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The performance of the K6 and K10 screening scales for psychological distress in the Australian National Survey of Mental Health and Well-Being
Abstract
Background. Two new screening scales for psychological distress, the K6 and K10, have been developed but their relative efficiency has not been evaluated in comparison with existing scales. Method. The Australian National Survey of Mental Health and Well-Being, a nationally representative household survey, administered the WHO Composite International Diagnostic Interview (CIDI) to assess 30-day DSM-IV disorders. The K6 and K10 were also administered along with the General Health Questionnaire (GHQ-12), the current de facto standard of mental health screening. Performance of the three screening scales in detecting CIDI/DSM-IV mood and anxiety disorders was assessed by calculating the areas under receiver operating characteristic curves (AUCs). Stratum-Specific Likelihood Ratios (SSLRs) were computed to help produce individual-level predicted probabilities of being a case from screening scale scores in other samples. Results. The K10 was marginally better than the K6 in screening for CIDI/DSM-IV mood and anxiety disorders (K10 AUC: 0·90, 95%CI: 0·89–0·91 versus K6 AUC: 0·89, 95%CI: 0·88–0·90), while both were significantly better than the GHQ-12 (AUC: 0·80, 95%CI: 0·78–0·82). The SSLRs of the K10 and K6 were more informative in ruling in or out the target disorders than those of the GHQ-12 at both ends of the population spectrum. The K6 was more robust than the K10 to subsample variation. Conclusions. While the K10 might outperform the K6 in screening for severe disorders, the K6 is preferred in screening for any DSM-IV mood or anxiety disorder because of its brevity and consistency across subsamples. Precision of individual-level prediction is greatly improved by using polychotomous rather than dichotomous classification.
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In the citing paper
“The K-10 has been used as a screener to accurately detect common mental disorders.24”
From Evaluating a stepped care model of psychological support for adults affected by adversity: study protocol for a randomised controlled trial in Jordan (2024) · cites this paper as [24]
In the citing paper
“This measure has good reliability (α = 0.93) (44) and validity (45).”
From The acceptability, feasibility, and preliminary efficacy of a supported online self-help treatment program for binge-eating disorder (2023) · cites this paper as [45]
In the citing paper
“Several Australian studies using national survey data support the psychometric properties of the K10 including its validity as a measure of distress and as screen for mental health disorders, particularly anxiety and depressive conditions (1, 42, 43).”
In the citing paper
“The K-10 has excellent psychometric properties (Andrews and Slade, 2001), including high internal consistency (α = 0.93; Kessler et al., 2002) and discriminant validity (Furukawa et al., 2003).”
From Online mindfulness-enhanced cognitive behavioural therapy for anxiety and depression: Outcomes of a pilot trial (2018) · cites this paper as Furukawa et al., 2003
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Metadata
- Authors
- FURUKAWA, T. A., KESSLER, R. C., SLADE, T., & ANDREWS, G.
- Affiliations
- Harvard University (US)
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2003-02
- Volume
- 33
- Issue
- 2
- Pages
- 357-362
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2167044045
- Cited by
- 1,570
- References
- 4
- Citations by year
- 2026: 46 · 2025: 87 · 2024: 89 · 2023: 92 · 2022: 104 · 2021: 140 · 2020: 108 · 2019: 74 · 2018: 83 · 2017: 69 · 2016: 85 · 2015: 84 · 2014: 81 · 2013: 70 · 2012: 74
- FWCI
- 15.31
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (U01-MH-60220, U01MH060220)
- National Institute on Drug Abuse (R01DA012058, R01 DA12058)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- K6, K10, psychological distress screening, GHQ-12, mood disorders, anxiety disorders, DSM-IV disorders, Composite International Diagnostic Interview, receiver operating characteristic, personalized prediction
- MeSH terms
- Adolescent, Adult, Australia, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Mass Screening, Middle Aged, Surveys and Questionnaires, Self Concept, Reproducibility of Results, Prevalence, Logistic Models, Diagnostic and Statistical Manual of Mental Disorders
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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