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

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

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

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

What is HADS-D?

HADS-D (Hospital Anxiety and Depression Scale (Depression)) is a validated clinical instrument used to assess 7-item depression subscale designed for hospital and clinical outpatient settings.. It is most often used for 7-item depression subscale designed for hospital and clinical outpatient settings.. The instrument contains 7 items. Typical administration time is ≈ 2 min.

Source / attribution: Free to use with citation

Clinical context: when HADS-D is used

7-item depression subscale designed for hospital and clinical outpatient settings. HADS-D 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-D 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-D

Answer all 7 items below to see your HADS-D 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-D is scored

Sum 7 depression items scored 0-3. Total range 0-21. Score >= 8 suggests possible depression.

Scoring notes: Sum 7 depression items scored 0-3. Total range 0-21. Score >= 8 suggests possible depression.

HADS-D 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-D: 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 still enjoy the things I used to enjoyNot quite so much1
2I can laugh and see the funny side of thingsNot quite so much1
3I feel cheerfulNot quite so much1
4I feel as if I am slowed downNot very much1
5I have lost interest in my appearanceQuite a lot2
6I look forward with enjoyment to thingsNot quite so much1
7I can enjoy a good book or radio or TV programOnly a little2

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 10 → Mild

Step 4 — What does this mean clinically?

Mild. Monitor

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

Score HADS-D with your own answers above →

HADS-D psychometric properties

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

Limitations & common pitfalls

How HADS-D compares to other depression scales

If HADS-D doesn't fit your context, related instruments in depression include:

ScaleMeasuresItemsTime
PHQ-2Ultra-brief depression screening for busy clinical settings.2≈ 1 min
PHQ-8Research version of PHQ-9 excluding suicidality item for general population studies.8≈ 2 min
CES-D20-item screening test for depressive symptoms in the general population.20≈ 5 min
SDS20-item self-report scale measuring affective, psychological, and somatic symptoms of depression.20≈ 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-D

What does HADS-D measure?

HADS-D (Hospital Anxiety and Depression Scale (Depression)) is a validated instrument that assesses hospital and clinical outpatient 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.

How long does HADS-D take to complete?

HADS-D 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.

How many items are on HADS-D?

HADS-D 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’.

What is a high HADS-D score?

On the HADS-D (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.

What is a low HADS-D score?

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.

How reliable is HADS-D?

HADS-D has reported Cronbach's α of 0.82 in validation samples and test–retest reliability of 0.75. Valid in medical and psychiatric populations. In practical terms, a Cronbach’s α around 0.82 indicates good internal consistency (the items hang together well), and a test–retest reliability of 0.75 means scores are well when the scale is repeated without real clinical change.

Is HADS-D free to use?

HADS-D 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.

What is the source paper for HADS-D?

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-D — the reference to cite when reporting results.

Can HADS-D replace clinical judgment?

No. HADS-D is a structured assessment aid, not a diagnostic test. Its proper role is clinical assessment of hospital and clinical outpatient 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.

References & validation

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