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PATIENT HEALTH QUESTIONNAIRE-9 (PHQ-9)
ShareThe PHQ-9 is a multipurpose instrument for screening, diagnosing,
monitoring and measuring the severity of depression.
OVER THE LAST 2 WEEKS, HOW OFTEN HAVE YOU BEEN BOTHERED BY THE FOLLOWING
PROBLEMS?
NOT AT ALL
SEVERAL DAYS
MORE THAN HALF THE DAYS
NEARLY EVERY DAY
1. LITTLE INTEREST OR PLEASURE IN DOING THINGS
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
2. FEELING DOWN, DEPRESSED OR HOPELESS
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
3. TROUBLE FALLING ASLEEP, STAYING ASLEEP, OR SLEEPING TOO MUCH
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
4. FEELING TIRED OR HAVING LITTLE ENERGY
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
5. POOR APPETITE OR OVEREATING
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
6. FEELING BAD ABOUT YOURSELF - OR THAT YOU’RE A FAILURE OR HAVE LET YOURSELF OR
YOUR FAMILY DOWN
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
7. TROUBLE CONCENTRATING ON THINGS, SUCH AS READING THE NEWSPAPER OR WATCHING
TELEVISION
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
8. MOVING OR SPEAKING SO SLOWLY THAT OTHER PEOPLE COULD HAVE NOTICED. OR, THE
OPPOSITE - BEING SO FIDGETY OR RESTLESS THAT YOU HAVE BEEN MOVING AROUND A LOT
MORE THAN USUAL
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
9. THOUGHTS THAT YOU WOULD BE BETTER OFF DEAD OR OF HURTING YOURSELF IN SOME WAY
Not at all0
Several days+1
More than half the days+2
Nearly every day+3
PHQ-9 SCORE OBTAINED BY ADDING SCORE FOR EACH QUESTION (TOTAL POINTS)
INTERPRETATION:
* Total scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate,
moderately severe and severe depression, respectively.
* Note: Question 9 is a single screening question on suicide risk. A patient
who answers yes to question 9 needs further assessment for suicide risk by an
individual who is competent to assess this risk.
INTERPRETATION
Provisional Diagnosis and Proposed Treatment Actions PHQ-9 ScoreDepression
SeverityProposed Treatment Actions 0 – 4 None-minimal None 5 – 9 Mild Watchful
waiting; repeat PHQ-9 at follow-up 10 – 14 Moderate Treatment plan, considering
counseling, follow-up and/or pharmacotherapy 15 – 19 Moderately Severe Active
treatment with pharmacotherapy and/or psychotherapy 20 – 27 Severe Immediate
initiation of pharmacotherapy and, if severe impairment or poor response to
therapy, expedited referral to a mental health specialist for psychotherapy
and/or collaborative management
SOURCES
* Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2:
Validity of a Two-Item Depression Screener. Medical Care. 2003;41:1284-92.
* Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression
severity measure. J Gen Intern Med. 2001;16:606-13.
* Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity
measure. Psychiatr Ann. 2002;32:509-21.
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