7-item anxiety subscale for hospital and clinical settings. ≈ 2 min to complete. Free with attribution.
HADS-A (Hospital Anxiety and Depression Scale (Anxiety)) is a validated clinical instrument used to assess 7-item anxiety subscale for hospital and clinical settings.. It is most often used for 7-item anxiety subscale for hospital and clinical settings.. The instrument contains 7 items. Typical administration time is ≈ 2 min.
Source / attribution: Free to use with citation
7-item anxiety subscale for hospital and clinical settings. HADS-A is part of standard practice in this setting because it provides a structured, replicable assessment that can be tracked over time and compared across patients or visits.
Like all screening or assessment instruments, HADS-A is a structured aid — not a diagnostic test in isolation. Results should be interpreted alongside history, examination, and clinical context. Where a score crosses an actionable threshold, the next step is typically a more detailed clinical evaluation rather than a definitive diagnosis.
Answer all 7 items below to see your HADS-A score and interpretation.
Each item is scored on a 4-point scale (0–3). Your score updates live as you answer.
All scoring runs in your browser. No data is sent anywhere — close the tab and the answers are gone.
Sum 7 anxiety items scored 0-3. Total range 0-21. Score >= 8 suggests possible anxiety.
Scoring notes: Sum 7 anxiety items scored 0-3. Total range 0-21. Score >= 8 suggests possible anxiety.
The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.
| Score range | Band | Interpretation |
|---|---|---|
| 0–7 | Normal | None |
| 8–10 | Mild | Monitor |
| 11–14 | Moderate | Consider treatment |
| 15–21 | Severe | Active treatment |
This is an illustrative walkthrough, not a real patient. Follow the same four steps with your own answers — or use the live calculator at the top of this page.
Read each question and choose the response that best fits. Each response has a number next to it — that number is the item's score. The example below uses illustrative answers.
| # | Item | Example response | Score |
|---|---|---|---|
| 1 | I feel tense or wound up | Not very much | 1 |
| 2 | I get a sort of frightened feeling as if something awful is about to happen | Not very much | 1 |
| 3 | Worrying thoughts go through my mind | Not very much | 1 |
| 4 | I can sit at ease and feel relaxed | Not quite so much | 1 |
| 5 | I get a sort of frightened feeling like butterflies in the stomach | Quite a lot | 2 |
| 6 | I feel restless as if I have to be on the move | Not very much | 1 |
| 7 | I get sudden feelings of panic | Quite a lot | 2 |
Add up all the item scores you noted in Step 1.
1 + 1 + 1 + 1 + 2 + 1 + 2 = 9
Find the row in the interpretation table whose range contains your total:
Total = 9 falls between 8 and 10 → Mild
Mild. Monitor
A score is one input alongside history and examination. HADS-A supports clinical judgment — it does not replace it.
Psychometric figures are drawn from the validation literature and may vary across clinical populations and translations.
If HADS-A doesn't fit your context, related instruments in anxiety include:
| Scale | Measures | Items | Time |
|---|---|---|---|
| GAD-2 | Ultra-brief anxiety screening based on first two GAD-7 items. | 2 | ≈ 1 min |
| STAI | Measures both temporary state anxiety and long-standing trait anxiety. | 20 | ≈ 10 min |
| BAI | 21-item self-report inventory measuring severity of anxiety symptoms with focus on somatic symptoms. | 21 | ≈ 5 min |
| PSWQ | 16-item measure of worry tendency as a stable personality trait. | 16 | ≈ 5 min |
| PHQ-9 | Severity of depression | 9 | ≈ 3 minutes |
| GAD-7 | Severity of generalized anxiety | 7 | ≈ 2 minutes |
| AUDIT | 10-item WHO screening tool for hazardous alcohol consumption and dependence. | 10 | ≈ 3 min |
| CHA2DS2-VASc | Annual stroke risk in non-valvular atrial fibrillation | 8 | — |
HADS-A (Hospital Anxiety and Depression Scale (Anxiety)) is a validated instrument that assesses hospital and clinical settings. It is designed for clinicians, medical students, evidence-synthesis researchers. It takes about 2 min to complete, and the 7 items are summed to produce a total score.
HADS-A typically takes about 2 min to administer. The exact duration varies a little depending on whether it is self-administered or completed with a clinician. Its brief format is part of what makes it practical for routine clinical use and for repeat administration when tracking change over time.
HADS-A contains 7 items. Item scores are summed to produce the total. Scores run from 0 to 21, grouped into 4 interpretation bands from ‘Normal’ up to ‘Severe’.
On the HADS-A (total score 0–21), scores of 15–21 fall in the ‘Severe’ band — interpreted as: Active treatment. The full ladder is: 0–7 — Normal: None.; 8–10 — Mild: Monitor.; 11–14 — Moderate: Consider treatment.; 15–21 — Severe: Active treatment. A higher score reflects a more severe presentation, and crossing a cutoff is a prompt to step up assessment or care — but these bands are screening thresholds, not diagnoses.
Scores of 0–7 fall in the ‘Normal’ band: None. A low score is reassuring but does not by itself rule out the underlying condition — if symptoms or clinical suspicion persist, reassess over time or use a complementary evaluation rather than relying on the number alone.
HADS-A has reported Cronbach's α of 0.8 in validation samples and test–retest reliability of 0.74. Designed to be independent of somatic symptoms. In practical terms, a Cronbach’s α around 0.8 indicates good internal consistency (the items hang together well), and a test–retest reliability of 0.74 means scores are well when the scale is repeated without real clinical change.
HADS-A is free to use with attribution — clinical, educational, and research use is permitted provided the original source is credited. If you publish results or reproduce the scale, include the citation to the source paper.
Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370. This is the original publication for the HADS-A — the reference to cite when reporting results.
No. HADS-A is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of hospital and clinical settings — it standardizes assessment and flags who needs closer evaluation, but the result must be weighed alongside history, examination, and clinical context. When a score conflicts with your clinical impression, clinical judgment takes precedence; treatment decisions should never rest on a screening score alone.
HADS-A is supported by the following peer-reviewed sources: