{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T11:05:08Z","timestamp":1779966308486,"version":"3.53.1"},"reference-count":22,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T00:00:00Z","timestamp":1779926400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Relapsing-remitting multiple sclerosis (RRMS) is frequently associated with anxiety and depressive symptoms, which significantly impact quality of life and clinical outcomes. The Hospital Anxiety and Depression Scale (HADS) is widely used to screen for psychological distress in medical populations. To perform a preliminary psychometric evaluation of the Romanian version of HADS in patients with RRMS, focusing on internal consistency and construct-related associations. Methods: This cross-sectional study included 60 RRMS patients. Internal consistency was assessed using Cronbach\u2019s alpha and corrected item\u2013total correlations. Construct-related evidence was explored through correlations with Expanded Disability Status Scale (EDSS) scores and disease duration, as well as known-groups comparisons based on disability level. Results: HADS demonstrated acceptable internal consistency (HADS-A \u03b1 = 0.834; HADS-D \u03b1 = 0.767). Depressive symptoms showed a moderate association with neurological disability (\u03c1 = 0.456, p &lt; 0.001), whereas no significant association was observed between anxiety symptoms and EDSS. Patients with higher disability had significantly higher HADS-D scores (p = 0.001), while HADS-A scores did not differ between groups. Conclusions: The Romanian version of HADS provides preliminary evidence of acceptable internal consistency and construct-related validity in RRMS. These findings support its potential use as a screening tool for psychological distress while highlighting the need for larger studies including factor analysis and test\u2013retest reliability.<\/jats:p>","DOI":"10.3390\/jcm15114165","type":"journal-article","created":{"date-parts":[[2026,5,28]],"date-time":"2026-05-28T09:57:43Z","timestamp":1779962263000},"page":"4165","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Preliminary Psychometric Evaluation of the Romanian Version of the Hospital Anxiety and Depression Scale in Relapsing-Remitting Multiple Sclerosis"],"prefix":"10.3390","volume":"15","author":[{"given":"Lilia","family":"B\u00f6ckels","sequence":"first","affiliation":[{"name":"Neurology Department, Rehabilitation Hospital, 700661 Ia\u0219i, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 16 Universitatii Street, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vitalie","family":"Lisnic","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Medicine and Pharmacy \u201cNicolae Testemitanu\u201d, MD-2004 Chisinau, Moldova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Alexa","sequence":"additional","affiliation":[{"name":"Neurology Department, Rehabilitation Hospital, 700661 Ia\u0219i, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 16 Universitatii Street, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Belenciuc","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Medicine and Pharmacy \u201cNicolae Testemitanu\u201d, MD-2004 Chisinau, Moldova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raul Andrei","family":"Cre\u021bu","sequence":"additional","affiliation":[{"name":"Neurology Department, Rehabilitation Hospital, 700661 Ia\u0219i, Romania"},{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 16 Universitatii Street, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2265-8658","authenticated-orcid":false,"given":"Doina","family":"Ropot","sequence":"additional","affiliation":[{"name":"Department of Neurology, State University of Medicine and Pharmacy \u201cNicolae Testemitanu\u201d, MD-2004 Chisinau, Moldova"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Valentin","family":"B\u00eelcu","sequence":"additional","affiliation":[{"name":"Doctoral School, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700454 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dan Iulian","family":"Cuciureanu","sequence":"additional","affiliation":[{"name":"Neurology Department, Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 16 Universitatii Street, 700115 Ia\u0219i, Romania"},{"name":"Neurology Department I, \u201cProf. Dr. N. Oblu\u201d Emergency Clinical Hospital, 2 Ateneului Street, 700309 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1038\/nrneurol.2014.139","article-title":"The link between multiple sclerosis and depression","volume":"10","author":"Feinstein","year":"2014","journal-title":"Nat. Rev. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1177\/1352458514564487","article-title":"The incidence and prevalence of psychiatric disorders in multiple sclerosis: A systematic review","volume":"21","author":"Marrie","year":"2015","journal-title":"Mult. 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