Development of a scale to measure symptoms of anxiety and depression in the general UK population: the psychiatric symptom frequency scale.
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OBJECTIVES: The psychiatric symptom frequency (PSF) scale was developed to assess symptoms of anxiety and depression (i.e. affective symptoms) experienced over the past year in the general population. This study aimed to examine the distribution of PSF scores, internal consistency, and factor structure and to investigate relationships between total scores for this scale and other indicators of poor mental health. PARTICIPANTS: The Medical Research Council national survey of health and development, a class stratified cohort study of men and women followed up from birth in 1946, with the most recent interview at age 43 when the PSF scale was administered. MAIN RESULTS: The PSF scale showed high internal consistency between the 18 items (Cronbach's alpha = 0.88). Ratings on items of the scale reflected one predominant factor, incorporating both depression and anxiety, and two additional factors of less statistical importance, one reflecting sleep problems and the other panic and situational anxiety. Total scores were calculated by adding 18 items of the scale, and high total scores were found to be strongly associated with reports of contact with a doctor or other health professional and use of prescribed medication for "nervous or emotional trouble or depression," and with suicidal ideas. CONCLUSIONS: The PSF is a useful and valid scale for evaluating affective symptoms in the general population. It is appropriate for administration by lay interviewers with minimal training, is relatively brief, and generates few missing data. The total score is a flexible measure which can be used in continuous or binary form to suit the purposes of individual investigations, and provides discrimination at lower as well as upper levels of symptom severity.
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The suicide items of the PSF have demonstrated high internal reliability and validity.
“The suicide items of the PSF have demonstrated high internal reliability and validity [36].”
From A brief intervention to increase uptake and adherence of an online program for depression and anxiety: Protocol for the Enhancing Engagement with Psychosocial Interventions (EEPI) Randomized Controlled Trial (2019) · cites this paper as [36]
The Internal Consistency section reports high reliability (α = 0.88) for the 18-item PSF scale, and the Psychometric Properties section reports that PSF scores discriminate between people with and without suicidal ideation. But the Main Study section says the suicide questions were excluded from that scale; the paper does not establish the internal reliability or validity of the suicide items themselves. Page numbers were not supplied for these passages. (LLM, conf=0.88)
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“A single item from the Psychiatric Symptom Frequency Scale (PSF (Lindelow et al., 1997)) was used to measure suicidal ideation.”
BackgroundMethodMilton, A., Hambleton, A., Roberts, A., Davenport, T., Flego, A., Burns, J., & Hickie, I. (2021) · JMIR Formative Research · doi:10.2196/25329 · Cited by 43 · see citing works
“Respondents’ levels of suicidal thoughts and behaviors in the past 12 months were measured using the 5-item suicidal thoughts and acts subscale from the Psychiatric Symptom Frequency Scale [75].”
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von Spreckelsen, P., Schouten, D., Waslam, N. G., Katuin, P., Heering, H. D., Planting, C., Antypa, N., Kivelä, L., Lancel, M., & Schweren, L. J. S. (2025) · Sleep Medicine: X · doi:10.1016/j.sleepx.2025.100145 · Cited by 7 · see citing works
- Authors
- Lindelow, M., Hardy, R., & Rodgers, B.
- Affiliations
- University College London (GB)
- ORCID
- Venue
- Journal of Epidemiology and Community Health
- Publisher
- BMJ
- Published
- 1997-10
- Volume
- 51
- Issue
- 5
- Pages
- 549-557
- ISSN
- 0141-7681 (ISSN-L)
- 0143-005X
- 1470-2738
- PMC
- PMC1060542
- OpenAlex
- W2068345173
- Cited by
- 113
- References
- 1
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 2 · 2023: 2 · 2022: 4 · 2021: 7 · 2020: 6 · 2019: 10 · 2018: 5 · 2017: 6 · 2016: 5 · 2015: 3 · 2014: 10 · 2013: 3 · 2012: 3
- FWCI
- 2.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Journal of Epidemiology & Community Health (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- ANU Open Research (Australian National University) (submittedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Social Psychology › Mental Health Treatment and Access
- Social Sciences › Decision Sciences › Management Science and Operations Research › Psychometric Methodologies and Testing
- Keywords
- anxiety, depression, affective symptoms, scale development, factor structure, internal consistency, sleep disorders, panic, suicidal ideation, mental health, general population
- MeSH terms
- Adult, Anxiety, Depression, Female, United Kingdom, Humans, Male, Patient Acceptance of Health Care, Psychiatric Status Rating Scales, Psychometrics, ROC Curve, Suicide, Cohort Studies
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