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anxiety, depressive symptoms, essential hypertension, reliability, tripartite model



  1. Xiao, Jing MD, PhD
  2. Kong, Tianzhu MS
  3. McWhinnie, Chad M. PhD
  4. Yao, Shuqiao PhD
  5. Zhu, Xiongzhao PhD
  6. Zhao, Shuiping MD
  7. Duan, Shu MD


Background: In patients with hypertension, psychosocial factors, such as depressive symptoms and anxiety, are associated with reduced quality of life and triple the risk of nonadherence with medical treatment regimens. Thus, screening tests are crucial to identify patients who may require further assessment and treatment.


Objectives: The objective of the current study was to test the psychometric properties of the Chinese version of the Mood and Anxiety Symptoms Questionnaire-Short Form (MASQ-SF-C) in patients with essential hypertension.


Methods: The MASQ-SF-C, the Center for Epidemiologic Studies Depression Scale (CES-D), and the State-Trait Anxiety Inventory (STAI) were administered to a convenience sample of 869 hypertensive patients in 4 hospitals. A confirmatory factor analysis was used to test the tripartite model. We evaluate the internal consistency of the MASQ-SF-C and we used the Bland-Altman approach to evaluate convergent validity between the MASQ-SF-C t score and symptoms of (1) depressive symptoms and (2) anxiety.


Results: Cronbach's [alpha] coefficient for the total MASQ-SF-C was .95, and Cronbach's [alpha] coefficients for the 3 subscales were .83 for anhedonic depression (AD), .91 for anxiety arousal (AA), and .94 for general distress (GD), indicating adequate internal consistency reliability. The mean interitem correlation coefficients were as follows: MASQ-SF-C, 0.29; AD, 0.28; AA, 0.38; and GD, 0.40. The 1-month test-retest reliability for the MASQ-SF-C was 0.72. Confirmatory factor analyses indicated that the 3 first-order factors (GD, AD, and AA) fit the data well (nonnormed fit index = 0.953, comparative fit index = 0.936, incremental fit index = 0.936, root-mean-square error of approximation = 0.038).


Conclusions: This study supported the reliability and validity of the MASQ-SF-C, indicating that it can be used for assessing depressive symptoms and anxiety concurrently in Chinese-speaking patients with hypertension.