Levels of family anxiety and depression is assessed by the Hospital Anxiety and Depression Scale which consists of 14 items, seven on anxiety and seven on depression, forming two sub-scales. Each item has four descriptive response options to be scored on a 0 to 3 scale. A value of 0 corresponds to not having the symptom, 3 corresponds to having the symptom to a high level. Scores for each of the two sub-scales are constructed by simple summation of its seven items. The developers have suggested that sub-scale scores of 0-7 represent non-cases, 8-10 represent doubtful cases, and 11-21 represent definite cases.