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.

It asks about depression-related thoughts and feelings during the past seven days.

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

It measures one symptom domain. It does not make a diagnosis.

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.

That distinction matters.

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 rates each of eight experiences from never to always based on the past seven days.

Each response contributes a value from 1 to 5.

Eight items. Seven days. One response per item.

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.

Different content. Different scales.

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.

If six or seven items are answered, multiply the available raw sum by 8, divide by the number answered, and round to the nearest whole number. Then use the conversion table.

Do not score the form when fewer than six items are answered.

Raw score is not T-score.

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.

A severity band is not a diagnosis.

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 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.

Short forms trade breadth for speed. Keep that tradeoff visible.