The underdiagnosis of depression and anxiety in the medical complications, improve compliance to treatment, and facilitate the "appropriate" use of health care resources.

OBJECTIVES: To determine the prevalence of depression and/or anxiety in the in-patient medically ill and to validate the Hospital Anxiety and Depression Scale (HADS) for Filipinos.

METHODS: To aid clinicians, the Hospital Anxiety and Depression Scale (HADS), a 14-item self-report questionnaire was validated in this cross-sectional study of 710 medically ill in-patients, to be able to determine how well it identified depression and anxiety against the criterion of a diagnostic psychiatric interview and to determine the optimal cut-off score of the HADS for Filipinos with the use of the Receiver Operating Characteristics (ROC).

RESULTS: The prevalence of depression was 26.9% anxiety was 14.3%, and the 'mixed diagnosis' of both was 13.7% among the medically-ill. The overall prevalence was 54.9%. The results showed that the optimal cut-off score for the HADS/ HADS-P is a score of 11, with a sensitivity of 75%, specificity of 70% and PPV of 75%.

CONCLUSION: The HADS/ HADS-P will provide clinicians with a reliable, valid and practical screening tool for identifying the two most common clinical problems in the medically ill, depression and anxiety. The HADS/ HADS-P can serve as a guide for clinicians towards the diagnosis of depression and anxiety, but it cannot be the sole basis for diagnosis.