DASS-21 Scoring Ranges: Normal vs. Abnormal

Introduction to DASS-21

The DASS-21 uses an optimal cutoff score of >33 to detect common mental disorders (depression and anxiety) with a sensitivity of 79.1% and specificity of 77.0% 1

The DASS-21 has high internal consistency, with a Cronbach's alpha of 0.88 for the total scale, 0.92 for depression, 0.90 for stress, and 0.86-0.70 for anxiety 4

In patients with substance use disorders, the DASS-21 should be administered after detoxification to obtain the best predictive validity, with a sensitivity of 78-89% and specificity of 71-76% 1
The American Psychological Association recommends using the DASS-21 as a general screening tool to detect the presence of common mental disorders, but not to differentiate between specific types of disorders 1

A total score of ≤33 indicates low risk of common mental disorder, while a score of >33 indicates high risk and requires further evaluation 1
If the score is >33, a comprehensive diagnostic evaluation should be performed using specific instruments, such as the PHQ-9 for depression and the GAD-7 for anxiety, and a structured clinical interview if available 2, 3, 4
The National Institute of Mental Health recommends evaluating for medical causes, such as uncontrolled pain, fatigue, delirium, thyroid disorders, and medication effects, before attributing symptoms to psychiatric causes 2, 5