The Structure and Reliability of the Amharic Version of the Hospital Anxiety and Depression Scale in Orphan Adolescents in Addis Ababa

BACKGROUND The Hospital Anxiety and Depression Scale was developed as a self-assessment tool to identify anxiety and depression in patients of age 16-65 years. Its use in younger age groups and illiterate populations is not well examined. The purpose of this study was to examine the structure, reliability, and applicability of its Amharic version in a community sample of early orphan adolescents. METHODS Secondary data primarily collected from randomly selected 804 orphans using the Amharic version of the Hospital Anxiety and Depression Scale by interview technique in March 2010 in Addis Ababa was used with permission. Confirmatory factor analysis with principal components extraction and oblique rotation (delta=0) was computed. The internal consistency of the subscales was assessed using Cronbach's alpha and the correlation between the subscales was assessed using Pearson correlation. RESULTS In the whole sample (age 11-18 years), two factors: anxiety and depression, explaining a total of 45.9% of the variance were found. In the 11-15 years sub-sample, the same two factors were extracted explaining a total of 45.7% of the variance. The Amharic-HADS had Cronbach's alpha of 0.81 and 0.76 in the whole sample for the anxiety and depression sub-scales, respectively. In the 11-15 years sub-sample the corresponding alpha values for anxiety and depression scales were 0.80 and 0.77, respectively. The correlation between the anxiety and the depression subscales were 0.66 (p<0.001) and 0.67 (p< 0.001) for the whole sample and for the 11-15 years group, respectively. CONCLUSION Administering the Amharic version of the Hospital Anxiety and Depression Scale by interviewers gave meaningful data starting from the age of 11 suggesting successful applicability of the scale with further validation.