Are men more depressed than women in Norway? Validity of the Hospital Anxiety and Depression Scale.

OBJECTIVE AND METHODS The aim was to evaluate the depression subscale of the Hospital Anxiety and Depression Scale (HADS-D) by comparing the gender-specific scores with another self-rated measure of mental health (MH), the SF-12 Health Survey, in a large general population (N=16,116). RESULTS Using a score of 8 as a cut-off point for depression, the odds ratio for depression among men versus women was 1.29 [P<.0001; 95% confidence interval (CI): 1.16-1.43]. This contrasted with the results from the SF-12, in which the women had markedly and significantly poorer scores than men did. The women also reported a higher use of medicine for depression. Two of the seven HADS-D questions, related to interest in personal appearance and the ability to enjoy television, radio, and books, explained 70% of the higher depression scores among men. CONCLUSION The results suggest that the validity related to gender differences in HADS-D is highly questionable.