Finally, The Hospital Anxiety and Depression Scale (HADS, 30) is a widely used scale for measuring the symptoms of anxiety and depression among medical inpatients, outpatients and in the general population (31). The HADS is a 14-item questionnaire that measures symptoms of anxiety (7 items) and depression (7 items). For each item, the patient is asked to select from among 4 possible choices (scored from 0 to 3) the one that best describes how they have been feeling over the past week. The HADS yields an anxiety (HADS-A) and a depression (HADS-D) subscale score. We have chosen to administer only the (HADS-D) component because we feel that the other anxiety measure provide enough information in regards to anxiety. In general, the psychometric properties of the HADS are excellent. It has been administered in more than 700 studies to more than 35,000 individuals. Internal consistency for the anxiety and depression subscales show Chronbach alphas of between 0.80-0.93 for the anxiety subscale and between 0.81 and 0.90 for the depression subscale (31,32). Concurrent validity of the HADS is very good as measured by correlation coefficients of between 0.62 and 0.73 for the HADS-D with various well-validated depression scales (e.g., Beck Depression Inventory, SCL-90 Depression subscale (31,32). The HADS has been demonstrated to be sensitive to changes due to disease progression and in response to therapeutic interventions (32). The 7 item modified HADS will take less than 2 minutes to fill out (33).