The Brief Symptom Inventory (BSI) is a 53-item screener for mental health problems. There are nine Symptom Scales, one of which is the 6-item Depression scale, and three composite Global Indices. Items are rated on a 5-point Likert scale, with higher scores indicating more severe psychological symptoms. It was normed on adolescents and adults who were not psychiatric patients, were psychiatric outpatients, or were psychiatric inpatients. The BSI is appropriate for individuals age 13 years and older. The Depression Symptom Scale is composed of six items largely related to the cognitive aspects of depression, though one item reflects suicidal thoughts. For linking the BSI to PROMIS Depression, raw scores are summed on these items, as opposed to the BSI normative scores.