Utility of the Hospital Anxiety and Depression Scale in patients with end-stage renal disease on continuous ambulatory peritoneal dialysis

The utility of the Hospital Anxiety and Depression Scale (HADS) as a screening instrument for patients with end-stage renal disease (ESRD) on continuous ambulatory peritoneal dialysis (CAPD) was investigated. A maximum likelihood factor analysis was conducted on the HADS to determine its psychometric properties and utility in 72 patients. Though internal reliability estimations of the anxiety and depression sub-scales were found to be acceptable the expected two-factor solution failed to emerge from the data set. The irregular factor structure that emerged appears to be sensitive to the unique characteristics of this patient population and may have special relevance to body image and self-perception concepts. The utility of the HADS in the routine assessment of renal patients on CAPD may be enhanced by additional assessment of self-report body image/self-perception.