Clinical Outcomes in Routine Evaluation - 10

The Clinical Outcomes in Routine Evaluation - 10 (CORE-10) is a highly validated, brief measure designed to capture a broad snapshot of general…

Questions: 10
Duration: 3 min
Original title: Clinical Outcomes in Routine Evaluation - 10
Adaptation: Clinical Outcomes in Routine Evaluation - 10
Authors: Barkham, M., Bewick, B., Mullin, T., Gilbody, S., Connell, J., Cahill, J., Mellor-Clark, J., Richards, D., Unsworth, G. & Evans, C.
Created: 2013

The Clinical Outcomes in Routine Evaluation - 10 (CORE-10) is a highly validated, brief measure designed to capture a broad snapshot of general psychological distress. Derived from the comprehensive CORE-OM, it efficiently assesses subjective well-being, common symptoms of anxiety and depression, social functioning, and risk to self.

Clinicians use the CORE-10 to establish a baseline of psychological distress and track changes over the course of therapy. As a repeatable measure, it offers a sensitive, session-by-session view of therapeutic progress. By anchoring clinical observation in standardized data, practitioners can confidently monitor outcomes and adjust treatment plans if distress levels plateau or unexpectedly increase.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

20/ 40

The CORE-10 is a brief 10-item self-report questionnaire designed for the assessment and monitoring of overall psychological distress in routine clinical practice. It measures common symptoms of anxiety, depression, trauma, functioning difficulties, and suicidal risk.

0–5

Healthy

6–10

Low Level

11–14

Mild

15–19

Moderate

20–24

Moderate-to-Severe

25–40

Severe

Indicates significant psychological distress, where symptoms are likely to interfere with daily functioning and require clinical attention.

généralemixed · general population · n = 1664 · Barkham (2007) · Bewick et al. (2008)

040

M = 7.26 ± 5.94

cliniquemixed · pathology: anxiety, depression · United Kingdom · n = 1835 · Connell et al. (2007)

040

M = 19.7 ± 7.7

For information

Cut-off≥ 11Clinically significant psychological distress

Identifies individuals with clinically significant psychological distress.

Connell et al. (2007)

Cut-off≥ 13Likely depression

Indicates probable presence of depression with high sensitivity.

Connell et al. (2007)

Scoring

Sum, total score from 0 to 40, each item is scored on a 5-point scale (from 0 to 4).

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What the test measures

The CORE-10 evaluates global psychological distress across four key domains of clinical experience. Rather than diagnosing a specific disorder, it provides a composite index of acute psychological suffering and functional impairment.

Well-being: The subjective sense of coping and overall contentment.
Symptoms: The presence and frequency of anxiety, depression, physical tension, and somatic distress.
Functioning: The capacity to maintain social connections and manage daily interpersonal demands.
Risk: The presence of active self-harm intent or suicidal planning, indicating a need for immediate crisis planning.

It is intended for use with adults and adolescents (typically 17 and older) presenting in primary care or psychological therapy settings.

When and why to use it

Clinicians integrate the CORE-10 into routine practice to systematically evaluate severity and track therapeutic change over time.

Intake assessment: To establish a baseline of general distress and rapidly flag immediate risk.
Routine monitoring: To track session-by-session progress and identify when distress levels fail to improve, prompting a review of the case formulation.
Evaluating functioning: To gauge how heavily symptoms interfere with the patient's daily life and social support network.
Clinical thresholding: To differentiate between sub-clinical distress and clinically significant impairment.

Using a validated measure like the CORE-10 grounds clinical intuition in robust data, highlighting subtle shifts in well-being that might be missed in unstructured conversation.

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The questions

This form has 10 statements about how you have been OVER THE LAST WEEK. Please read each statement and think how often you felt that way last week.
1. I have felt tense, anxious, or nervous.
This item probes the somatic and cognitive symptoms of general anxiety and physical tension.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
2. I have felt I have someone to turn to when I need support.
This item assesses the perceived availability and reliability of the patient's social support network.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
3. I have felt able to cope when things get difficult.
This item evaluates the patient's subjective sense of resilience and healthy [coping styles](/blog/en/coping-styles-responses) in the face of stress.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
4. Talking to others has felt too difficult for me.
This item screens for social withdrawal, [experiential avoidance](/blog/en/stop-avoidance-behavior), or feeling overwhelmed by interpersonal contact.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
5. I have felt panicked or terrified.
This item captures acute episodes of hyperarousal, fear, or panic attacks.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
6. I have thought about a specific plan to end my life.
This item is a critical risk indicator assessing the presence of active suicidal ideation or planning.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
7. I have had difficulty falling or staying asleep.
This item checks for sleep disturbances, a core physiological marker of dysregulation in the [autonomic nervous system](/blog/en/autonomic-nervous-system).
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
8. I have felt hopeless or useless.
This item probes for feelings of hopelessness, central to depressive episodes and psychological despair.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
9. I have felt unhappy.
This item assesses global low mood and subjective sadness.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time
10. I have been troubled by unwanted mental images or memories.
This item screens for intrusive thoughts, flashbacks, or other common [post-traumatic reactions](/blog/en/trauma-reactions-symptoms) related to unassimilated memories.
- Not at all
- Rarely
- Sometimes
- Often
- Almost all the time