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Hopkins Symptom Checklist (HSCL)

Hopkins Symptom Checklist-25 (HSCL-25)

The Hopkins Symptoms Checklist (HSCL) is a well-known and widely used screening instrument whose history dates from the 1950s. It was originally designed by Parloff, Kelman, and Frank at Johns Hopkins University.1 Professor Karl Rickels, one of the original developers of the HSCL, demonstrated with his colleagues the usefulness of a 25- item version of the HSCL in a family practice or a family planning service.2, 3

The HSCL-25 is a symptom inventory which measures symptoms of anxiety and depression. It consists of 25 items: Part I of the HSCL-25 has 10 items for anxiety symptoms; Part II has 15 items for depression symptoms. The scale for each question includes four categories of response (“Not at all,” “A little,” “Quite a bit,” “Extremely,” rated 1 to 4, respectively). Two scores are calculated: the total score is the average of all 25 items, while the depression score is the average of the 15 depression items. It has been consistently shown in several populations that the total score is highly correlated with severe emotional distress of unspecified diagnosis, and the depression score is correlated with major depression as defined by the Diagnostic and Statistical Manual of the American Psychiatric Association, IV Version (DSM-IV).4

HPRT has translated the HSCL-25 and a manual for its use into Bosnian, Cambodian, Croatian, Japanese, Laotian, and Vietnamese. All of these include an English translation. Currently, all versions of the HSCL-25, as well as the Indochinese Manual (incorporates Cambodian, Laotian, and Vietnamese), are available by ordering the Measuring Trauma, Measuring Torture manual.

Screening instruments should be administered by health care workers under the supervision and support of a psychiatrist, medical doctor, and/or psychiatric nurse. They were not designed to be used as a self-report; no checklist can replace the role of a mental health professional.

1 Parloff MB, Kelman HC, Frank JD. Comfort, effectiveness, and self-awareness as criteria for improvement in psychotherapy. American Journal of Psychiatry. 1954; 3:343-351.

2 Hesbacher PT, Rickels K, Morris RJ, et al. Psychiatric illness in family practice. Journal of Clinical Psychiatry. 1980; 41:6-10.

3 Winokur A, Winokur DF, Rickels K et al. Symptoms of emotional distress in a family planning service: stability over a four-week period. British Journal of Psychiatry. 1984; 144: 395-399.

4 American Psychiatric Association, Committee on Nomenclature and Statistics. Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Washington, DC: American Psychiatric Association; 1994.