The CORE‐10: A short measure of psychological distress for routine use in the psychological therapies
Abstract
Background : There is a need for a generic, short, and easy‐to‐use assessment measure for common presentations of psychological distress in UK primary care mental health settings. This paper sets out the development of the CORE‐10 in response to this need. Method : Items were drawn from the CORE‐OM and 10 items were selected according to a combination of usefulness, coverage of item clusters, and statistical procedures. Three CORE‐OM datasets were employed in the development phase: (1) a primary care sample, (2) a sample from an MRC platform trial of enhanced collaborative care of depression in primary care, and (3) a general population sample derived from the Office of National Statistics Psychiatric Morbidity Follow‐up survey. A fourth dataset comprising a sample from an occupational health setting was used to evaluate the CORE‐10 in its standalone format. Results : The internal reliability (alpha) of the CORE‐10 was .90 and the score for the CORE‐10 correlated with the CORE‐OM at .94 in a clinical sample and .92 in a non‐clinical sample. The clinical cut‐off score for general psychological distress was 11.0 with a reliable change index (90% CI) of 6. For depression, the cut‐off score for the CORE‐10 was 13 and yielded sensitivity and specificity values of .92 (CI=.83–1.0) and 0.72 (CI=.60–.83) respectively. Conclusion : The CORE‐10 is an acceptable and feasible instrument that has good psychometric properties and is practical to use with people presenting with common mental health problems in primary care settings.
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Previous studies by Spence et al. (2024) found that almost half (47.6%) of CMs scored 13 or over on the CORE-10, which is associated with having clinical depression.
“almost half (47.6%) scoring 13 or over, which is associated with having clinical depression (Barkham et al., 2013).”
From Content Moderator Mental Health and Associations with Coping Styles: Replication and Extension of Previous Studies (2025) · cites this paper as Barkham et al., 2013
One study found that over half of the surveyed content moderators scored high (13 and over) on a general depression scale (CORE-10), indicating clinical depression.
“One study found that over half of the surveyed content moderators scored high (13 and over) on a general depression scale (CORE-10), indicating clinical depression [13,169].”
From Measuring the Mental Health of Content Reviewers, a Systematic Review (2025) · cites this paper as [13]
CORE-OM and CORE-10 have good psychometric properties.
“Both CORE-OM and CORE-10 have shown good psychometric properties [55, 56].”
The CORE-OM and CORE-10 are screening measures for psychological distress, including items for well-being, psychological symptoms, functioning, and risk.
“The CORE-OM and CORE-10 are screening measures for psychological distress, including items for well-being, psychological symptoms, functioning, and risk.”
From A Virtual Reality-Assisted Cognitive Behavioral Therapy for and With Inuit in Québec: Protocol for a Proof-of-Concept Randomized Controlled Trial (2023) · cites this paper as [30]
The CORE-10 with a cutoff score of 11 differentiated between clinical and nonclinical general samples with a sensitivity of .85.
“The CORE-10 with a cutoff score of 11 differentiated between clinical and nonclinical general samples with a sensitivity of .85.”
From A Virtual Reality-Assisted Cognitive Behavioral Therapy for and With Inuit in Québec: Protocol for a Proof-of-Concept Randomized Controlled Trial (2023) · cites this paper as [30]
The CORE-10 internal consistency was α=.90, and it had a reliable change index of 6 points.
“Its internal consistency was α=.90, and it had a reliable change index of 6 points [30].”
From A Virtual Reality-Assisted Cognitive Behavioral Therapy for and With Inuit in Québec: Protocol for a Proof-of-Concept Randomized Controlled Trial (2023) · cites this paper as [30]
The CORE-10 has excellent internal reliability (α = .90) with a clinical cut-off of 11 for general psychological distress.
“It has excellent internal reliability ( α = .90) with a clinical cut-off of 11 for general psychological distress.”
From ACT-i, an insomnia intervention for autistic adults: A pilot study (2023) · cites this paper as Barkham et al., 2013
We used the CORE-10 to ensure randomization was successful in terms of distress at pre.
“Likewise, we used the CORE-10 (Barkham et al., 2013) to ensure randomization was successful in terms of distress, at pre.”
From An ACT self-help intervention for adults with a visible difference in appearance: A pilot feasibility and acceptability randomized controlled study. (2023) · cites this paper as Barkham et al., 2013
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“The Friedman test was non-significant for both the CORE-10, λ 2 = 3.00, p = .223, and FFS, λ 2 = 2.70, p = .260.”
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“The CORE-10 (Barkham et al., 2013) was used prior to randomization to ascertain that the participants met the inclusion and exclusion criteria.”
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“Outcomes in Routine Evaluation (Core-10; Barkham et al., 2013) The CORE-10 assesses psychological distress over the previous week.”
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“…10/11 (where 10 is in the non-clinical range and 11 is in the clinical range), while a cut-off score of 13 yields sensitivity and specificity values of .92 and 0.72, respectively, against a diagnosis of DSM-IV depression (Barkham et al ., 2013; Connell and Barkham, 2007; Jacobson and Truax, 1991).”
BackgroundMethodInfluentialMeasuring the Mental Health of Content Reviewers, a Systematic Review
Gonzalez, A., & Matias, J. N. (2025) · arXiv · doi:10.48550/arxiv.2502.00244 · Cited by 1 · see citing works
“One study found that over half of the surveyed content moderators scored high (13 and over) on a general depression scale (CORE-10), indicating clinical depression [13, 169].”
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- Authors
- Barkham, M., Bewick, B., Mullin, T., Gilbody, S., Connell, J., Cahill, J., Mellor-Clark, J., Richards, D., Unsworth, G., & Evans, C.
- Affiliations
- University of Sheffield (GB)
- University of Leeds (GB)
- University of York (GB)
- CORE IMS Rugby
- University of Exeter (GB)
- Kingston Hospital (GB)
- University of Nottingham (GB)
- Corresponding author
- Barkham, Michael
- ORCID
- Venue
- Counselling and Psychotherapy Research
- Publisher
- Wiley
- Published
- 2013-02-26
- Volume
- 13
- Issue
- 1
- Pages
- 3-13
- ISSN
- 1473-3145 (ISSN-L)
- 1746-1405
- OpenAlex
- W2046014761
- Cited by
- 413
- References
- 22
- Citations by year
- 2026: 49 · 2025: 66 · 2024: 50 · 2023: 48 · 2022: 41 · 2021: 39 · 2020: 26 · 2019: 18 · 2018: 15 · 2017: 17 · 2016: 14 · 2015: 12 · 2014: 12 · 2013: 5 · 2012: 1
- FWCI
- 12.85
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Counselling and Psychotherapy Research (publishedVersion)
- Topics
- 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
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Keywords
- CORE-10, psychological distress, CORE-OM, depression screening, primary care mental health, collaborative care, psychometric properties, occupational health, psychiatric morbidity
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