Acta Scientific Medical Sciences (ASMS)(ISSN: 2582-0931)

Research Article Volume 5 Issue 11

Hospital Anxiety and Depression Scale (HADS) Test for Balance Disorder Patients

Toru Miwa1,2*

1Department of Otolaryngology-Head and Neck Surgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Japan
2Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Japan

*Corresponding Author: Toru Miwa, Department of Otolaryngology-Head and Neck Surgery, Graduate School of Medicine, Kyoto University, Japan.

Received: August 04, 2021; Published: October 20, 2021



Introduction: The Hospital Anxiety and Depression Scale (HADS) was developed by Zigmond and Snaith in 1983. HADS is a widely-used 14-item self-reported scale designed to briefly measure anxiety and depressive symptoms in non-psychiatric hospital patients. HADS only takes 2 to 5 minutes to complete. There are independent subscales for anxiety and depression.

Materials and Methods: We performed the HADS test on 25 balance disorder patients, and then investigated relationships between their HADS scores and their prognoses based upon their medical records. The 25 patients underwent the HADS test and an equilibrium test. We categorized positive (>12) and negative (<11) on the HADS test. We also categorized their prognoses into 4 categories: “cure”; “improved”; “unchanged”; and “deteriorated”.

Results: Thirteen patients (52%) showed positive results, and twelve patients (48%) showed negative results, on the HADS test. Seven (53.8%) of the 13 patients who demonstrated HADS test positive result showed “cure” or “improved” prognoses, while the eleven (91.7%) of the 12 patients who demonstrated HADS test negative result showed “cure” or “improved” prognoses.

Conclusions: Screening of patents with dizziness to check for depression and anxiety with the use of HADS was useful in the treatment and prognosis assessment of dizziness.


Keywords: Anxiety; Depression; HADS; Balance Disorder



  1. Staab JP and Ruckenstein MJ. “Chronic dizziness and anxiety: Effect of course of illness on treatment outcome”. Archives of Otolaryngology--Head and Neck Surgery 8 (2005): 675-679.
  2. Staab JP., et al. “Anxious, introverted personality traits in patients with chronic subjective dizziness”. Journal of Psychosomatic Research 1 (2014): 80-83.
  3. Staab JP and Ruckenstein MJ. “Which comes first? Psychogenic dizziness versus otogenic anxiety”. Laryngoscope 10 (2003): 1714-1718.
  4. Horii A. “Involvement of anxiety and depressive disorder”. Equilibrium Research3 (2008): 251-255.
  5. Zigmond AS and Snaith RP. “The hospital anxiety and depression scale”. Acta Psychiatrica Scandinavica 6 (1983): 361-370.
  6. Hatta H., et al. “A validation of the hospital anxiety and depression scale”. Japanese Journal of Psychosomatic Medicine 5 (1998): 309-315.
  7. Hosaka T., et al. “Screening for adjustment disorders and major depression in otolaryngology patients using the Hospital Anxiety and Depression Scale”. 3.1 (2009): 43-48.
  8. Tjernström F., et al. “Romberg ratio in quiet stance posturography—Test to retest reliability”. Gait Posture1 (2015): 27-31.
  9. Okuni M. “Orthostatic Dysregulation in Childhood with Special Reference to the Standing Electrocardiogram: Conference on Neurocirculatory Asthenia and Allied Diseases and Orthostatic Hypotensive Diseases”. Japanese Circulation Society 2 (1963): 200-204.
  10. Schellong F and Lüderitz B. “Regulationsprüfung Des Kreislaufs Funktionelle Differentialdiagnose von Herz- Und Gefässstörungen”. Steinkopff (1954).
  11. Miwa T and Minoda R. “Analysis of postoperative vertigo or dizziness in cochlear implant patients”. Equilibrium Research1 (2012): 16-22.
  12. Miwa T., et al. “Vestibular function in superficial siderosis”. BMC Ear, Nose Throat Disorder1 (2013).
  13. Miwa T. “Vestibular Function After the 2016 Kumamoto Earthquakes: A Retrospective Chart Review”. Frontiers in Neurology 11 (2021): 626613.
  14. Miwa T., et al. “The effect of cochlear implants on vestibular-evoked myogenic potential responses and postural stability”. Auris Nasus Larynx1 (2019): 50-57.
  15. Young Y-H. “Potential application of ocular and cervical vestibular-evoked myogenic potentials in meniere’s disease: A review”. Laryngoscope2 (2013): 484-491.
  16. Horii A., et al. “Effects of fluvoxamine on anxiety, depression, and subjective handicaps of chronic dizziness patients with or without neuro-otologic diseases”. Journal of Vestibular Research 1 (2007): 1-8.


Citation: Toru Miwa. “Hospital Anxiety and Depression Scale (HADS) Test for Balance Disorder Patients". Acta Scientific Medical Sciences 5.11 (2021): 106-110.


Acceptance rate30%
Acceptance to publication20-30 days
Impact Factor1.403

Indexed In

News and Events

Contact US