Psychometric adaptation of the hospital anxiety and depression scale as a self-rated suicide risk assessment instrument among Nigerian surgical patients

Abstract

Background: A key step in the detection of suicide risk in a primarily nonpsychiatric population will be the use of a simple brief self-reported psychometrically valid and reliable instrument that does not require prior training to administer. Objective: This study aimed to explore the possibility of adapting the 14‑item hospital anxiety and depression scale (HADS) as a self-rated suicide risk screening tool in a sample of Nigerian surgical patients. Materials and Methods: This is a cross-sectional study involving 462 Nigerian patients attending a surgical outpatient clinic. They completed the Sociodemographic questionnaire, the 14-item HADS, the suicidality module of the Mini‑International Neuropsychiatric Interview, and the brief version of the World Health Organization Quality of Life Questionnaire. The reliabilities of the HADS-anxiety and depression subscales were evaluated by calculating the omega (ω) coefficients. Receiver operating characteristics curve analysis was performed to determine the suicide risk screening characteristics of the HADS-anxiety and depression subscales. Results: The omega (ω) reliability coefficients of the HADS subscales were satisfactory. At a cutoff score of 10 HADS-anxiety subscale exhibited satisfactory sensitivity (0.750) and specificity (0.938) while the HADS-Depression subscale at a cutoff score of 7 had the best combination of sensitivity (0.750) and specificity (0.905). The prevalence rate of lifetime suicide attempts in our sample was 1.5%, whereas 1.8% of our respondents had high suicide risk. Conclusion: The 14-item HADS has shown to be a suitable self-rated suicide risk assessment tool among Nigerian surgical patients.