The following questions ask how you have been feeling over the past 4 weeks. For each question, choose the option that best describes how often you had this feeling.
None of the time1
A little of the time2
Some of the time3
Most of the time4
All of the time5
Score
01In the past 4 weeks, about how often did you feel tired out for no good reason?
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02In the past 4 weeks, about how often did you feel nervous?
-
03In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down?
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04In the past 4 weeks, about how often did you feel hopeless?
-
05In the past 4 weeks, about how often did you feel restless or fidgety?
-
06In the past 4 weeks, about how often did you feel so restless you could not sit still?
-
07In the past 4 weeks, about how often did you feel depressed?
-
08In the past 4 weeks, about how often did you feel that everything was an effort?
-
09In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up?
-
10In the past 4 weeks, about how often did you feel worthless?
-
0-3score item↑↓moveScored locally - nothing leaves this page
0 of 10
0 / 50
K100 / 10
The following questions ask how you have been feeling over the past 4 weeks. For each question, choose the option that best describes how often you had this feeling.
Scored locally - nothing leaves this page
01In the past 4 weeks, about how often did you feel tired out for no good reason?
02In the past 4 weeks, about how often did you feel nervous?
03In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down?
04In the past 4 weeks, about how often did you feel hopeless?
05In the past 4 weeks, about how often did you feel restless or fidgety?
06In the past 4 weeks, about how often did you feel so restless you could not sit still?
07In the past 4 weeks, about how often did you feel depressed?
08In the past 4 weeks, about how often did you feel that everything was an effort?
09In the past 4 weeks, about how often did you feel so sad that nothing could cheer you up?
10In the past 4 weeks, about how often did you feel worthless?
The Kessler Psychological Distress Scale (K10) measures non-specific psychological distress - the mixture of anxious and depressive symptoms that runs through most common mental disorders. Its ten items ask how often, over the past four weeks, a person has felt nervous, hopeless, restless, depressed, worthless or that everything was an effort. Each item is rated from 1 (none of the time) to 5 (all of the time), so the scale captures frequency of distress rather than the presence of any specific diagnosis.
That deliberate non-specificity is the point. Rather than screening for one disorder, the K10 estimates how likely a person is to have any common mental disorder, and how severe it is likely to be. This makes it well suited to intake triage, population surveys and routine outcome monitoring, where the first question is not "which diagnosis?" but "how unwell, and does this person need further assessment?"
02 - Origin & purpose
Where it comes from.
The K10 was developed by Ronald Kessler and Daniel Mroczek for the United States National Health Interview Survey, and the definitive psychometric account was published by Kessler and colleagues in Psychological Medicine in 2002. The developers used item response theory to select ten items, from a much larger pool, that discriminate most precisely in the clinical range of distress - the region where screening decisions are made.
The scale was adopted early and enthusiastically in Australia, where the National Survey of Mental Health and Well-Being and the Australian Bureau of Statistics used it to track population distress, and where Andrews and Slade published the interpretation conventions most services use today. It has since spread worldwide through the WHO World Mental Health surveys, and in Australian primary mental health care it is a mandated routine outcome measure. Its shorter sibling, the K6, was derived from the same item pool for surveys where every question counts.
03 - Scoring & cutoffs
How scoring works.
Each of the ten items is scored 1-5 and the items are summed, giving a total between 10 and 50. Higher scores indicate more frequent distress. The severity bands shown below follow the widely used Australian convention described by Andrews and Slade (2001): 10-19 likely to be well, 20-24 likely mild disorder, 25-29 likely moderate disorder, and 30-50 likely severe disorder. In the 1997 Australian national survey the population mean was 14.2, so most respondents without a mental disorder score well under 20.
One caution when reading the literature: a second scoring convention, used in some US studies, scores each item 0-4 for a total of 0-40. The bands on this page assume the 10-50 convention used by the calculator above; subtract 10 to compare with 0-40 studies.
Score
Severity
Interpretation
10–19
Likely to be well
Score in the range typically associated with no significant psychological distress.
20–24
Mild distress
Likely to have a mild mental disorder. Consider monitoring and brief support.
25–29
Moderate distress
Likely to have a moderate mental disorder. Further assessment is warranted.
30–50
Severe distress
Likely to have a severe mental disorder. Active assessment and treatment are indicated.
04 - Validation evidence
How well it performs.
The K10's screening performance has been examined in large population samples. In the Australian National Survey of Mental Health and Well-Being, Furukawa and colleagues found the K10 discriminated respondents with DSM-IV mood and anxiety disorders from those without, with an area under the ROC curve of 0.90 - marginally better than the six-item K6. Internal consistency is consistently high across countries and administration modes, with Cronbach's alpha typically between 0.88 and 0.93. Against structured diagnostic interviews it performs as well as, or better than, considerably longer distress measures.
0.90
AUC, DSM-IV MOOD & ANXIETY (95% CI 0.89-0.91)
0.88-0.93
CRONBACH'S α ACROSS VALIDATION STUDIES
14.2
MEAN SCORE, 1997 AUSTRALIAN POPULATION
~2-3 min
10 ITEMS - ROUTINE INTAKE & MONITORING
05 - How it compares
How it compares to the alternatives.
Instrument
Items
Time
When to reach for it
K10
10
~2-3 min
Free, well-normed distress index for intake triage and routine outcome monitoring; slightly finer severity gradation than the K6.
When the question is specifically depression severity and monitoring, not general distress.
06 - When to use it
Right tool, wrong tool.
Reach for it when
-Intake triage where you need a fast, diagnosis-agnostic estimate of how unwell someone is.
-Routine outcome monitoring of general distress across a caseload, including mixed anxiety-depression presentations.
-Population or service-level surveys tracking distress over time against established norms.
-Settings that need a free, well-normed instrument with no licensing overhead.
Reach for something else when
-Diagnosing any specific disorder - the K10 cannot distinguish anxiety from depression, let alone subtype either.
-Suicide risk assessment; no item asks about self-harm or suicidal ideation.
-Disorder-specific severity monitoring - use the PHQ-9 for depression or GAD-7 for anxiety.
-Children and younger adolescents; the K10 was developed and normed on adults.
07 - Confidence & precision
Reading the score with care.
The K10 was built, via item response theory, to be most precise in the 90th-99th percentile range of the population distribution - exactly where screening decisions are made - and less precise at low scores. No widely accepted minimal clinically important difference has been established. In practice, small changes of a few points should not be over-interpreted; movement between severity bands, sustained across occasions, is a sounder signal of change than any single-point shift. A standard error of measurement is not routinely reported for the summed score, which is another reason to read band shifts rather than point differences.
08 - Limitations
What it cannot tell you.
- Non-specific by design: an elevated score says "probably unwell", not what with. It cannot separate anxious from depressive presentations.
- Two scoring conventions (10-50 and 0-40) coexist in the literature and cause avoidable confusion when comparing cutoffs.
- The four-week window makes it insensitive to very recent change and unsuited to session-by-session tracking.
- Cutoffs derive mainly from Australian population data; optimal thresholds vary across countries, languages and cultural groups.
- It contains no risk items, so it must never substitute for asking directly about suicidality.
- Like all self-report measures, scores reflect willingness to disclose as much as underlying distress.
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