anxiety and Depression Scale in general hospital units and a community sample in Nigeria. Br J Psychiatry 1994 165: 669-72. http://dx.doi.org/10.1192/bjp.165.5.669
[12] Zigmond AS, Snaith RP. Hospital anxiety and depression scale. Acta Psychiatr Scand 1983; 68: 361-70. http://dx.doi.org/10.1111/j.1600-0447.1983.tb09716.x
[13] Wittchen HU, Robins LN, Cottler LB, Sartorius N, Burke JD, Regier D. Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). The Multicentre WHO/ADAMHA Field Trials. Br J Psychiatry 1991; 159: 645-53, 658. http://dx.doi.org/10.1192/bjp.159.5.645
[14] Gureje O, Lasebikan VO, Kola L, Makanjuola V. Lifetime and 12-month prevalence of mental disorders in the Nigerian Survey of Mental Health and Well-Being. Br J Psychiatry 2006; 188: 467-71. http://dx.doi.org/10.1192/bjp.188.5.465
[15] Gureje O, Lasebikan VO, Ephraim-Oluwanuga O, Olley BO, Kola L. Community study of knowledge of and attitude to mental illness in Nigeria. Br J Psychiatry 2005; 186: 436-41. http://dx.doi.org/10.1192/bjp.186.5.436
[16] Hall JN. Inter-rater reliability of ward rating scale. Br J Psychiatry 1974; 125: 248-55. http://dx.doi.org/10.1192/bjp.125.3.248
[17] Reda AA. Reliability and Validity of the Ethiopian Version of the Hospital Anxiety and Depression Scale (HADS) in HIV Infected Patients. PLoS ONE 2011; 6: e16049. http://dx.doi.org/10.1371/journal.pone.0016049
[18] Rabkin JG. HIV and Depression: 2008 review and update. Curr HIV/AIDS Rep 2008; 5: 163-71. http://dx.doi.org/10.1007/s11904-008-0025-1
[19] Elkin E. Mental Health Online 2000. Retrieved 22nd August, 2010, 1710hrs, from http//www.thebody.com/content/ art40482.html
[20] Abiodun OA. Neuro-psychiatric Manifestations of Acquired Immune Deficiency Syndrome (AIDS). Cent Afr J Med 1990; 36: 224-30.
[21] Rodkjaer L, Lauren T, Balle N, Sodemann M. Depression in patients with HIV is underdiagnosed: a cross sectional study in Denmark. HIV Med 2010; 11: 46-53. http://dx.doi.org/10.1111/j.1468-1293.2009.00741.x
[22] Chizie UE, Otakpor AN, Kuteyi OB, James BO. Depression among people living with human immunodeficiency syndrome in Benin City, Nigeria: a comparative study. Niger J Clin Pract 2013; 16: 238-42. http://dx.doi.org/10.4103/1119-3077.110148
[23] Lyketsos CG, Hutton H, Fishman M, Schwartz J, Treisman GJ. Psychiatric morbidity on entry to an HIV – primary care clinic. AIDS 1996; 10: 1033-9. http://dx.doi.org/10.1097/00002030-199610090-00015