DSM-5-TR Level 2 Depression measure for adults

What this assessment is

The DSM-5-TR Level 2 Depression measure for adults is the eight-item PROMIS Emotional Distress Depression Short Form 8b. A complete raw total from 8 to 40 converts to a T-score from 37.1 to 81.1, and the interpretation bands apply to the T-score, not the raw total. It covers the past seven days and does not diagnose depression.

The American Psychiatric Association lists it among the Level 2 cross-cutting measures used for closer review after a broader symptom assessment.

Who it was designed for

The adult form is for people aged 18 and over.

It is normally completed by the person receiving care before a clinical visit. A knowledgeable informant can complete it when the person cannot, but the PROMIS group has not validated the form as an informant-report measure. Self-report and informant report are not interchangeable evidence.

Use the adult form only for the population and role named on the measure.

How it is administered

The respondent gives one 1-to-5 response for each of eight experiences based on the past seven days.

Each response contributes a value from 1 to 5.

The measure can be repeated at clinically useful intervals. Keep the respondent role, language, timeframe, and scoring version consistent when tracking change.

What it measures

The form focuses on emotional and cognitive experiences of depression, including sadness, helplessness, hopelessness, failure, and negative expectations.

It does not cover every symptom used to diagnose major depressive disorder.

The PHQ-9 maps to nine major-depression symptom groups over two weeks. The CES-D is a 20-item past-week population measure. The BDI-II covers a broader set of self-reported depression symptoms. Do not compare raw totals across them.

How scoring works

Add the eight responses for a raw total from 8 to 40.

Then use the official Depression 8b conversion table to convert the raw total to a PROMIS T-score. For a complete form, the available T-scores run from 37.1 to 81.1.

A T-score of 50 represents the reference mean. Ten T-score points represent one reference standard deviation.

Two authorities give different missing-response instructions. The DSM-5-TR form permits a prorated raw score when six or seven items are answered: multiply the available raw sum by 8, divide by the number answered, round to the nearest whole number, and use its conversion table. Under that method, do not score fewer than six answers.

The current HealthMeasures PROMIS Depression scoring manual uses a different rule. Its raw-sum lookup tables require all eight responses, and it directs missing-response cases to response-pattern scoring through the HealthMeasures Scoring Service.

Record which source and method produced the score. Do not mix the two missing-response rules.

How to interpret the T-score

The official interpretation ranges are:

• below 55: none to slight
• 55.0 to 59.9: mild
• 60.0 to 69.9: moderate
• 70 or higher: severe

These labels describe depression symptom severity on the PROMIS metric. They do not establish major depressive disorder.

Review the T-score with functioning, duration, other symptoms, medical context, and the clinical interview.

For change over time, compare T-scores produced by the same form and method.

What the score cannot tell you

The T-score cannot identify the cause of symptoms, establish a full depressive episode, or choose treatment.

The short form does not cover every physical, behavioral, or diagnostic feature of depression. It also cannot separate depression from grief, trauma, substance use, medication effects, or medical illness.

Use broader assessment when decisions depend on the result.

Evidence and limitations

The official DSM-5-TR measure provides the eight-item form, prorating rule, conversion table, and T-score interpretation bands.

The HealthMeasures PROMIS scoring manual confirms the complete-form range and gives the stricter response-pattern scoring direction for missing responses.

The PROMIS emotional-distress calibration study used a large adult sample and found that short forms retained useful measurement information across a broad severity range.

An independent construct-validity study found expected relationships with other measures but also raised questions about how narrowly the depression construct is represented.