The Symptom Checklist-90-Revised (SCL-90-R; Derogatis, 1977, 1994) was constructed to measure both general psychological distress and specific primary symptoms of distress. In this study, we evaluated to what extent the scale scores of the Dutch SCL-90-R reflect general and/or specific aspects of psychological distress in a psychiatric outpatients sample (N = 1,842), using a hierarchical factor model. The results revealed that the total scale score measures general psychological distress, with high reliability. The subscale scores Sleep Difficulties, Agoraphobia, Hostility, and Somatization reflect the specific primary symptoms reasonably well, with high reliability. The subscale score Depression hardly measures specific symptoms of distress, but instead a very common construct as is measured with the total scale of the SCL-90-R. The use of the Depression subscale score beyond the total scale score of the SCL-90-R appears therefore of limited value in clinical practice.