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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?

1. Little interest or pleasure in doing things

2. Feeling down, depressed or hopeless

3. Trouble falling asleep, staying asleep, or sleeping too much

4. Feeling tired or having little energy

5. Poor appetite or overeating

6. Feeling bad about yourself - or that you’re a failure or have let yourself or your family down

7. Trouble concentrating on things, such as reading the newspaper or watching television

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

9. Thoughts that you would be better off dead or of hurting yourself in some way

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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Since you've received 80% or better on this quiz, you may claim continuing education credit.

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