Measuring Patient/Client Wellness: The WHO-5

Dawn Sowell | Aug 14, 2022 | 4 min read


The World Health Organization Well-Being Index (WHO-5) is an assessment tool that utilizes a rating scale to measure subjective psychological well-being in the last two weeks (Topp et al., 2015). The WHO-5 includes positively framed questions that demonstrate the WHO's stance of positive well-being being synonymous with mental health and aims to avoid symptom-related language (Topp et al., 2015). The WHO-5 can be used to measure quality of life, screen for depressive symptoms and monitor both emotional and psychological well-being, and assess severity of suicide attempts (Dadfar, 2018).

Psychometric Qualities

The WHO-5 uses a Likert rating scale from zero (none of the time) to five (all of the time) that measures well-being based on five questions that ask how well each applies to respondents (Topp et al., 2015). Reliability and validity are considered adequate for the WHO-5 as a screening tool for depression and as an outcome measure in clinical trials and has been successfully applied as a scale for well-being across a variety of study fields (Topp et al., 2015).

Scoring and Interpretation

Respondents raw scores are converted to a score from zero to one hundred in which lower scores are indicative of poor well-being. A score of ≤ 50 suggests further investigation into depressive symptoms may be necessary and indicates poor well-being, and a score of ≤ 28 indicates depression (Omani-Samani, 2019).

Strengths and Limitations

Strengths of the WHO-5 include global compatibility across cultures; it has been used in research studies all over the world and has been translated into more than 30 languages (Topp et al, 2015). Additionally, the second step of the diagnostic process when screening for depression using the WHO-5 consists of diagnostic interviews with clinicians that may reveal false positives- those who screen positive on the WHO-5 but do not meet criteria for depression- and further informs treatment planning and interventions. Another strength of the WHO-5 is clinical applicability across study fields (Topp et al., 2015).

A limitation of the WHO-5 is the assessment approach, which measures only positive aspects of emotions and does not measure all emotional experiences that influence our well-being (Kusier & Folker, 2020). Another limitation includes measurement content; while the WHO-5 measures frequency of emotions, it lacks measurement of intensity and duration of emotions (Kusier & Folker, 2020).

Application in Practice

The WHO-5 is a widely applicable generic assessment tool that can be used to screen for well-being and quality of life and influence further assessment for multiple mental health disorders and symptoms including depression, suicidality, and substance use disorders (Topp et al., 2015). It has also been used in the medical field to measure patient well-being with conditions such as diabetes, cardiovascular disease, and cancer (Topp et al., 2015) and infertility (Omani-Samani, 2019). This assessment is a quick tool that can be utilized with clients across the lifespan, with differing life circumstances, and across cultural experiences.


Dadfar, D., Momeni Safarabad, N., Asgharnejad Farid, A. A., Nemati Shirzy, M., & Ghazie Pour Abarghouie, F. (2018). Reliability, validity, and factorial structure of the World Health Organization-5 well-being index (WHO-5) in Iranian psychiatric outpatients. Trends in Psychiatry and Psychotherapy, 40(2), 79-84. Link

Kusier, A. O., & Folker, A. P. (2020). The well-being index WHO-5: hedonistic foundation and practical limitations. Medical Humanities, 46(3), 333-339. Link

Omani-Samani, R., Maroufizadeh, S., Almasi-Hashiani, A., Sepidarkish, M., & Amini, P. (2019). The WHO-5 well-being index: a validation study in people with infertility. Iranian Journal of Public Health, 48(11), 2058-2064. Link

Topp, C.W., Østergaard, S. D., Søndergaard, S., & Bech, P. (2015). The WHO-5 well-being index: a systematic review of the literature. Psychotherapy and Psychosomatics, 84(3), 167-176. Link

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