[2] Zigmond and Snaith created this outcome measure specifically to avoid reliance on aspects of these conditions that are also common somatic symptoms of illness, for example fatigue and insomnia or hypersomnia.
This, it was hoped, would create a tool for the detection of anxiety and depression in people with physical health problems.
A number of researchers have explored HADS data to establish the cut-off points for caseness of anxiety or depression.
Bjelland et al (2002)[3] through a literature review of a large number of studies identified a cut-off point of 8/21 for anxiety or depression.
[4] Coyne and Sonderen argue in a letter published in the same issue, that Cosco, et al.[4] provides grounds for abandoning HADS altogether.