Symptom Checklist-90

The Symptom Checklist-90 (SCL-90), developed by Derogatis in 1973, is a self-report measure of psychological symptoms and one of the most widely used mental health screening tools in China and internationally. Its 90 items cover nine dimensions: somatization, obsessive–compulsive symptoms, interpersonal sensitivity, depression, anxiety, hostility, phobic anxiety, paranoid ideation, and psychoticism. It is mainly used for initial screening in psychiatric and counseling outpatient settings, helping describe the nature and severity of reported symptoms.

The SCL-90 uses a 5-point scale (1–5), from none to severe. Three main indicators are considered: total score (sum of all 90 items; normal <160), overall mean (total divided by 90; normal <1.78), and number of positive items (items rated ≥2; normal <43). Any factor mean ≥2.0 suggests possible difficulties in that dimension. Meeting any screening criterion—total >160, positive items >43, or any factor mean ≥2.0—is considered a positive screen and warrants further professional assessment.

The SCL-90 is intended for adolescents and adults aged 16 and over. It can be used for community screening, clinical assessment, and initial assessment in counseling, especially when a broad picture of psychological symptoms is needed. It is a screening tool, not a diagnostic instrument, and cannot diagnose a mental disorder on its own. People with limited education or understanding may need assistance completing it.

The BSI-18 is a shortened version of the SCL-90, with 18 items covering somatization, depression, and anxiety. It takes about 5 minutes. The SCL-90 has 90 items covering nine symptom dimensions and takes about 20 minutes, providing a more comprehensive assessment. Choose the BSI-18 for quick screening or the SCL-90 for a detailed symptom profile. Both have good reliability and validity.

The nine factors are: ① Somatization: physical discomfort. ② Obsessive–compulsive symptoms: intrusive thoughts and compulsive actions. ③ Interpersonal sensitivity: discomfort in relationships. ④ Depression: low mood and reduced interest. ⑤ Anxiety: tension, unease, and panic. ⑥ Hostility: anger and aggressive tendencies. ⑦ Phobic anxiety: fear of specific objects or situations. ⑧ Paranoid ideation: suspicion and feelings of persecution. ⑨ Psychoticism: experiences such as hallucinations and disordered thinking. A factor mean ≥2.0 suggests possible difficulties in that area.

If your SCL-90 total is >160, your number of positive items is >43, or any factor mean is ≥2.0, consult a mental health professional promptly. Seek help as soon as possible if a high depression score is accompanied by suicidal thoughts, a high psychoticism score involves hallucinations or delusions, or several elevated factors seriously disrupt daily life. The SCL-90 is only a screening tool; any diagnosis requires a comprehensive professional assessment.

GSI 是总体严重程度指数，就是总分除以 90; PST 是阳性项目总数，就是单项分大于等于 2 的题数; 各维度分是该维度所有题的平均分。 总分大于 160, PST 大于 43，或者任一维度分大于等于 2.0，都提示筛查阳性，建议进一步找专业人员评估。 SCL-90 只是筛查工具，不能单独用来下诊断。