ArticleBMC psychology2026
The Kessler 6 psychological distress scale (K6) in swedish: a psychometric study of reliability, factor structure and measurement invariance in a large population-based sample.
Article in BMC psychology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundPsychological distress is a major public health concern, and brief, reliable screening instruments are essential for early detection and monitoring. The six-item Kessler Psychological Distress Scale (K6) is widely used internationally; however, evidence regarding its psychometric properties in Sweden remains limited. This study examined the reliability, factor structure, and measurement invariance of the Swedish version of the K6 in a large population-based sample.
methodsData were obtained from the Life and Health Survey (2022), conducted in five regions in Mid-Sweden. The study included 31,759 adults aged 18-102 years. Internal consistency was assessed using McDonald's omega total. Structural validity was evaluated using confirmatory factor analysis, comparing a one-factor model, a two-factor model representing depression and anxiety, and a bifactor model comprising a general psychological distress factor and two specific factors representing depression and anxiety. Measurement invariance of one-factor model was examined across age groups and by gender using multigroup CFA, testing configural and metric invariance.
resultsInternal consistency was high across all demographic groups (McDonald's omega total 0.883-0.899). The one-factor model demonstrated best fit, with acceptable values according to CFI, TLI, and SRMR, but unacceptable according to RMSEA (CFI = 0.996, TLI=0.993, RMSEA=0.069, SRMR=0.020), with standardized loadings ranging from 0.70 to 0.91. The two-factor model showed acceptable fit according to CFI, TLI and SRMR, but unacceptable fit according to RMSEA (CFI=0.989, TLI=0.982, RMSEA=0.109, SRMR=0.040). Standardized factor loadings were high for both factors (Factor 1: 0.78; Factor 2: 0.78-0.91). The correlation between the two latent factors was extremely strong (r=.99). The bifactor model did not converge and therefore could not be evaluated or interpreted further. Configural and metric invariance were supported across the age groups and between men and women.
conclusionsThe Swedish version of the K6 demonstrates strong reliability and supports a unidimensional structure. Measurement invariance testing supported comparable measurement of psychological distress across age and gender. The scale is suitable for monitoring psychological distress in public health surveys and may also be useful as a brief screening tool in clinical practice. Further research should establish clinically relevant threshold values in a Swedish context.
trial registrationNot applicable.
Indexed as
Identifiers
42920194What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.