Usage conditions apply. Free to use. The Psychiatric Research Unit, Mental Health Centre North Zealand requests that you register before using the WHO-5 Well-Being Index.
Over the last two weeks, how often have you been bothered by…
At no time0
Some of the time1
Less than half of the time2
More than half of the time3
Most of the time4
All of the time5
Score
01I have felt cheerful and in good spirits.
-
02I have felt calm and relaxed.
-
03I have felt active and vigorous.
-
04I woke up feeling fresh and rested.
-
05My daily life has been filled with things that interest me.
-
0-3score item↑↓moveScored locally - nothing leaves this page
0 of 5
0 / 25
WHO-50 / 5
Over the last two weeks, how often have you been bothered by…
Scored locally - nothing leaves this page
01I have felt cheerful and in good spirits.
02I have felt calm and relaxed.
03I have felt active and vigorous.
04I woke up feeling fresh and rested.
05My daily life has been filled with things that interest me.
The WHO-5 Well-Being Index is a five-item self-report measure of subjective psychological wellbeing over the preceding two weeks. Unlike most instruments in this library, every item is positively worded - respondents rate how often they have felt cheerful, calm, active, rested and interested in daily life. It measures the presence of wellbeing rather than the presence of symptoms, which makes it acceptable to patients and useful where symptom checklists feel confronting.
Because low wellbeing tracks closely with depression, the WHO-5 doubles as a first-line depression screen: low scores flag people who warrant assessment with a symptom-based instrument. It is also widely used as an outcome measure, sensitive to change in trials of antidepressants, psychotherapy and diabetes care.
02 - Origin & purpose
Where it comes from.
The WHO-5 was developed by Per Bech and colleagues at the WHO Collaborating Centre in Mental Health, Frederiksborg General Hospital (Hillerød, Denmark), and introduced in 1998 by the WHO Regional Office for Europe as part of the DEPCARE project on wellbeing and depression in primary care. It was distilled from longer WHO wellbeing scales, retaining only positively phrased items covering mood, vitality and interest.
Its purpose was a brief, non-intrusive measure usable across cultures and settings. It has since been translated into more than 30 languages and applied in over 35 countries, in settings from primary care and endocrinology to psychiatry. In 2024 WHO formally took over the copyright, keeping the instrument freely available without permission requirements.
03 - Scoring & cutoffs
How scoring works.
Each of the five items is scored 0 ("at no time") to 5 ("all of the time"), giving a raw score of 0-25. The raw score is multiplied by 4 to give a percentage score of 0-100, where 0 is worst imaginable and 100 is best imaginable wellbeing - note that higher scores are better, the reverse of most scales in this library. A score of 50 or below indicates poor wellbeing and is the standard trigger for a follow-up depression assessment; a score of 28 or below suggests likely depression. A change of 10 points is regarded as clinically meaningful.
Score
Severity
Interpretation
0–7
Very low
Very low wellbeing. Screen further for depression.
8–12
Low
Low wellbeing. A score of 13 or below (50% or less) indicates a need for further assessment.
13–25
Adequate
Adequate wellbeing.
04 - Validation evidence
How well it performs.
The 2015 systematic review by Topp and colleagues, covering 213 studies, concluded the WHO-5 has high clinimetric validity, works as a depression screen across clinical populations, and is sensitive to change. In a prospective primary-care cohort (Henkel et al., 2003), it detected depression with high sensitivity but modest specificity - it casts a wide net, so positive screens need confirmation with a diagnostic instrument. Item-response-theory analyses across 35 countries support a single wellbeing dimension with measurement invariance across cultures.
93% / 64%
Sensitivity / specificity
Depression screening in primary care at the ≤52 cutoff (Henkel et al., 2003).
0.81-0.92
Cronbach's alpha
Internal consistency across validation studies.
10 points
Meaningful change
On the 0-100 scale (Topp et al., 2015).
35+
Countries validated
Available in more than 30 languages.
05 - How it compares
How it compares to the alternatives.
Instrument
Items
Time
When to reach for it
WHO-5
5
~1 min
Positively worded wellbeing index; screen and outcome measure.
Broad health-related quality of life; reach for it for whole-of-health outcome measurement.
06 - When to use it
Right tool, wrong tool.
Reach for it when
-Routine wellbeing monitoring in long-term conditions, for example diabetes reviews
-First-line depression screening where symptom checklists feel stigmatising
-Tracking response to treatment over time
-Older adults and perinatal settings, where positive wording aids acceptability
-Population and workplace wellbeing surveys
Reach for something else when
-Confirming a depression diagnosis (use the PHQ-9 or MDI)
-Assessing suicide risk - there is no risk item, so use a dedicated tool
-Measuring specific symptom domains such as anxiety or insomnia
-Acute crisis assessment
07 - Confidence & precision
Reading the score with care.
A 10-point change on the 0-100 scale is the accepted threshold for clinically meaningful change (Topp et al., 2015). With only five items the scale is short, so single-administration precision is limited and scores near the 50-point cutoff should be interpreted with a margin of roughly one response step per item (equivalent to 4 points each). Its specificity of around 64% as a depression screen means roughly one in three positive screens will not have depression on structured assessment - treat a low score as a prompt for conversation and formal assessment, not a diagnosis.
08 - Limitations
What it cannot tell you.
It measures wellbeing, not depression symptoms - a diagnosis can never rest on the WHO-5 alone. Modest specificity produces false-positive screens. Ceiling effects limit discrimination among people with good wellbeing. The two-week window can miss episodic symptoms. Wholly positive wording can be influenced by response style and cultural norms around expressing contentment. It contains no suicidality item, so it must not substitute for risk assessment.
09 - Licensing, explained
How licensing works.
Free to use. The Psychiatric Research Unit, Mental Health Centre North Zealand requests that you register before using the WHO-5 Well-Being Index.
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