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The Ability of the Hopkins Symptom Checklist-5 to Identify Generalized Anxiety Disorder and Major Depressive Disorder in the General Population

Author

Listed:
  • Benedicte Kirkøen

    (Department of Mental Health, Norwegian Institute of Public Health, 0473 Oslo, Norway)

  • Ragnhild Elise Ørstavik

    (Department of Mental Health, Norwegian Institute of Public Health, 0473 Oslo, Norway)

  • Anne Reneflot

    (Department of Mental Health, Norwegian Institute of Public Health, 0473 Oslo, Norway)

  • Jens Christoffer Skogen

    (Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
    Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, 0473 Oslo, Norway
    Alcohol and Drug Research Western Norway, Stavanger University Hospital, 4068 Stavanger, Norway)

  • Børge Sivertsen

    (Department of Health Promotion, Norwegian Institute of Public Health, 5015 Bergen, Norway
    Department of Research & Innovation, Helse-Fonna HF, 5525 Haugesund, Norway)

  • Ann Kristin Skrindo Knudsen

    (Department of Disease Burden, Norwegian Institute of Public Health, 5015 Bergen, Norway)

Abstract

Background : The Hopkins Symptom Checklist (HSCL) is a widely used measure of anxiety and depression symptoms. The short form HSCL-5 is especially suitable for large population-based studies, but its ability to detect mental disorders in the general population remains unknown. The aim of the study was to assess how well the HSCL-5 identified cases of generalized anxiety disorder (GAD) and major depressive disorder (MDD) measured by the Composite International Diagnostic Interview (CIDI) 5.0 and to find the optimal sex-specific cut-off levels of the HSCL-5. Methods : Participants from the population-based Trøndelag Health Study (HUNT) in Norway were recruited for the current study. Between April and September 2020, 1343 participants (64% women) aged 20–65 years completed the CIDI, followed by the HSCL-5. The overall agreement between the HSCL-5 and GAD or MDD measured by CIDI was examined with Receiver Operator Characteristics (ROC) analysis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive values (NPV) for different cut-off levels were assessed. Results : The area under the curve for GAD or MDD was 0.90 (CI 95% = 0.85–0.95) for women and 0.85 (CI 95% = 0.68–1.00) for men. For women, a cut-off level of ≥1.80 had the best balance between sensitivity (85%) and specificity (84%), while the corresponding numbers were ≥2.00, 73%, and 93% for men. The global PPV was 21%, while the NPV was 99%. Conclusions : The HSCL-5 has high sensitivity and specificity for identifying cases of GAD or MDD. In the current study, the positive predictive value of HSCL-5 was low.

Suggested Citation

  • Benedicte Kirkøen & Ragnhild Elise Ørstavik & Anne Reneflot & Jens Christoffer Skogen & Børge Sivertsen & Ann Kristin Skrindo Knudsen, 2025. "The Ability of the Hopkins Symptom Checklist-5 to Identify Generalized Anxiety Disorder and Major Depressive Disorder in the General Population," IJERPH, MDPI, vol. 22(5), pages 1-14, April.
    • Handle: RePEc:gam:jijerp:v:22:y:2025:i:5:p:698-:d:1644837
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    References listed on IDEAS

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    1. Andrea Rørvik Marti & Eirik Degerud & Tom Sterud, 2022. "Onset of Work-Life Conflict Increases Risk of Subsequent Psychological Distress in the Norwegian Working Population," IJERPH, MDPI, vol. 19(20), pages 1-9, October.
    2. María Rodríguez-Barragán & María Isabel Fernández-San-Martín & Ana Clavería-Fontán & Susana Aldecoa-Landesa & Marc Casajuana-Closas & Joan Llobera & Bárbara Oliván-Blázquez & Eva Peguero-Rodríguez, 2021. "Validation and Psychometric Properties of the Spanish Version of the Hopkins Symptom Checklist-25 Scale for Depression Detection in Primary Care," IJERPH, MDPI, vol. 18(15), pages 1-15, July.
    3. Guo, Y. & Kopec, J.A. & Cibere, J. & Li, L.C. & Goldsmith, C.H., 2016. "Population survey features and response rates: A randomized experiment," American Journal of Public Health, American Public Health Association, vol. 106(8), pages 1422-1426.
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