• Bernice Andrews, Jennie Hejdenberg, and John Wilding.
• Department of Psychology, Royal Holloway University of London, Egham Surrey TW20 OEX, United Kingdom. b.andrews@rhul.ac.uk
• J Affect Disord. 2006 Oct 1;95(1-3):29-34.

BackgroundRecent reports note a reliance on self-report measures and a lack of information about diagnosable mental disorder in university students. Professional concern about perceived increases in student mental health problems raises questions about whether questionnaire assessments can provide valid approximations of such disorders in this group. The aim of this study was to validate the Hospital Anxiety and Depression Scale (HADS) against DSM-IV diagnoses in university students.MethodsEighty-nine students were administered with the HADS followed by the Structured Interview for DSM-IV.ResultsAt recommended cut-offs HADS anxiety and depression scales both showed good sensitivity in detecting DSM-IV anxiety and depression disorders, and the depression scale showed good specificity and overall efficiency. The HADS anxiety scale showed poor specificity and moderate overall efficiency. In the absence of an anxiety diagnosis, high HADS anxiety scores were not significantly associated with other measured indicators of serious mental health problems.LimitationsFurther research is needed to investigate whether the current findings hold for student populations with higher social diversity.ConclusionsThe HADS depression scale is likely to be a reasonably accurate indicator of depressive conditions in university students at the recommended cut-off but the HADS anxiety scale overestimates the extent of clinical anxiety. Students' self-reported higher symptom levels in comparison to general population norms cannot be assumed to indicate higher levels of more serious mental health conditions. However this is not to deny the genuine distress and severe problems that some students experience.

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