Four-Dimensional Symptom Questionnaire (4DSQ)

Terluin B

Distributed by Mapi Research Trust


Distributed by Mapi Research Trust

Basic description

Developed in 1994

Coming soon ! The Questionnaire is now distributed by Mapi Research Trust. The conditions of use are currently being updated. Please submit your request on our online request management


Terluin B

1996 - B. Terluin
To distinguish stress-related syndromes (denoted as stress, burnout, nervous breakdown) and psychiatric disorders (i.e. depression and anxiety disorders)
Therapeutic area
  • Mental Disorders
Therapeutic indication

Generic for Psychiatry/Psychology

Type of Clinical Outcome Assessment (COA)
  • pro PRO
Original language(s)
  • Dutch for the Netherlands
Bibliographic reference(s) of the original questionnaire

Terluin B: De Vierdimensionale Klachtenlijst (4DKL). Een vragenlijst voor het meten van distress, depressie, angst en somatisatie [The Four-Dimensional Symptom Questionnaire (4DSQ). A questionnaire to measure distress, depression, anxiety, and somatization]. Huisarts Wet 1996, 39:538-547

Terluin B, Van Marwijk HWJ, Adèr HJ, De Vet HCW, Penninx BWJH, Hermens MLM, Van Boeijen CA, Van Balkom AJLM, Van der Klink JJL, Stalman WAB: The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization. BMC Psychiatry 2006, 6:34 (Full text article)

Terluin B, Van Rhenen W, Schaufeli WB, De Haan M: The Four-Dimensional Symptom Questionnaire (4DSQ): measuring distress and other mental health problems in a working population. Work Stress 2004, 18:187-207 (Full text article)

Terluin B, Brouwers EPM, van Marwijk HWJ, Verhaak PFM, van der Horst HE. Detecting depressive and anxiety disorders in distressed patients in primary care; comparative diagnostic accuracy of the Four-Dimensional Symptom Questionnaire (4DSQ) and the Hospital Anxiety and Depression Scale (HADS). BMC Fam Pract 2009; 10:58 (Full text article)

Terluin B, Smits N, Brouwers EPM, de Vet HCW The Four-Dimensional Symptom Questionnaire (4DSQ) in the general population: scale structure, reliability, measurement invariance and normative data: a cross-sectional survey. Health Qual Life Outcomes 2016; 14(1):130 (Full text article)

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Contact and conditions of use


Terluin B

Department of General Practice
EMGO Institute
VU University Medical Center
Van der Boechorststraat 7
1081 BT Amsterdam
The Netherlands
Phone: +31 (0) 36 5342720
E-mail: berend@terluin.net

Terluin B publications (Pubmed)

Contact information

Mapi Research Trust
27 rue de la Villette
69003 Lyon
Phone: +33 (0)4 72 13 66 66

Review copy

Examination copies can only be used for the limited purpose of examining the suitability of the Questionnaire for subsequent research and/or clinical use, and cannot be used in research or in clinical practice or distributed to others.
You are not authorized to modify, retype, translate, copy or otherwise duplicate the Questionnaire except with the further and prior written permission of Mapi Research Trust / the developers / copyright holders / distributors.

Available on the EMGO website


Original language(s)

  • Dutch for the Netherlands


The listed translations may not have undergone a full linguistic validation process and may require further work to be suitable for use in a study. This list is subject to constant changes, therefore please check the status of translations with Mapi Research Trust / the developers / copyright holders / distributors.


Arabic for Egypt
Czech for Czech Republic
English for the UK
French for France
German for Germany
Greek for Greece
Polish for Poland
Romanian for Romania
Russian for Russia
Serbian for Serbia
Swedish for Sweden
Turkish for Turkey
Urdu for Pakistan

More information on translations

Bibliographic reference of the English translation:

Terluin B, Smits N, Miedema B. The English version of the four-dimensional symptom questionnaire (4DSQ) measures the same as the original Dutch questionnaire: A validation study. Eur J Gen Pract 2014; 20(4): 320-326 (PubMed abstract)


Bibliographic reference of the French translation:

Chambe J, Le Reste JY, Maisonneuve H, Sanselme AE, Oho-Mpondo J, Nabbe P, Terluin B. Evaluating the validity of the French version of the Four-Dimensional Symptom Questionnaire with differential item functioning analysis. Fam Pract 2015;  32: 474-9 (Full text article)


Bibliographic reference of the Polish translation:

Czachowski S, Terluin B, Izdebski A, Izdebski P. Evaluating the cross-cultural validity of the Polish version of the Four-Dimensional Symptom Questionnaire (4DSQ) using differential item functioning (DIF) analysis. Family Practice 2012; 29: 609-15 (Full text article)


Bibliographic reference of the Turkish translation:

Terluin B, Unalan PC, Turfaner Sipahioğlu N, Arslan Özkul S, van Marwijk HWJ. Cross-cultural validation of the Turkish Four-Dimensional Symptom Questionnaire (4DSQ) using differential item and test functioning (DIF and DTF) analysis. BMC Fam Pract 2016; 17(1):53 (Full text article)

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