Online Medical Tools — WHO-5
Printed on 9/4/2026
For informational purposes only. This is not medical advice.
WHO-5
WHO-5 is a concise positive-well-being measure focused on mood, vitality, and interest over the past two weeks. Lower scores indicate poorer well-being and support depression-focused follow-up screening.
Formula: WHO-5 raw total = sum of 5 items (0-25); percentage score = raw total x 4 (0-100).
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How It Works
Rate 5 Positive Wellbeing Items for the Past 2 Weeks
The patient rates 5 items about past 2-week positive wellbeing on a 0-5 scale: 0 = At no time, 1 = Some of the time, 2 = Less than half of the time, 3 = More than half of the time, 4 = Most of the time, 5 = All of the time. Items cover cheerfulness, calmness, vitality, restful sleep, and interest in daily activities.
Calculate Raw Score and Percentage Score
Sum the 5 items for a raw score of 0-25. Multiply by 4 to convert to a percentage score of 0-100. A raw score of 25 (100%) represents optimal wellbeing. No reverse scoring is required. Higher scores indicate better wellbeing.
Apply Clinical Thresholds
WHO-5 percentage score above 50 generally indicates good wellbeing. Percentage score below 50 (raw score below 13) = poor wellbeing warranting clinical assessment. Percentage score below 28 (raw score below 7) = likely depression — recommend full PHQ-9 or clinical depression assessment.
Who Uses the WHO-5
Population Wellbeing Monitoring
Public Health Agencies and Researchers
WHO-5 is one of the most internationally used wellbeing measures, validated in over 30 languages and used in national health surveys across Europe, Asia, and the Americas. It enables population-level wellbeing tracking, comparison across countries and demographic subgroups, and monitoring of temporal trends in population mental health.
Diabetes Care Depression Screening
Endocrinologists and Diabetes Care Teams
The International Diabetes Federation (IDF) Guideline on Self-Monitoring (2009) recommends WHO-5 as the standard depression screening tool for people with diabetes. Depression prevalence is 2-3 times higher in diabetes and significantly worsens glycemic control and self-management. WHO-5 below 50 triggers PHQ-9 assessment and potential antidepressant treatment.
Primary Care Annual Wellbeing Assessment
General Practitioners
WHO-5 provides a rapid positive wellbeing assessment at annual check-ups, wellness visits, and chronic disease reviews. Its positive framing (measuring wellbeing rather than symptoms) is perceived as less stigmatizing by patients and is particularly well-suited for routine population health screening in general practice.
Geriatric Wellbeing Monitoring
Geriatricians and Aged Care Teams
WHO-5 is valid and well-accepted in elderly populations, capturing positive affect and vitality that are important for healthy aging. Low WHO-5 scores in elderly patients prompt assessment of depression, chronic pain, social isolation, and functional decline — multiple contributors to poor wellbeing in older adults requiring targeted interventions.
Clinical Trial Quality of Life Endpoint
Clinical Researchers
WHO-5 is widely used as a patient-reported outcome and quality of life measure in clinical trials of antidepressants, psychological therapies, lifestyle interventions, and chronic disease management programs. Its 5-item brevity and sensitivity to change make it particularly valuable as a secondary endpoint measuring positive wellbeing alongside disorder-specific primary endpoints.
Employee Wellness Programs
Occupational Health Professionals
WHO-5 is increasingly used in workplace wellness programs to assess employee wellbeing at population level, benchmark against normative data, and measure the impact of wellbeing interventions including stress management programs, work-life balance policies, and positive psychology interventions. Higher WHO-5 scores correlate with greater work productivity and lower absenteeism.
Pro Tips
WHO-5 Measures POSITIVE Wellbeing — Higher Is Better
Unlike most mental health scales where higher scores mean worse outcomes, WHO-5 measures positive wellbeing (cheerfulness, calmness, vitality) — higher scores are better. This is a critical distinction from PHQ-9 and GAD-7. A WHO-5 of 100% represents optimal wellbeing; 0% represents complete absence of positive wellbeing.
WHO-5 Below 28% (Raw Below 7) Indicates Likely Depression
The depression screening threshold is WHO-5 percentage score below 28 (raw score below 7). At this threshold, sensitivity for major depression is approximately 93% and specificity is 57% — optimized for sensitivity to avoid missing depression. Always follow up WHO-5 below 28% with full PHQ-9 or clinical interview.
WHO-5 Was Developed as Part of WHO-10 Then Shortened
WHO-5 was originally developed as part of the WHO Psychiatric Rating Scales (WHO-10), then shortened to 5 items for feasibility. It was initially developed in the 1990s by Per Bech and has since been validated in 213 studies covering over 355,000 participants (Topp et al. 2015 systematic review).
IDF Recommends WHO-5 Specifically for Diabetes Depression Screening
The International Diabetes Federation explicitly recommends WHO-5 as the preferred depression screening tool for diabetes care — not PHQ-9. This is because WHO-5's positive framing avoids somatic items (fatigue, sleep changes) that overlap with diabetes symptoms and side effects of diabetes medications, reducing false positive depression screens in this population.
WHO-5 Captures Hedonia — Complements PHQ-9 Focus on Anhedonia
PHQ-9 specifically measures anhedonia (loss of pleasure) as a core depression symptom. WHO-5 measures hedonia (presence of positive affect and vitality) as a wellness indicator. These constructs are complementary — a patient can show PHQ-9 improvement (less anhedonia) while WHO-5 remains low (absence of positive affect not yet restored). Both measures provide clinically distinct information.
WHO-5 Is Sensitive to Change — Useful for Monitoring Recovery
WHO-5 is particularly well-suited for monitoring treatment response and recovery, as it tracks positive wellbeing restoration rather than just symptom reduction. Patients often report WHo-5 improvement before PHQ-9 shows full remission, making it a valuable early indicator of wellbeing recovery during antidepressant or psychological therapy.
WHO-5 Available in 30+ Languages — Free to Use With No Copyright Restrictions
WHO-5 is available free of charge with no copyright restrictions from the WHO Regional Office for Europe. Official translations in 30+ languages are available and have been validated for cross-cultural equivalence. This makes WHO-5 one of the most practical global mental health screening tools for multilingual and international clinical settings.
Common Questions About Your Results
Evidence-Based Methodology
WHO-5 Wellbeing Index published by Bech (Psychiatry Clin Neurosci 2012) and Topp et al. (Psychother Psychosom 2015) systematic review. Meta-analysis of 213 studies (N=355,000+): AUC 0.89 for depression at threshold 50/100 (sensitivity 86%, specificity 81%). International Diabetes Federation (IDF) Guideline on Self-Monitoring 2009 recommends WHO-5 for depression screening in diabetes. Available free from WHO Regional Office for Europe. Validated in 30+ languages. Topp et al. 2015 is the primary contemporary reference for WHO-5 psychometric properties.
Clinical Content Trust
- Last reviewed:
- April 21, 2026
- Guideline version:
- General evidence framework v2026.04
- Source set version:
- Primary-source set v1
How to Interpret Your Result
Lower WHO-5 scores indicate poorer positive well-being and support additional mood-focused assessment.
When to Use This Tool
Use for concise wellbeing tracking in primary care, wellness programs, and mental-health follow-up.
Limitations
WHO-5 is a positive-wellbeing measure, not a standalone diagnostic psychiatric instrument.
For related assessments, see PHQ-9, MDI Depression Scale and PHQ-4.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
Sources
Changelog
April 21, 2026 · trust-baseline
Clinical trust metadata enabled for this tool page with structured review/version fields.
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