This DASS 21 depression anxiety stress scale test evaluates the severity of mental disorder symptoms associated to the three and provides a mild, moderate or severe result. Below the form there are instructions on how to interpret the result as well as in which axis each of the questions belongs too.

1 I found it hard to wind down
2I was aware of dryness of my mouth
3 I couldn’t seem to experience any positive feeling at all
4 I experienced breathing difficulty
5 I found it difficult to work up the initiative to do things
6 I tended to over-react to situations
7 I experienced trembling (eg, in the hands)
8 I felt that I was using a lot of nervous energy
9 I was worried about situations in which I might panic and make a fool of myself
10 I felt that I had nothing to look forward to
11 I found myself getting agitated
12 I found it difficult to relax
13 I felt down-hearted and blue
14I was intolerant of anything that kept me from getting on with what I was doing
15 I felt I was close to panic
16 I was unable to become enthusiastic about anything
17 I felt I wasn’t worth much as a person
18I felt that I was rather touchy
19 I was aware of the action of my heart in the absence of physical exertion
20 I felt scared without any good reason
21 I felt that life was meaningless

Depression Score = 0. This is Normal level.

Anxiety Score = 0. This is a Normal level.

Stress Score = 0. This is a Normal level.

Disclaimer: This tool should NOT be considered as a substitute for any professional medical service, NOR as a substitute for clinical judgement.

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How does this DASS 21 depression anxiety stress scale test work?

This is a health tool that evaluates the severity of behavioral and emotional symptoms that are correlated with depression, anxiety disorder and stress.

There are 21 items that need to be scored as listed below and the test usually takes around 3 to 5 minutes. The assessor advises the patient to consider what they have experienced in the past week as well as at the present and to choose the answer that first comes in mind.

■ Depression symptoms related items: 3, 5, 10, 13, 16, 17, 21.

■ Anxiety disorder related items: 2, 4, 7, 9, 15, 19, 20.

■ Stress related items: 1, 6, 8, 11, 12, 14, 18.

The DASS 21 depression anxiety stress test is not a diagnosis mean by itself, it is merely a self report scheme and should be followed by a complete psychological or psychiatric evaluation.

1. (s) I found it hard to wind down.

2. (a) I was aware of dryness of my mouth.

3. (d) I couldn’t seem to experience any positive feeling at all.

4. (a) I experienced breathing difficulty.

5. (d) I found it difficult to work up the initiative to do things.

6. (s) I tended to over-react to situations.

7. (a) I experienced trembling (eg, in the hands).

8. (s) I felt that I was using a lot of nervous energy.

9. (a) I was worried about situations in which I might panic and make a fool of myself.

10. (d) I felt that I had nothing to look forward to.

11. (s) I found myself getting agitated.

12. (s) I found it difficult to relax.

13. (d) I felt down-hearted and blue.

14. (s) I was intolerant of anything that kept me from getting on with what I was doing.

15. (a) I felt I was close to panic.

16. (d) I was unable to become enthusiastic about anything.

17. (d) I felt I wasn’t worth much as a person.

18. (s) I felt that I was rather touchy.

19. (a) I was aware of the action of my heart in the absence of physical exertion.

20. (a) I felt scared without any good reason.

21. (d) I felt that life was meaningless.

The four available answer choices are described as follows:

■ Never – did not apply to me at all, awarded 0 points.

■ Sometimes – applied to me to some degree, or some of the time, awarded 1 point.

■ Often – applied to me to a considerable degree, or a good part of time, awarded 2 points.

■ Almost always – applied to me very much, or most of the time, awarded 3 points.

DASS 21 score interpretation

The 21 item Depression, Anxiety, Stress Scale questionnaire is used as a quantitative measure of distress along the 3 axes of depression, anxiety and stress reactions and management. Each of the questions is rated from 0 to 3. Therefore each of the axes presents partial scores of 0 to 18-24 depending on the number of questions assigned.

There have been created cut off points for each of the severity categories, however, these should be cautiously used in conjunction to other clinical and observational data and are described in the table below:

Level/Disorder Depression Anxiety Stress
Normal 0 - 4 0 - 3 0 - 7
Mild 5 - 6 4 - 5 8 - 9
Moderate 7 - 10 6 - 7 10 - 12
Severe 11 - 13 8 - 9 13 - 16
Extremely severe ≥ 14 ≥ 10 ≥ 17

References

1. Henry JD, Crawford JR. (2005) The short-form version of the Depression Anxiety Stress Scales (DASS-21): construct validity and normative data in a large non-clinical sample. Br J Clin Psychol; 44(Pt 2):227-39.

2. Wiseman TA, Curtis K, Lam M, Foster K. (2015) Incidence of depression, anxiety and stress following traumatic injury: a longitudinal study. Scand J Trauma Resusc Emerg Med;23:29.

3. Lovibond SH, Lovibond PF. (1995) Manual for the Depression Anxiety & Stress Scales (second edition). Psychology Foundation.