Date completed: __ __ / __ __ / __ __ __ __Identifier:|___|___|___|___|___|___|___|___|___|___|___|___|

Interviewer
Administered

K6+

Last Name:First Name:
Date of Birth:___ ___ / ___ ___ / ___ ___ ___ ___

Sex:
Male1

FemaleAddress:

Q1a. The next questions are about how you have been feeling during the past 30 days.
About how often during the past 30 days did you feel nervous — would you say all ofthe time, most of the time, some of the time, a little of the time, or none of the time?
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSED
Q1b. During the past 30 days, about how often did you feel hopeless — all of the time,
most of the time, some of the time, a little of the time, or none of the time?
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSED2

Q1c. During the past 30 days, about how often did you feel restless or fidgety? (IF NEC:all, most, some, a little, or none of the time?)
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSED
Q1d. How often did you feel so depressed that nothing could cheer you up? (IF NEC:all, most, some, a little, or none of the time?)
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSED
Q1e. During the past 30 days, about how often did you feel that everything was aneffort? (IF NEC: all, most, some, a little, or none of the time?)
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSED
Q1f. During the past 30 days, about how often did you feel worthless? (IF NEC: all,most, some, a little, or none of the time?)
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSEDQ2. The last set of questions asked about feelings that might have occurred during thepast 30 days. Taking them altogether, did these feelings occur more often in the past 30days than is usual for you, about the same as usual, or less often than usual?
1. MORE OFTEN THAN USUAL ....................................... GO TO Q2b
2. ABOUT THE SAME AS USUAL ................................... GO TO Q3
3. LESS OFTEN THAN USUAL
4. (IF VOL) NEVER HAVE THESE FEELINGS ............... GO TO Q3
8. (IF VOL) DON’T KNOW ................................................ GO TO Q3
9. (IF VOL) REFUSED ........................................................ GO TO Q3
Q2a. A lot less than usual, somewhat less, or only a little less than usual?
1. A LOT ............................................................................... GO TO Q3
2. SOMEWHAT .................................................................... GO TO Q3
3. A LITTLE ......................................................................... GO TO Q3
8. (IF VOL) DON’T KNOW ................................................ GO TO Q3
9. (IF VOL) REFUSED ........................................................ GO TO Q3
Q2b. A lot more than usual, somewhat more, or only a little more than usual?
1. A LOT
2. SOMEWHAT
3. A LITTLE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSEDQ3. INTERVIEWER CHECKPOINT
1. R ANSWERED “A LITLE,” “SOME,” “MOST,” OR “ALL” TO AT LEAST ONE
QUESTION IN THE Q1 SERIES
2. ALL OTHERS .................................................................. END SECTION
Q4. The next questions are about how these feelings may have affected you in the past 30
days. How many days out of the past 30 were you totally unable to work or carry out
your normal activities because of these feelings?
_________ NUMBER OF DAYS
98. (IF VOL) DON’T KNOW
99. (IF VOL) REFUSEDQ5. INTERVIEWER CHECKPOINT
1. R ANSWERED “30” IN RESPONSE TO Q4 .................. GO TO Q7
2. ALL OTHERSQ6. [Not counting (that day/those days)], how many days in the past 30 were you able todo only half or less of what you would normally have been able to do because of thesefeelings?
_________ NUMBER OF DAYS
98. (IF VOL) DON’T KNOW
99. (IF VOL) REFUSED
Q7. During the past 30 days, how many times did you see a doctor or other healthprofessional about these feelings?
______ NUMBER OF TIMES
98. (IF VOL) DON’T KNOW
99. (IF VOL) REFUSEDQ8. During the past 30 days, how often have physical health problems been the maincause of these feelings – all of the time, most of the time, some of the time, a little of thetime, or none of the time?
1. ALL2. MOST
3. SOME
4. A LITTLE
5. NONE
8. (IF VOL) DON’T KNOW
9. (IF VOL) REFUSEDINTERVIEWER TRAINING NOTES:
1. The General Interviewer Training (GIT) procedures for nondirective probing outlinedin the GIT Training Manual of the Survey Research Center at the University of Michigan
are the preferred GIT procedures to be followed in administering the K6. As GIT
procedures vary across survey organizations, those used by the organization that carries
out the survey should be used if a professional survey organization is administering thequestions.
2. All bolded words in questions should be emphasized by voice inflection.
3. All parenthetical phrases in questions are optional.

4. "IF NEC" means "if necessary." The interviewer should prompt R with the response
categories, using the truncated wording when specified, until R has learned them wellenough to respond without prompting.
5. "IF VOL" means "if volunteered." If the respondent volunteers one of the specified
responses, that response should be recorded without additional probing. The interviewer's
response to other responses that are not included among the pre-specified responses (e.g.,a response of "quite a bit of the time") should be handled following the GIT procedures
specified for the survey. In most cases, GIT will call for repeating the response options
once and coding the response as a refusal with a marginal note describing the exact
response if the respondent continues to give a response other than those that are prespecified.

© Ronald C. Kessler, PhD. 2003
All rights reserved. Based on the Composite International Diagnostic Interview © 2001 Ronald C.
Kessler, PhD. All rights reserved. Used with permission. Requests for permission to reproduce ortranslate should be addressed to Professor Ronald Kessler, PhD, Department of Health Care Policy,Harvard Medical School, (email: ronkadm@hcp.med.harvard.edu).