Internet administration of the Hospital Anxiety and Depression Scale in a sample of tinnitus patients

J Psychosom Res. 2003 Sep;55(3):259-62. doi: 10.1016/s0022-3999(02)00575-5.


Objective: To administer and validate the Hospital Anxiety and Depression Scale (HADS) via the Internet to a sample of persons with tinnitus.

Method: The HADS was converted into a Web page and administered via the Internet to a sample of 157 persons with tinnitus who were recruited for participation in a treatment trial. Also included were the Tinnitus Reaction Questionnaire (TRQ) and the Anxiety Sensitivity Index (ASI). A clinical comparison sample (n=86) was also recruited who completed the same tests in a paper-and-pencil format.

Results: Both the Internet and the paper-and-pencil version yielded comparable results in terms of psychometric properties. When using the cut-off of 11 points suggested by Zigmond and Snaith [Acta Psychiatr. Scand. 67 (1983) 361] a 25% (n=40) prevalence of probable anxiety and a 17% (n=27) prevalence of probable depression were found in the Internet group. In the clinic sample, the prevalence was only 15% for both anxiety and depression, suggesting that Internet administration might result in higher percentages. The HADS correlated with both tinnitus distress and anxiety sensitivity.

Conclusions: Internet administration of the HADS results in meaningful and valid data. Consistent with previous research anxiety and depression are common comorbid conditions in individuals with tinnitus, but norms should be developed for Internet based screening.

Publication types

  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adult
  • Anxiety Disorders / complications
  • Anxiety Disorders / diagnosis*
  • Depressive Disorder / complications
  • Depressive Disorder / diagnosis*
  • Female
  • Humans
  • Internet*
  • Male
  • Middle Aged
  • Psychiatric Status Rating Scales*
  • Psychometrics
  • Sensitivity and Specificity
  • Tinnitus / psychology*