Hospital Anxiety and Depression Scale (HADS) detects states of anxiety and depression in an adult population. Originally developed by Zigmond and Snaith (1983), it is commonly used to determine the levels of anxiety and depression that a patient is experiencing. The HADS is a fourteen item scale that generates ordinal data, and takes 2- 5 minutes to complete. Seven of the items relate to anxiety and seven relate to depression. Zigmond and Snaith created this outcome measure specifically to avoid reliance on aspects of these conditions that are also common somatic symptoms of illness, for example fatigue and insomnia or hypersomnia. This, it was hoped, would create a tool for the detection of anxiety and depression in people with physical health problems.