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Use the concern that best matches the first screening question, not every possible symptom.
Estimate one sitting, including reading instructions and checking the result.
Choose how the selected screener result will be used after completion.
Use direct item when self-harm wording should stay inside the first screener route.
Use balanced for general routing, or emphasize speed, safety, repeat monitoring, or broad distress coverage.
Choose whether the briefing should favor one source page, a two-step route, or a broad-first handoff.
Screener route Fit Length Recall window Why it fits Safety caveat Copy
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Decision Recommendation Details Copy
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Source slug Screener page Primary focus Items Score range Recall window State Copy
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Tags: Diagnostics, Psychology, Psychometrics
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People rarely experience low mood, worry, tension, and overload in tidy separate boxes. A rough week can include sadness, sleep changes, panic-like body symptoms, irritability, work pressure, loneliness, and fear about what the symptoms mean. Screening is useful because it gives the first conversation a structure, but the first questionnaire still has to match the question being asked.

A depression screener is built around low mood, loss of interest, sleep, energy, appetite, concentration, and related depressive symptoms. An anxiety screener puts worry, fear, restlessness, and nervous arousal closer to the center. Stress and broad distress measures ask a different question again: how burdened someone feels, how nonspecific distress has changed, or how several symptom areas overlap. Older-adult mood screening adds another distinction because medical illness, medication effects, isolation, function, cognition, bereavement, and safety can all change how a mood questionnaire should be read.

Symptom focus
The main concern a questionnaire is meant to summarize, such as depression, anxiety, stress, broad psychological distress, or older-adult mood.
Recall window
The time period used by the questions. A past-week DASS result, a last-2-weeks PHQ-9 or GAD-7 result, and a past-month PSS or Kessler result should not be compared as if they measured the same span.
Direct-risk wording
Whether the questionnaire asks directly about self-harm. A useful symptom screener without that wording still needs a separate safety question when risk may be present.
Diagram showing symptom focus, use context, recall window, and safety wording feeding a route fit score.
Route fit is a choice aid for the first questionnaire and the next handoff, not a symptom severity score.

The common mistake is to treat one familiar score as a complete answer. PHQ-9 and BDI-II contain direct self-harm wording, while GAD-7, DASS, PSS-10, K10, K6, CES-D-20, GDS-15, BAI, and SAS-style routes do not directly cover the same safety question. That difference should affect routing, not cause people to dismiss otherwise appropriate symptom measures.

A route comparison is most useful before choosing a screener, during visit preparation, or when a program needs a consistent starting point. It cannot diagnose depression or anxiety, prove that someone is safe, or replace qualified care. Its narrower job is to choose the first source page, explain the backup route, and keep the recall window and safety caveat attached to the recommendation.

How to Use This Tool:

Set the routing question before reading the table. The default setup compares mixed mood and stress in a 3 to 6 minute first-pass check while preferring direct self-harm wording.

  1. Choose Primary concern from the symptom area that should drive the first questionnaire: depression or low mood, anxiety or panic symptoms, stress or overload, mixed mood and stress, general psychological distress, or older-adult mood check.
  2. Set Available time for one realistic sitting. Short limits favor K6, GAD-7, PHQ-9, K10, PSS-10, and other compact routes; longer budgets allow DASS-42, BDI-II, BAI, and detailed routes to stay competitive.
  3. Use Use context to separate a first-pass self check from repeat tracking, visit preparation, or a population/program screen. The same screener may rank differently when repeat monitoring or survey use matters.
  4. Set Safety signal preference before trusting the top row. If direct wording is preferred and the best route lacks it, use the Safety Briefing recommendation before opening a symptom page.
  5. Open Advanced only when the routing should lean toward speed, safety, repeat monitoring, broad distress coverage, or a specific Pairing style. Pairing style changes the briefing guidance rather than merging the source screeners.
  6. Read Screener Route Table first, then check Screener Fit Heatmap and Symptom Coverage Matrix when a route looks surprising. The heatmap explains the score components; the matrix shows symptom and safety coverage across routes.
  7. Use Safety Briefing and Source Tool Ledger as the final check. A result is ready to share only when the top route, backup route, recall window, source page, and safety caveat all make sense together.

If the top route feels wrong, change one control at a time. Large ranking shifts usually come from the main concern, direct-risk preference, time budget, or comparison lens.

Interpreting Results:

The main value is a route fit score from 0 to 100. It ranks the source screener pages against the selected concern, time budget, use context, safety preference, and advanced lens. It does not describe how severe a person's symptoms are, and it does not say that a lower-ranked questionnaire is invalid in another setting.

Fit band Score boundary Meaning Before using it
Primary route 85 to 100 Best first questionnaire for the current setup. Confirm the recall window and safety caveat.
Strong fit 72 to 84 Good backup or alternate route. Check why it lost to the top row.
Use with caveat 58 to 71 Useful for a narrower reason, but not the natural first choice. Read the focus label and caveat before choosing it.
Secondary fit 0 to 57 Weak match for the selected route question. Use only if the concern, time, context, or safety plan changes.

The heatmap is useful when the top route is not the expected symptom match. A depression screener can rise in a safety-first setup because it contains direct self-harm wording. A broad distress route can rise in a population screen because it is brief and nonspecific. The corrective check is to compare the heatmap cells with the safety briefing, not to read the fit number by itself.

The false-confidence risk is safety. A symptom route cannot clear immediate danger, self-harm concern, psychosis, severe withdrawal, abuse, inability to stay safe, or a medical emergency. In the United States, call or text 988 for crisis support when crisis help is needed.

Technical Details:

Screener routing combines instrument facts with the current use case. Each source route has a focus label, item count, estimated minutes, recall window, score range, source state, direct-risk flag, clarity score, concern scores, and context scores. The comparison does not read questionnaire answers; it scores the routes themselves.

The score construction starts with five component values on a 0 to 5 scale: focus, time, context, safety, and clarity. Focus carries the largest base share because a first questionnaire should answer the right symptom question. Safety can still overrule a clean symptom match when direct self-harm wording is requested inside the first route.

Formula Core

The displayed route fit score is the weighted component average, converted to 0 to 100, adjusted by the selected lens, rounded to a whole point, and limited to the 0 to 100 range.

S = bounded ( round ( Fwf + Twt + Cwc + Ywy + Lwl wf + wt + wc + wy + wl ÷ 5 × 100 + A ) , 0 , 100 )
Symbol Component Base weight What changes it
F Focus fit 42% Match between the source screener focus and the selected concern.
T Time fit 15% Estimated minutes compared with the selected time budget.
C Use-context fit 16% First-pass use, repeat monitoring, visit preparation, or population screening.
Y Safety fit 17% Direct-risk wording versus a separate urgent-risk screen or symptom-only monitoring.
L Clarity fit 10% How directly the source screener maps to a clear route decision.
A Lens adjustment varies Speed, safety, monitoring, and broad-distress lenses can add or subtract route points.

For example, the default mixed mood-and-stress setup with 3 to 6 minutes available gives PHQ-9 and DASS-21 a 88/100 Primary route score. PHQ-9 wins the safety component because it has direct self-harm wording, while DASS-21 wins the focus component because it separates depression, anxiety, and stress. The same number can therefore mean two different strengths.

Boundary rules are inclusive at the lower edge of each named band. A score of 85 enters Primary route, 72 enters Strong fit, and 58 enters Use with caveat. Time fit is full credit when the route fits the selected budget; over-budget routes drop according to the overage ratio, with a floor so longer routes can still appear as backups.

Route family Main strength Important limit
PHQ-9 and BDI-II Depression screening, with direct self-harm wording. Any positive self-harm response needs follow-up as its own safety signal.
GAD-7, BAI, and SAS-style anxiety Anxiety-focused symptom routing. They do not directly assess self-harm, and body symptoms may overlap with medical conditions.
DASS-21 and DASS-42 Separate depression, anxiety, and stress lanes for the past week. DASS is dimensional rather than diagnostic and has no suicide item.
PSS-10 Perceived stress burden over the past month. It is not a depression, anxiety, or urgent-risk screener.
K10 and K6 Broad nonspecific psychological distress for quick triage or survey use. They do not split depression, anxiety, and stress into separate scores.
GDS-15 Older-adult depression screening using a short yes/no style. Medical illness, medication effects, cognition, function, isolation, and safety still need separate review.

Repeat comparisons are fair only when the route, recall window, completion setting, and safety plan stay consistent. Switching from a past-week DASS route to a last-2-weeks PHQ-9 route changes the question as well as the resulting score.

Responsible Use Note:

The comparison uses fixed route choices rather than written symptom answers, but the selected settings and exported rows can still reveal sensitive mental-health context. Treat copied tables, chart images, JSON, documents, and shared recommendations like personal health notes.

Screeners are informational aids. They do not diagnose a condition, prove safety, or replace a qualified professional. If there is immediate danger, self-harm concern, inability to stay safe, severe withdrawal, psychosis, abuse, or a medical emergency, use local emergency or crisis support instead of relying on a questionnaire route.

Advanced Tips:

  • Use Safety-aware first pass only when direct self-harm wording should influence the first route. It can legitimately lift PHQ-9 above a cleaner anxiety or stress match.
  • Use Fastest credible route when completion burden matters more than depth. Routes at or under about 3 minutes receive the strongest speed benefit.
  • Use Broad distress coverage for unclear symptom mixes or program screens, then check whether K6, K10, PSS-10, or DASS-21 should be followed by a narrower source page.
  • Compare the Screener Fit Heatmap with Symptom Coverage Matrix. A route can have high fit because it matches the workflow while still covering only part of the symptom picture.
  • Keep the safety caveat with copied or downloaded results. A route name and score without the caveat can make a routing recommendation look like a clinical decision.

Worked Examples:

Low mood with direct-risk wording

A first-pass depression check with Under 3 minutes and Prefer a direct self-harm item puts PHQ-9 at 99/100 as the Primary route. The important next action is not just opening PHQ-9; it is keeping the item 9 follow-up caveat visible for any non-zero self-harm response.

Mixed symptoms in a short sitting

The default mixed mood-and-stress setup can rank PHQ-9 and DASS-21 together at 88/100. PHQ-9 anchors safety wording, while DASS-21 separates depression, anxiety, and stress. The Safety Briefing and Symptom Coverage Matrix explain why either route may be the better first move depending on the handoff.

Broad distress in a program screen

Broad distress, Under 3 minutes, Population or program screen, a planned separate urgent-risk screen, and the broad-distress lens can lift K6 and K10 to 100/100. That makes sense for quick nonspecific distress routing, but the safety workflow must already exist outside the source questionnaire.

Anxiety route displaced by safety

An anxiety-first setup with Under 3 minutes, Prefer a direct self-harm item, and Safety-aware first pass can put PHQ-9 above GAD-7. That does not mean PHQ-9 measures anxiety better. It means the current route question gives direct-risk wording enough weight to change the first recommendation; choose a separate urgent-risk screen when GAD-7 should remain the anxiety route.

FAQ:

Is the fit score a depression, anxiety, or stress score?

No. It chooses a screener route. Symptom severity is calculated only after the selected source assessment is completed and interpreted with that source page's scoring rules.

Why can a depression screener outrank an anxiety screener?

The selected safety preference or comparison lens may be giving direct self-harm wording more weight than symptom focus. Check Safety signal preference, Comparison lens, and the heatmap before assuming the anxiety route is poor.

Should I choose one broad screener or two narrower screeners?

Use a broad route when distress is unclear or the time budget is tight. Use two narrower routes when depression, anxiety, stress, older-adult mood, or safety needs separate wording and separate scores.

Why do recall windows matter?

A past-week DASS result, a last-2-weeks PHQ-9 or GAD-7 result, and a past-month PSS or Kessler result summarize different periods. For repeat checks, keep the source screener and recall window consistent.

What should I do if the top route lacks a direct-risk item?

Read Safety Briefing. If safety may matter, add a separate urgent-risk screen or use qualified support rather than treating a symptom score as a safety clearance.

Glossary:

Route fit
A 0 to 100 score for choosing a first screener route, not a symptom severity score.
Fit band
The label attached to a route score, such as Primary route, Strong fit, Use with caveat, or Secondary fit.
Recall window
The time period the questionnaire asks the respondent to consider.
Direct-risk wording
A question that asks directly about self-harm or a related safety concern.
Broad distress
Nonspecific psychological distress that may include low mood, anxiety, stress, and related burden.
Safety clearance
A decision that someone is safe; symptom screeners should not be treated as providing one.

References: