<p>Anxiety and depression are two of the most common psychological disorders which cause disability and death. Therefore, it is important to have an adequate instrument to improve the management of health resources. The Hospital Anxiety and Depression Scale (HADS) is a widely used screening tool whose psychometric properties have not been evaluated in the Ecuadorian context. We assessed the validity and reliability of the HADS in a sample of 490 adults using exploratory factor analysis and confirmatory factor analysis of nine different versions to determine the underlying factor structure of the instrument. We find that the original version has, relatively, the best psychometric properties. However, consistent with other research, we find ambiguous results that suggest that HAD scores must be interpreted with caution.</p>