Cross-cultural adaptation into Punjabi of the English version of the Hospital Anxiety and Depression Scale

Deirdre A Lane^*¹ , Jagdish Jajoo^*¹^,2 , Rod S Taylor³ , Gregory YH Lip¹ and Kate Jolly³ for the Birmingham Rehabilitation Uptake Maximisation (BRUM) Steering Committee

¹University Department of Medicine, City Hospital, Dudley Road, Birmingham B18 7QH, UK

²Department of Psychiatry, Dorothy Pattison Hospital, Walsall WS2 9XH, UK

³Department of Public Health and Epidemiology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK

author email corresponding author email* Contributed equally

BMC Psychiatry 2007, 7:5doi:10.1186/1471-244X-7-5


Published:	26 January 2007

Abstract

Background

We wanted to use a Punjabi version of the Hospital Anxiety and Depression Scale (HADS) to enable non-English speaking patients to participate in a clinical trial. The aim of the study was to translate and validate the Hospital Anxiety and Depression Scale into Punjabi.

Methods

The HADS was translated into Punjabi by a multidisciplinary team, verified against the original version, and administered to 73 bilingual patients attending an outpatient clinic.

Results

One sample t-tests and the Bland-Altman plots demonstrated acceptable linguistic agreement between the two versions of the HADS. Spearman's rank-order correlation coefficients (p < 0.0001) demonstrate excellent conceptual agreement between each item and its corresponding subscale score, for both versions. Concordance rates revealed that the Punjabi HADS adequately identified borderline cases of anxiety (80.8%), definite cases of anxiety (91.8%) and depression (91.8%), but was less reliable in identifying borderline cases of depression (65.8%). Cronbach alpha coefficients revealed high levels of internal consistency for both the Punjabi and English versions (0.81 and 0.86 for anxiety and 0.71 and 0.85 for depression, respectively).

Conclusion

The Punjabi HADS is an acceptable, reliable and valid measure of anxiety and depression among physically ill Punjabi speaking people in the United Kingdom.