Survey Measurement Tools

Patient Health Questionnaire (PHQ-9)

Description: The PHQ-9 is a self-administered 9-item scale used to detect and assess the severity of depressive symptoms. Items ask respondents to reflect upon feelings and experiences over the past 2-week period. It is also available as an 8, 4 or 2 item scale. 

Scale: 0 (not at all); 1 (several days); 2 (more than half of days); 3 (nearly every day)

Language availability: Spanish; Multiple languages available here

Example publications: 

• B. Arroll: Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population
• C. Beard et al: Validation of the PHQ-9 in a psychiatric sample
• G.E. Simon et al: Does response on the PHQ-9 depression questionnaire predict subsequent suicide attempt or suicide death?

Center for Epidemiologic Studies Depression Scale Revised (CESD-R-10)

Description: The CESD-R-10 is a self-administered 10-item depression screening tool. Items ask respondents to reflect upon their feelings and experiences over the past 1-2 weeks. 

Scale: 0 (rarely or none of the time); 1 (some or a little of the time); 2 (occasionally or a moderate amount of time); 3 (all of the time)

Language availability: Multiple languages available here

Example publications: 

• A. Butler et al: Interrelationships among depression, anxiety, flourishing and cannabis use in youth
• D. Chelowby et al: Mobile app use in adults with comorbid Type 2 diabetes and depression
• A. Ehsan et al: Collaborative competence, social capital, and mental health: A cross-sectional analysis of a community-based intervention for older adults
• E. Haroz: Psychometric evaluation of a self-report scale to measure adolescent depression: the CESDR-10 in two national adolescent samples in the United State

Mental Health Interview (MHI-5)

Description: The MHI-5 is a 5-item self-administered screening of depression and anxiety. Participants are asked to reflect upon positive and negative aspects of mental health over the past month.  

Scale: 6 (All of the time); 5 (Most of the time); 4 (A good bit of the time); 3 (Some of the time); 2 (A little bit of the time); 1 (None of the time); some items are reverse scored so that a higher score indicates better mental health, and lower scores are indicative of possible poor mental health.

Example publications: 

• M. Rivera-Riquelme et al: The Revised Mental Health Inventory-5 (MHI-5) as an ultra-brief screening measure of bidimensional mental health in children and adolescents
• H.J. Rompf et al: Screening for mental health: validity of the MHI-5 using DSM-IV Axis 1 psychiatric disorders as a gold standard 
• B.L. Wise et al: Psychological factors and their relation to osteoarthritis pain

Composite International Diagnostic Interview

Description: The CIDI was developed by the World Health Organization (WHO) to assess prevalence and epidemiology of generalized anxiety disorder, panic disorder and major depression. Lifetime and 12-month versions of the interview are available, as well as long and short forms. 

Scale: Each item is scored individually.

Example publications:

• M.P Austin: Depressive and anxiety disorders in the postpartum period: how prevalent are they and can we improve their detection?
• E. Chiu: Epidemiology of depression in the Asia Pacific region
• D.C. Steffans: Prevalence of depression among older Americans: The Aging, Demographics and Memory Study

Major Depression Inventory

Description: The MDI is a brief self-report measure of the presence and severity of depressive symptoms according to the DSM-IV definitions. It was developed by the World Health Organization’s Collaborating Center on Mental Health. Participants are asked to report their feelings over the past 2-week period.

Scale: 6 (All of the time); 5 (Most of the time); 4 (Slightly more than half of the time); 3 (Slightly less than half of the time); 2 (Some of the time); 1 (At no time); higher scores indicate more severe depressive symptoms

Example publications:

• P. Bech: Psychometric evaluation of the Major Depression Inventory (MDI) as depression severity scale using the LEAD (Longitudinal Expert Assessment of All Data) as index of validity

• P. Bech: Applicability and validity of the Major Depression Inventory in patients with Parkinson’s disease

• P. Cuijpers et al: Sensitivity and specificity of the Major Depression Inventory in outpatients

Hamilton Depression Rating Scale

Description: The HDRS is a 17-item scale designed to detect depression and severity of symptoms among adults. Items assess recent feelings, mood, suicidality, appetite and sleep patterns. A 21-item version is available, with 4 additional items used to identify depression subtype. It is designed to be administered by physicians to patients.

Scale: Each item is scored individually on a scale of 0 to 4. Items are summed to create a total score, with higher scores indicating more severe depression.

Example publications:

• J.B.W. Williams: Standardizing the Hamilton Depression Rating Scale: Past, present and future

• J.B.W. Williams: A Structured Interview Guide for the Hamilton Depression Rating Scale

• M. Zimmerman et al: A Review of Studies of the Hamilton Depression Rating Scale in Healthy Control: Implications for the Definition of Remission in Treatment Studies of Depression

Kessler-6

Description: The Kessler-6 is a 6-item inventory of participant experiences of distress resulting from depression and anxiety in the previous 4-week period.

Scale: Likert scale: 5 (All of the time); 4 (Most of the time); 3 (Some of the time); 2 (A little of the time); 1 (None of the time); higher scores indicate greater feelings of distress

Language availability: Multiple languages available here

Example publications:

• J. Prochaska et al: Validity study of the K6 scale as a measure of moderate mental distress based on mental health treatment need and utilization

• Y. Stolk et al: Clinical use of the Kessler psychological distress scales with culturally diverse groups

• L. Zhang: A Mokken scale analysis of the Kessler-6 screening measure among Chinese older population: findings from a national survey

Depression, Anxiety and Stress Scale (DASS)

Description: The DASS is a 42-item self-administered assessment of the negative emotional impacts of depression, anxiety and stress. Participants are asked to reflect upon their emotional states over the past week. A shortened 21-item version is also available for use.

Scale: 0 (Did not apply to me at all); 1 (Applied to me to some degree); 2 (Applied to me to a considerable degree); 3 (Applied to me very much)

Language availability: Multiple languages available here

Example publications:

• M. Antony et al: Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales (DASS) in clinical groups and a community sample

• N. Cunningham et al: The structure of emotional symptoms in the postpartum period: Is it unique?

• M. Szabó & P. Lovibond: Anxiety, depression and tension/stress in children

Columbia Suicide Severity Rating Scale (CSSR-S)

Description: The CSSR-S is a measure of suicidal ideation, intent and self-harm, intended to be used primarily in an interview format. Participants are asked about suicidal thoughts, intent and self-harm behaviors both over the lifetime and in the past week.

Scale: Presence or absence of each suicidal risk behaviors/intent. Scores are summed, and higher scores indicate higher risk for suicide and/or self-harm.

Language availability: Multiple languages available here

Example publications:

• L.A. Brown et al: C-SSRS performance in emergency department patients at high risk for suicide

• P. Gipson: Columbia-Suicide Severity Rating Scale: Predictive Validity With Adolescent Psychiatric Emergency Patients

• I Katz et al: Use of the Columbia-Suicide Severity Rating Scale (C-SSRS) in a large sample of Veterans receiving mental health services in the Veterans Health Administration

• K Yershova: Asking about Suicide as Suicide Prevention: The Columbia Suicide Severity Rating Scale (C-SSRS)

Hospital Anxiety and Depression Scale (HADS)

Description: The HADS is a 14-item scale that includes 7 items related to depression and 7 items related to anxiety, to be used for patients in a hospital or outpatient setting. Participants are asked about their feelings and experiences over the past week.

Scale: Each item is scored individually on a scale of 0-3. Anxiety measures and depression measures are summed separately.

Example publications:

• I. Bjelland: The validity of the Hospital Anxiety and Depression Scale An updated literature review

• B. Carroll: Screening for Depression and Anxiety in Cancer Patients Using the Hospital Anxiety and Depression Scale

General Health Questionnaire-12 (GHQ-12)

Description: The GHQ-12 is a 12-item measure of current mental health, including depression. Respondents are asked about their recent mental health state, including both positive and negative feelings, symptoms and behaviors.

Scale: 0 (Not at all); 1 (No more than usual); 2 (Rather more than usual); 3 (Much more than usual); some items are reverse-coded

• M. Hankins: The reliability of the twelve-item general health questionnaire (GHQ-12) under realistic assumptions

• Y. Hu: Can the 12-item General Health Questionnaire be used to measure positive mental health?

• M. Romppel: What is the General Health Questionnaire-12 assessing?: Dimensionality and psychometric properties of the General Health Questionnaire-12 in a large scale German population sample

Beck’s Depression Inventory

Description: BDI is a 21-item self-assessment of depression symptoms, including current feelings, thoughts and physical symptoms.

Scale: Items are scored individually on a scale of 0-3 and summed for a total score.

Example publications:

• A. Beck et al: Psychometric properties of the Beck Depression Inventory: Twenty-five years of evaluation

• R. Steer et al: Use of the Beck Depression Inventory-II with depressed geriatric inpatients

• A. Beck et al: Screening for major depression disorders in medical inpatients with the Beck Depression Inventory for Primary Care

Generalized Anxiety Disorder Scale (GAD-7)

Description: The GAD-7 is a 7-item self-administered screening to detect symptoms of generalized anxiety disorder. Respondents are asked to recall their feelings and behaviors over the past 2 weeks.

Scale: 0 (Not at all); 1 (Several days); 2 (More than half of days); 3 (Nearly every day); items are summed for a total score

Language availability: Additional languages available here

Example publications:

• C. Beard et al: Beyond generalized anxiety disorder: Psychometric properties of the GAD-7 in a heterogeneous psychiatric sample

• M.A. Ruiz et al: Validity of the GAD-7 scale as an outcome measure of disability in patients with generalized anxiety disorders in primary care

• R. Spitzer et al: A Brief Measure for Assessing Generalized Anxiety Disorder: The GAD-7

Cambridge Depersonalization Scale

Description: The Cambridge Depersonalization Scale is a 29-item assessment of depersonalization, defined by feelings of detachment (separation from one’s own body or thoughts) and derealization (an altered perception of the world or reality).

Scale: Each item asks participants to rate the frequency (0=never; 1=rarely; 2=often; 3=very often; 4=all of the time) and duration (1=few seconds; 2=few minutes; 3=few hours; 4=about a day; 5=more than a day; 6=more than a week) of feelings/thoughts; items are summed for a total score and a higher score indicates higher depersonalization

Example publications:

• M. Michal et al: Distinctiveness and overlap of depersonalization with anxiety and depression in a community sample: Results from the Gutenberg Heart Study

• M. Tuineag et al: Dissociative symptoms as measured by the Cambridge Depersonalization Scale in patients with a bipolar disorder

Description: The Revised Life Orientation Test (LOT-R) is a 10-item self-assessment of one’s general disposition, optimism/pessimism and outlook on life.

Scale: Likert scale: 0 (strongly disagree); 1 (disagree); 2 (neutral); 3 (agree); 4 (strongly agree). Items 3, 7 and 9 are reverse-coded; items 2, 5, 6 and 8 do not contribute to the final score. Other items should be summed for a total score.

Example publications:

• H. Achat et al: Optimism and depression as predictors of physical and mental health functioning: The normative aging study

• H. Glaesmer et al: Psychometric properties and population-based norms of the Life Orientation Test Revised (LOT-R).

• P.Y. Herzberg et al: Separating optimism and pessimism: A robust psychometric analysis of the Revised Life Orientation Test (LOT-R).

• T.W. Smith et al: Optimism, neuroticism, coping, and symptom reports: An alternative interpretation of the Life Orientation Test.

Satisfaction With Life Scale

Description: The Satisfaction With Life Scale is a 5-item self-assessment to measure one’s judgment of their life satisfaction.

Scale: 7 (strongly agree); 6 (agree); 5 (slightly agree); 4 (neither agree nor disagree); 3 (slightly disagree); 2 (disagree) 1 (strongly disagree); items are summed for a total score, and a higher score indicates greater life satisfaction

Example publications:

• A. Gigantesco: The Relationship Between Satisfaction With Life and Depression Symptoms by Gender

• W. Pavot et al: The Satisfaction With Life Scale and the emerging construct of life satisfaction

• W. Pavot et al: Further Validation of the Satisfaction With Life Scale: Evidence for the Cross-Method Convergence of Well-Being Measures

Multidimensional Scale of Perceived Social Support

Description: The Multidimensional Scale of Perceived Social Support (MSPSS) is a 12-item self-assessment of the perceived adequacy of one’s social support from family members, friends and romantic partners.

Scale: 7 (very strongly agree); 6 (strongly agree); 5 (mildly agree); 4 (neutral); 3 (mildly disagree); 2 (strongly disagree); 1 (very strongly disagree); items are summed for a total score and a higher score indicates greater perceived social support.

Example publications:

• J. Canty-Mitchell et al: Psychometric Properties of the Multidimensional Scale of Perceived Social Support in Urban Adolescents

• S.T. Cheng et al: The multidimensional scale of perceived social support: dimensionality and age and gender differences in adolescents

• G.D. Zimet et al: Psychometric characteristics of the Multidimensional Scale of Perceived Social Support.