The HADS was developed in 1983 [37] and has since been widely used for assessing depression and anxiety [38]. It is self-reported, concise, and uses separate subscales for anxiety and depression, each consisting of seven items rated on a four-point Likert scale. It has been validated in several countries and adapted for use in different languages and settings [3942]. A score of 7 or less is considered normal, 8–11 as borderline and greater than 11 is diagnostic of anxiety or depression. The HADS was used in studies evaluating the psychiatric morbidity amongst SARS survivors [43,44].

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