About the PHQ-9
The Patient Health Questionnaire-9 is one of the most widely used, validated tools for screening and monitoring depression.
What it measures
Each of the nine items maps to a DSM criterion for major depressive disorder: anhedonia, depressed mood, sleep, fatigue, appetite, self-worth, concentration, psychomotor change, and thoughts of death or self-harm. It asks how often each was experienced over the past two weeks.
How scoring works
Each item is scored 0 (Not at all), 1 (Several days), 2 (More than half the days) or 3 (Nearly every day). Item scores are summed for a total of 0–27. A final, unscored question rates functional difficulty.
| Score | Severity | Proposed action |
|---|---|---|
| 0–4 | None / Minimal | No treatment typically indicated. |
| 5–9 | Mild | Watchful waiting; repeat PHQ-9 in 2–4 weeks. |
| 10–14 | Moderate | Schedule an appointment with a doctor or mental health professional. |
| 15–19 | Moderately Severe | Seek a clinical evaluation soon — ideally within the next week. |
| 20–27 | Severe | Contact a healthcare provider promptly for evaluation. |
A score of ≥10 showed 88% sensitivity and 88% specificity for major depression in the original validation study. Any positive answer to item 9 warrants a direct suicide-risk assessment, regardless of the total score.
Medical disclaimer
The PHQ-9 is a screening tool, not a diagnostic test. Only a qualified clinician can diagnose depression, after considering your history, other conditions (e.g. thyroid disease, bereavement, bipolar disorder) and a clinical interview. ClinicalPDF.org does not provide medical advice and does not store your answers.
References
- Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606–613.
- Spitzer RL, Kroenke K, Williams JBW. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282(18):1737–1744.
- Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals. 2002;32(9):509–515.
- Levis B, Benedetti A, Thombs BD. Accuracy of PHQ-9 for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476.
The PHQ-9 was developed with an educational grant from Pfizer Inc. No permission is required to reproduce, translate, display or distribute it.