HADS-A: Hospital Anxiety and Depression Scale (Anxiety)

7-item anxiety subscale for hospital and clinical settings. ≈ 2 min to complete. Free with attribution.

anxiety 7 items ≈ 2 min Updated 2026-05-06

Score HADS-A below → Download printable PDF View source paper (DOI)
What is HADS-A? HADS-A (Hospital Anxiety and Depression Scale (Anxiety)) is a validated instrument used to assess 7-item anxiety subscale for hospital and clinical settings.. It is used in 7-item anxiety subscale for hospital and clinical settings.. It comprises 7 items. Administration takes about 2 min.

What is HADS-A?

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

Clinical context: when HADS-A is used

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.

Score HADS-A

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.

How HADS-A is scored

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.

HADS-A score interpretation

The cutoffs below are drawn from the published validation literature. Always interpret in clinical context.

Score rangeBandInterpretation
0–7NormalNone
8–10MildMonitor
11–14ModerateConsider treatment
15–21SevereActive treatment

How to score HADS-A: a step-by-step worked example

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.

Step 1 — Score each item

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.

#ItemExample responseScore
1I feel tense or wound upNot very much1
2I get a sort of frightened feeling as if something awful is about to happenNot very much1
3Worrying thoughts go through my mindNot very much1
4I can sit at ease and feel relaxedNot quite so much1
5I get a sort of frightened feeling like butterflies in the stomachQuite a lot2
6I feel restless as if I have to be on the moveNot very much1
7I get sudden feelings of panicQuite a lot2

Step 2 — Add up the scores

Add up all the item scores you noted in Step 1.

1 + 1 + 1 + 1 + 2 + 1 + 2 = 9

Step 3 — Look up the band

Find the row in the interpretation table whose range contains your total:

Total = 9 falls between 8 and 10Mild

Step 4 — What does this mean clinically?

Mild. Monitor

A score is one input alongside history and examination. HADS-A supports clinical judgment — it does not replace it.

Score HADS-A with your own answers above →

HADS-A psychometric properties

Psychometric figures are drawn from the validation literature and may vary across clinical populations and translations.

Limitations & common pitfalls

How HADS-A compares to other anxiety scales

If HADS-A doesn't fit your context, related instruments in anxiety include:

ScaleMeasuresItemsTime
GAD-2Ultra-brief anxiety screening based on first two GAD-7 items.2≈ 1 min
STAIMeasures both temporary state anxiety and long-standing trait anxiety.20≈ 10 min
BAI21-item self-report inventory measuring severity of anxiety symptoms with focus on somatic symptoms.21≈ 5 min
PSWQ16-item measure of worry tendency as a stable personality trait.16≈ 5 min
PHQ-9Severity of depression9≈ 3 minutes
GAD-7Severity of generalized anxiety7≈ 2 minutes
AUDIT10-item WHO screening tool for hazardous alcohol consumption and dependence.10≈ 3 min
CHA2DS2-VAScAnnual stroke risk in non-valvular atrial fibrillation8

Frequently asked questions about HADS-A

What does HADS-A measure?

HADS-A (Hospital Anxiety and Depression Scale (Anxiety)) is a validated instrument that assesses 7-item anxiety subscale for hospital and clinical settings.. Its primary clinical use is 7-item anxiety subscale for hospital and clinical settings..

How long does HADS-A take to complete?

HADS-A typically takes ≈ 2 min to administer. Time can vary slightly depending on whether it is self-administered or clinician-led.

How many items are on HADS-A?

HADS-A contains 7 items. Items are summed to produce a total score.

What is a high HADS-A score?

Scores of 15–21 fall in the "Severe" band. Active treatment

What is a low HADS-A score?

Scores of 0–7 fall in the "Normal" band. None

How reliable is HADS-A?

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.

Is HADS-A free to use?

HADS-A is free to use with attribution. Free to use with citation

What is the source paper for HADS-A?

Zigmond, A. S., & Snaith, R. P. (1983). The Hospital Anxiety and Depression Scale. Acta Psychiatrica Scandinavica, 67(6), 361-370.

Can HADS-A replace clinical judgment?

No. HADS-A is a structured assessment aid. A score is one input alongside history, examination, and clinical context. Treatment decisions should never rest on a screening score alone.

References & validation

HADS-A is supported by the following peer-reviewed sources: