Anxiety and depression in the working population using the HAD Scale--psychometrics, prevalence and relationships with psychosocial work characteristics

Soc Psychiatry Psychiatr Epidemiol. 2004 Aug;39(8):637-46. doi: 10.1007/s00127-004-0797-6.


Background: The purposes of this study were: 1) to explore the psychometric properties of the HAD Scale in the working population, 2) to determine the prevalence of anxiety and depression on two severity levels among employees, and 3) to examine whether psychosocial work-related determinants for both categories of mental health problems may differ.

Methods: Data were taken from 7482 employees participating in the epidemiological Maastricht Cohort Study on Fatigue at Work. Anxiety and depression were measured with the easy to administer self-report Hospital Anxiety and Depression (HAD) Scale, while several questionnaires and self-formulated questions were used to measure psychosocial work-related characteristics.

Results: A principal component analysis indicated that the HAD Scale enables measuring anxiety and depression as separate constructs among employees. On a subclinical level, prevalences of anxiety and depression were both considerable: anxiety prevalences were 8.2 % for males and 10 % for females, and depression prevalences were 7.1% for males and 6.2% for females. Regarding self-reported psychosocial work characteristics, in multivariate regression analyses partly differential cross-sectional associations were found for anxiety and depression.

Conclusions: The results indicate that subclinical anxiety and depression are considerable in the working population and provide suggestive evidence that diagnosing, preventing or managing anxiety and depression among employees may require focusing on different aspects of their psychosocial work environment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anxiety Disorders / diagnosis
  • Anxiety Disorders / epidemiology*
  • Cohort Studies
  • Cross-Sectional Studies
  • Depressive Disorder / diagnosis
  • Depressive Disorder / epidemiology*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Netherlands / epidemiology
  • Occupational Diseases / diagnosis
  • Occupational Diseases / epidemiology*
  • Personality Inventory / statistics & numerical data*
  • Prospective Studies
  • Regression Analysis