PHQ-9 Depression Scale
Patient Health Questionnaire-9 (PHQ-9) for depression screening and severity assessment. Validated tool for clinical use.
Patient Health Questionnaire (PHQ-9)
Over the last 2 weeks, how often have you been bothered by any of the following problems?
1Little interest or pleasure in doing things
Select one option for each question
2Feeling down, depressed, or hopeless
3Trouble falling or staying asleep, or sleeping too much
4Feeling tired or having little energy
5Poor appetite or overeating
6Feeling bad about yourself — or that you are a failure or have let yourself or your family down
7Trouble concentrating on things, such as reading the newspaper or watching television
8Moving 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
9Thoughts that you would be better off dead or of hurting yourself in some way
PHQ-9 Score
Answer all 9 questions to see your score
Scoring Guide
Note: The PHQ-9 is a screening tool, not a diagnostic instrument. Results should be interpreted by a qualified healthcare professional and confirmed with clinical evaluation.
About This Calculator
The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression. It is based on the DSM-IV criteria for major depressive disorder and is validated for use in primary care. The PHQ-9 is in the public domain and can be used without permission.
Formula
Total Score = Sum of all 9 item scores (0-27)Each of the 9 items is scored 0-3: • 0 = Not at all • 1 = Several days • 2 = More than half the days • 3 = Nearly every day Total score ranges from 0 to 27.
Clinical Considerations
- •Question 9 assesses suicidal ideation - ANY positive response requires immediate safety assessment
- •PHQ-9 is a screening tool - clinical judgment is required for diagnosis
- •Consider cultural factors that may affect symptom reporting
Limitations
- •Does not differentiate between types of depression
- •May not capture atypical presentations
- •Self-report may be affected by recall bias
- •Should be used in conjunction with clinical interview
Interpretation Guide
| Range | Classification | Recommendation |
|---|---|---|
| <-4 | Minimal Depression | No treatment typically indicated; monitor if risk factors present |
| 5-9 | Mild Depression | Watchful waiting; repeat PHQ-9 at follow-up; consider counseling |
| 10-14 | Moderate Depression | Treatment plan indicated; consider counseling and/or pharmacotherapy |
| 15-19 | Moderately Severe Depression | Active treatment with pharmacotherapy and/or psychotherapy warranted |
| 20-27 | Severe Depression | Immediate initiation of pharmacotherapy; consider specialty referral |
Frequently Asked Questions
What is the PHQ-9?
The PHQ-9 (Patient Health Questionnaire-9) is a validated 9-item screening tool for depression based on DSM-IV criteria. It can be used for screening, diagnosis, and monitoring treatment response.
How is the PHQ-9 scored?
Each question is scored 0-3 based on symptom frequency over the past 2 weeks. Total scores range from 0-27. Scores of 5, 10, 15, and 20 represent cut-points for mild, moderate, moderately severe, and severe depression.
What score indicates major depression?
A PHQ-9 score ≥10 has 88% sensitivity and 88% specificity for major depression. However, diagnosis should be confirmed with clinical interview. The PHQ-9 is a screening tool, not a diagnostic instrument alone.
How should I interpret Question 9 (suicidal ideation)?
Any positive response to Question 9 (thoughts of being better off dead or hurting oneself) requires immediate assessment of suicide risk, regardless of total score. This should prompt safety evaluation and appropriate intervention.
How often should PHQ-9 be administered?
For monitoring treatment, PHQ-9 can be administered at baseline and at regular intervals (e.g., every 2-4 weeks initially, then monthly). A 5-point change is considered clinically significant improvement or worsening.
References
1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: Validity of a Brief Depression Severity Measure. J Gen Intern Med. 2001. doi: 10.1046/j.1525-1497.2001.016009606.x
View Source →2. Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener. Med Care. 2003. doi: 10.1097/01.MLR.0000093487.78664.3C
Last updated: 2024-12-18
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