Kessler Psychological Distress Scale (K10)

Ten feelings make up the scale: tiredness for no good reason, nervousness, being so nervous that nothing could calm one down, hopelessness, restlessness or fidgeting, being so restless that one could not sit still, depression, feeling that everything was an effort, being so sad that nothing could cheer one up, and worthlessness. Each is rated by how often it occurred over the past four weeks, from none of the time to all of the time. The items cover the anxious and depressive feelings that most people in psychological difficulty report, without asking about any particular disorder.

Kessler and colleagues (2002) developed the scale for national population health surveys, selecting items that discriminated well across the full range of distress so that a short form could identify people likely to meet criteria for an anxiety or mood disorder. Because of its brevity, it became a standard component of large epidemiological studies, including the World Health Organization (WHO) World Mental Health surveys, and interpretive bands for the total were later described by Andrews and Slade (2001).

The ten ratings are summed into a single total. Lower totals indicate that feelings of distress were rare over the past month; higher totals indicate that they were frequent and, at the upper end, present most of the time. The report places the total within the published descriptive bands. Because the scale measures general distress rather than specific symptoms, a high score indicates that a fuller assessment may be useful without suggesting what the underlying difficulty is.

The scale is used in population surveys, in primary care and in mental health services to identify elevated distress and to monitor change during treatment. On this site, the PHQ-9 and GAD-7 separate depressive and anxious symptoms, the Depression Anxiety Stress Scales (DASS-21) add a stress dimension, and the WHO-5 Well-Being Index approaches the same ground from the side of positive mood.

The Kessler Psychological Distress Scale was developed to measure nonspecific distress, the anxiety and depressed mood shared across common mental disorders, and its scores predict diagnoses of anxiety and mood disorders in population surveys (Kessler et al., 2002; Furukawa et al., 2003).

Higher scores are associated with a greater likelihood of a current mental disorder and with more disability (Andrews & Slade, 2001). Because it targets general distress, it does not discriminate between depression and anxiety, which is a deliberate boundary of the construct (Kessler et al., 2002).

Good discrimination of DSM-IV mood and anxiety disorders (area under the curve about 0.87-0.88); severity bands fall at totals of 20, 25, and 30 (Andrews & Slade, 2001).

“tired out for no good reason?”

Illustrative only. During administration items are presented one screen-set at a time; response-key direction is never shown to respondents.

Item responses are summed to a total score and compared against published screening cutoffs.

The report explains which published screening bands your score falls in and what they mean.