The Korean questionnaire wording was translated freshly from English, so
a score built from it was comparable to nothing in the literature. Each
instrument now carries the text its own publisher put out, or no Korean
at all.
PHQ-9 and GAD-7 come verbatim from the instrument owner's distribution —
Pfizer's `PHQ9_Korean for Korea.pdf` (2010-06-15) and `GAD7_Korean for
Korea.pdf` (2010-05-18), the latter being the file Ahn/Kim/Choi 2019
names as what it validated. The sheets grant reproduction, translation,
display and distribution without permission. Verbatim means verbatim:
the spacing in "7 일 이상 방해 받았다" and the sheet's "안절부절 못하거나"
against the GAD-7 sheet's "안절부절못해서" are reproduced as printed.
WHO-5 has no official Korean arm. Neither the WHO's 2024 distribution
(26 languages) nor the Psychiatric Research Unit folder it inherited
from (31 languages) has ever carried one, and ePROVIDE lists the same
31. Korean therefore carries the published forward/back-translation
from Kim HJ et al., J Korean Geriatr Psychiatry 2010;14(2):90-96, which
is CC BY-NC and so redistributable; the attribution line names it. Its
validation sample was community-dwelling elderly rather than general
adults, which the definition says out loud.
The Sleep Condition Indicator reverts to English. It is validated in
English only, its cut-off was derived from those words, and no openly
redistributable Korean exists — so `ko` now matches de/es/fr/it/pl:
items, section stems and response anchors byte-identical to en.json,
under the localized "validated in English" note.
`ALL_APP_LOCALES` grows to seven, which is what stops the check-in
wizard claiming English wording over Korean items on every Korean
check-in.
One gap is deliberate and not yet resolved. The official Korean PHQ-9
and GAD-7 sheets disagree on anchor 2 — "7 일 이상 방해 받았다" against
"2 주 중 절반 이상 방해 받았다" — but both instruments read one shared
`mentalHealth.options` set, which holds for the other six locales
because their two sheets agree word for word. Korean takes the PHQ-9
wording for both here. GAD-7's anchors are therefore validated in
substance but not verbatim; splitting them into a `gad7Options`
namespace is the fix, and is left for the maintainer to weigh against
the 24 duplicated keys it would add across the other locales.
The functional-impairment item and its four anchors come from the same
PHQ-9 sheet. They are not scored and not covered by the
`validatedItemLocales` contract.
The reverse-coverage guard asserts that every key in the bundle is reachable
from a call site. It had stopped doing that for most of the bundle. A template
whose only static anchor was a namespace root registered that root as a subtree
base, so a single per-provider OAuth key marked every key under `settings.*`
reachable, and the same shape did it for `measurementReminders.*`. A cache-key
string that happens to start with a namespace word had quietly done it for
`insights.*` too. The guard stayed green throughout, which is the part worth
noticing: a pair guard degrades into a one-end guard without any signal.
Extract the matcher into a helper with its own unit tests, and change what it
accepts. A template carrying both a literal prefix and a literal suffix now
records the pair and requires both ends to match, so the OAuth template covers
the provider keys and nothing else. A template with no suffix whose anchor is a
bare namespace no longer whitelists anything — it fails the guard by name, with
the two honest remedies in the message. The same door is used by the template,
assignment and concatenation arms, so none of them can reopen it. Template
bodies are read by scanning forward from a known opening backtick rather than
by pairing backticks across the tree, which was drifting and dropping whole
files out of the scan.
Three call sites build their keys whole instead of interpolating onto a
namespace root: the two measurement-reminder due helpers, the mental-health
option labels, and the OAuth error copy, which now names its per-provider base.
Two audit-log action names that merely look like keys carry a written
exemption; the API error catalog is a runtime lookup and is allowlisted with
its reason.
With the matcher honest, 149 keys had no call site left. They belong to an
explainer popover, a hypnogram, a passkey table and an insights hero that were
all rebuilt or removed, and they are deleted from all six locales. The
explainer guard stops pinning its title leaves, which no surface has rendered
since the popover went.
The PHQ-9 item-9 crisis card routed every "de" locale to the Germany-only
TelefonSeelsorge freephone lines. Those numbers don't connect from Austria
or Switzerland, so a Swiss or Austrian user in crisis was shown dead numbers
first on the one surface where that costs the most.
Add dedicated Austria (Telefonseelsorge 142) and Switzerland (Die
Dargebotene Hand 143) resource sets. `User.locale` only ever stores a bare
short code today, so an unqualified "de" now resolves to a combined
DE/AT/CH set (112 first, then every country's own line) instead of
defaulting to Germany; a region-qualified tag resolves to the exact country
when one is available.
Two new self-report instruments join the mental-wellbeing engine on the
existing PHQ-9 / GAD-7 infrastructure:
- WHO-5 Well-Being Index: 5 items on the 6-point 5..0 scale over the last
two weeks; the reported total is raw-sum x 4 (0-100) per the official
WHO scoring (WHO/UCN/MSD/MHE/2024.1, CC BY-NC-SA 3.0 IGO). A total of
50 or below follows the WHO comment (below 50 = indication for further
assessment).
- Sleep Condition Indicator: 8 DSM-5-aligned items, 0-4 each with
item-specific anchors, total 0-32, higher = better sleep; a total of
16 or below maps to the probable-insomnia range of the source
publication (Espie et al., BMJ Open 2014;4:e004183, CC BY-NC,
(c) Sleepio Limited).
The instrument registry generalises rather than forking: per-item answer
ceilings, option order/label schemes, recall-stem captions, a reported-
score multiplier, score direction (higher-is-better inverts the follow-up
threshold), per-instrument attribution lines, and the validated-item
locale set are now instrument properties. Scoring stays server-
authoritative; the create route validates the per-instrument answer
ceiling and projects the total onto a COMPUTED WHO5_SCORE / SCI_SCORE
measurement row (never client-attributable), which also auto-satisfies a
planned screening reminder. Migration 0226 adds the enum values
(additive, idempotent). OpenAPI regenerated.
Neither instrument carries a self-harm item; the PHQ-9 item-9 crisis
routing is unchanged.
Pin the highest-consequence numbers in the release: every PHQ-9/GAD-7 severity
band edge, the >=10 action threshold, and the item-9 ANY-non-zero safety flag
(true on item9 1/2/3, false on 0 or for GAD-7). Add a POST happy-path test
that would have caught the dead-on-arrival bug — a valid body now parses,
persists server-authoritative scoring, writes the derived score measurement,
and surfaces the crisis set on a positive item 9.
The PHQ-9/GAD-7 item wordings rendered in English for es/fr/it/pl users
(de was already validated). Replace them with the officially validated,
public-domain Pfizer/PRIME-MD localized screener wordings (distributed via
the MAPI Research Trust) rather than ad-hoc translations — re-wording a
validated instrument invalidates the score. Localize the crisis-resource
copy too: translate the descriptive parentheticals while keeping the org
proper-nouns (TelefonSeelsorge, Nummer gegen Kummer, krisenchat,
Find a Helpline) and the US brand lines (988, Crisis Text Line) verbatim.
Add the new mental-wellbeing module label/description and the nav label
across all six locales.
Add the validated mental-health self-assessment surface, beside mood tracking
(never replacing it) and off by default:
- MentalHealthAssessment stores per-item answers in a single AES-256-GCM Bytes
blob (registered for key rotation); only the server-authoritative total,
severity band, and item-9 flag are denormalised. The total projects to a
PHQ9_SCORE / GAD7_SCORE measurement row so the trend rides existing infra
without ever exposing item content.
- Item-9 safety: any non-zero PHQ-9 self-harm answer surfaces a calm,
locale-aware crisis-resource set (DE: TelefonSeelsorge 0800 111 0 111 / 112;
international fallback) and stamps crisisShownAt. No clinical interpretation,
no AI ingestion of item content, no third-party alerting.
- API + OpenAPI: POST/GET /api/mental-health/assessments; the response excludes
raw item answers by construction. Required Pfizer/PHQ attribution lives in the
instrument module, rendered verbatim.
The screener scores are kept off the Coach snapshot and MCP surfaces, and out of
exports by default — item content never reaches the AI pipeline.
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