Description

The Self Reporting Questionnaire (SRQ-F-28) is a standardized self-report screening instrument developed by the World Health Organization (WHO) to facilitate the early detection of common mental disorders and psychological distress in primary healthcare and community settings. The SRQ-F-28 is an extended version of the original Self Reporting Questionnaire (SRQ-24), developed by Harding and colleagues (1983), with the addition of four culturally sensitive items specifically designed to improve the assessment of individuals from diverse cultural backgrounds, including migrants, refugees, and populations living in developing countries.

The questionnaire consists of 28 dichotomous (Yes/No) items that assess a broad range of psychological, emotional, behavioral, and somatic symptoms commonly associated with anxiety disorders, depressive disorders, psychosomatic complaints, and severe mental illness. Unlike diagnostic psychiatric interviews, the SRQ-F-28 functions as a rapid screening instrument that identifies individuals who may require further psychological or psychiatric evaluation.

The instrument evaluates symptoms such as persistent sadness, anxiety, nervousness, fatigue, sleep disturbances, impaired concentration, reduced energy, psychosomatic complaints, emotional distress, and psychotic experiences. By providing a comprehensive assessment of psychological symptomatology, the SRQ-F-28 enables healthcare professionals to identify individuals who may be experiencing significant mental health difficulties while remaining practical for routine clinical use.

The SRQ-F-28 is extensively used in primary healthcare, psychiatry, psychology, public health, epidemiology, community mental health, humanitarian medicine, refugee health, occupational health, and international health research. Its simplicity, strong psychometric performance, and cross-cultural applicability have made it one of the most widely used mental health screening instruments worldwide.

Data Analysis and Use

The analysis of data obtained from the Self Reporting Questionnaire (SRQ-F-28) involves comprehensive psychometric and statistical procedures designed to evaluate psychological distress and identify individuals at increased risk of common mental disorders. Participant responses are converted into quantitative scores that reflect the presence or absence of clinically relevant psychological symptoms.

Psychometric evaluation includes the assessment of internal consistency, typically measured using Cronbach’s alpha coefficient, to determine the reliability of the questionnaire. Test–retest reliability is commonly examined to evaluate the temporal stability of responses, while exploratory and confirmatory factor analyses are conducted to verify the theoretical structure and dimensionality of the instrument.

Additional psychometric analyses include item-total correlations, composite reliability, convergent validity, discriminant validity, criterion validity, sensitivity, specificity, receiver operating characteristic (ROC) curve analysis, and measurement invariance, ensuring that the questionnaire accurately identifies individuals with probable psychiatric morbidity across diverse populations and cultural settings.

Statistical analyses frequently include descriptive statistics, correlation analyses, logistic regression, multiple regression models, structural equation modeling (SEM), latent class analysis, and longitudinal investigations to examine the relationships between psychological distress and demographic, occupational, medical, social, and behavioral variables.

The SRQ-F-28 is widely applied in clinical screening, epidemiological surveys, community mental health programs, refugee and migrant health services, humanitarian interventions, occupational health assessments, and public health surveillance. It also serves as an important outcome measure for evaluating mental health interventions and monitoring symptom changes over time.

Objective

The primary objective of the Self Reporting Questionnaire (SRQ-F-28) is to provide a reliable, valid, and culturally adaptable screening instrument for the early identification of individuals who may be experiencing common mental disorders or significant psychological distress. Rather than establishing a psychiatric diagnosis, the questionnaire serves as an efficient first-line screening tool that identifies individuals requiring comprehensive clinical evaluation.

The SRQ-F-28 supports healthcare professionals in detecting symptoms of anxiety, depression, psychosomatic distress, emotional dysfunction, and possible psychiatric morbidity within primary healthcare settings, where specialized psychiatric resources may not always be available. It also facilitates early intervention, timely referral, and ongoing monitoring of symptom progression or treatment response over time.

The questionnaire is particularly valuable in large-scale epidemiological studies, community mental health programs, humanitarian settings, refugee populations, occupational health research, and international public health initiatives, where brief, reliable, and culturally sensitive screening instruments are essential.

Scoring

The Self Reporting Questionnaire (SRQ-F-28) consists of 28 dichotomous items, with participants responding “Yes” or “No” according to whether each symptom or experience has been present during the specified reference period.

Each affirmative (“Yes”) response is scored as 1, while each negative (“No”) response is scored as 0. Individual item scores are summed to generate a total score reflecting the overall level of psychological distress and psychiatric symptomatology.

In the Greek adaptation, responses to the somatic symptom subscale (Items 1–20, 23, 24, and 27) are evaluated using an established cut-off score of 11. Furthermore, the presence of at least one positive response to a psychotic symptom item, in combination with scores exceeding the cut-off threshold, substantially increases the likelihood of underlying psychiatric morbidity and indicates the need for further clinical assessment.

Higher total scores indicate greater psychological distress, increased symptom burden, and a higher probability of common mental disorders, whereas lower scores suggest fewer psychological symptoms and better overall mental health. Interpretation should always be performed by qualified healthcare professionals and integrated with clinical interviews, medical history, and additional psychological assessment tools.

Psychometric Properties

The SRQ-F-28 has demonstrated excellent psychometric performance across multiple validation studies. The questionnaire exhibits high internal consistency, with a reported Cronbach’s alpha coefficient of 0.93, indicating excellent reliability across questionnaire items. Split-half reliability has also been reported as r = 0.92, demonstrating remarkable measurement consistency.

Construct validity has been supported through statistically significant correlations with structured psychiatric evaluations based on DSM-IV diagnostic criteria (r = 0.61, p < 0.01), confirming the instrument’s effectiveness as a screening measure for psychiatric morbidity. The questionnaire has also demonstrated good face validity and concurrent validity across diverse cultural populations and has been successfully adapted for use in numerous countries, including a validated Greek version standardized by Lyrakos (2012).

References

Harding, T. W., Climent, C. E., Diop, M., Giel, R., Ibrahim, H. H. A., Murthy, R. S., et al. (1983). The WHO Collaborative Study on Strategies for Extending Mental Health Care, II: The Development of New Research Methods. American Journal of Psychiatry, 140, 1471–1480.

Mari, J. J., & Williams, P. (1986). A Validity Study of a Psychiatric Screening Questionnaire (SRQ-20) in Primary Care in the City of São Paulo. British Journal of Psychiatry, 148, 23–26.

Youngmann, R., Zilber, N., Workneh, F., & Giel, R. (2008). Adapting the SRQ for Ethiopian Populations: A Culturally Sensitive Psychiatric Screening Instrument. Transcultural Psychiatry, 45(4), 566–589.

Lyrakos, G. (2012). Self Reporting Questionnaire (SRQ-F). In A. Stalikas, S. Triliva, & P. Roussi (Eds.), Psychometric Instruments in Greece (Revised and Expanded Edition, pp. 124–125). Pedio Publications.