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The WHO-5 Wellbeing Index is five questions long, takes under a minute, asks nothing about symptoms, and has been translated into more than thirty languages. It is arguably the most quietly successful instrument in wellbeing measurement — and its design contains one deliberate decision worth understanding.
In short
- Developed under the WHO Regional Office for Europe, in the form used today since 1998.
- Five items, every one positively worded. It never asks about a symptom.
- Each item scores 0–5, giving a raw score of 0–25, which is multiplied by 4 to give a percentage from 0 to 100.
- A score below 50 indicates poor wellbeing; a raw score below 13 is the conventional threshold for further assessment for depression.
- Free to use with acknowledgement, which is a large part of why it spread so widely.
What WHO-5 measures#
WHO-5 measures subjective psychological wellbeing over the previous two weeks. Its five items cover cheerfulness and good spirits, calm and relaxation, active vigour, waking rested, and daily life being filled with things that interest you.
That last item is doing more work than it appears to. Interest and engagement tend to fade before mood itself declines noticeably, which gives the scale a degree of early sensitivity that a purely hedonic question would not have.
Why every item is positive#
Every WHO-5 item asks about the presence of something good. None asks about the presence of something bad. This is a deliberate design decision with several consequences.
- It measures wellbeing, not the absence of illness. Someone with no symptoms at all can still score poorly, and that is a real and useful finding rather than an error.
- It reduces the stigma of answering. Being asked whether you have felt cheerful is a materially different experience from being asked whether you have wanted to hurt yourself.
- It travels well. Positively-worded items about everyday states translate across cultures far more cleanly than symptom language, which is heavily culture-bound.
- It resists a floor effect. In non-clinical populations, symptom scales bunch everyone at the bottom. A wellbeing scale keeps discriminating across the healthy range.
Not being unwell and being well are different questions. WHO-5 asks the second one.
How it is scored#
Each item is rated on a six-point frequency scale for the past two weeks, from at no time (0) to all of the time (5).
- Sum the five item scores. This gives a raw score from 0 to 25.
- Multiply the raw score by 4. This gives a percentage score from 0 to 100, where 0 is the worst imaginable wellbeing and 100 the best.
- Interpret against the thresholds below, and — more usefully — against the person's own previous scores.
| Raw score | Percentage | Conventional reading |
|---|---|---|
| 13 or above | 52–100 | Wellbeing within the expected range |
| Below 13 | Below 50 | Poor wellbeing — further assessment for depression is indicated |
| Any single item scored 0 or 1 | — | Also conventionally treated as grounds for further assessment |
A drop of 10 percentage points or more is generally treated in the literature as a meaningful change rather than noise — which makes WHO-5 useful for monitoring over time, not just for a one-off reading.
Where it is used#
WHO-5 appears across an unusually wide range of settings: primary care screening, diabetes and endocrinology, geriatrics, occupational health, clinical trial endpoints, and large-scale population surveys. A 2015 systematic review by Topp and colleagues examined its use across these domains and supported both its validity as a wellbeing measure and its performance as a screening tool for depression.
Its reach owes as much to licensing as to psychometrics. The instrument is free to use with acknowledgement, which removed the friction that keeps better-validated but licensed instruments out of ordinary practice.
Limits worth knowing#
- Five items is very short. Brevity buys repeatability and costs granularity. WHO-5 tells you that wellbeing has fallen, rarely why.
- A two-week window smooths detail. A hard Tuesday inside a good fortnight will not show up.
- It is a screening aid, not a diagnosis. A low score indicates that further assessment is warranted. Nothing more.
- It does not ask about risk. Unlike the PHQ-9, WHO-5 contains no item on self-harm, so it cannot surface an urgent safety signal.
WHO-5 and PANAS measure different things#
The two are often mentioned together and are frequently confused. They operate on different timescales and answer different questions.
| WHO-5 | [PANAS](/learn/panas-scale) | |
|---|---|---|
| Window | The past two weeks | Adjustable — from "right now" to "in general" |
| Structure | One score, 0–100 | Two independent subscales |
| Reads | A slow baseline | Short-window affect texture |
| Framing | Presence of wellbeing | Intensity of specific feelings |
In practice WHO-5 tells you roughly where the floor is, and PANAS tells you what is happening on top of it. Neither substitutes for the other, and a study using only one is usually making a deliberate choice about which question it cares about.
Common questions#
- What is the WHO-5 Wellbeing Index?
- The WHO-5 is a five-item questionnaire measuring subjective psychological wellbeing over the previous two weeks. All five items are positively worded, covering cheerfulness, calm, vigour, restful sleep and daily interest. It was developed under the WHO Regional Office for Europe and is used worldwide in both research and clinical practice.
- How is the WHO-5 scored?
- Each of the five items is rated 0 to 5, producing a raw score from 0 to 25. The raw score is multiplied by 4 to give a percentage score from 0 to 100, where 100 represents the best imaginable wellbeing.
- What does a WHO-5 score below 50 mean?
- A percentage score below 50, equivalent to a raw score below 13, conventionally indicates poor wellbeing and is treated as an indication that further assessment for depression is warranted. It is a screening signal, not a diagnosis.
- Is the WHO-5 free to use?
- Yes. The WHO-5 is free to use with appropriate acknowledgement, which is one reason it has been translated into more than thirty languages and adopted across a very wide range of settings.
immli is a wellbeing and understanding tool, not a medical service. Questions about this page go to hello@immli.me.
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