Patient Health Questionnaire (PHQ-9)

This easy to use patient questionnaire is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders.^[1] The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as "0" (not at all) to "3" (nearly every day). It has been validated for use in Primary Care.^[2] It is not a screening tool for depression but it is used to monitor the severity of depression and response to treatment. It can be used to make a tentative diagnosis of depression.^[3]

Patient Health Questionnaire (PHQ-9)
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Little interest or pleasure in doing things?
Feeling down, depressed, or hopeless?
Trouble falling or staying asleep, or sleeping too much?
Feeling tired or having little energy?
Poor appetite or overeating?
Feeling bad about yourself - or that you are a failure or have let yourself or your family down?
Trouble concentrating on things, such as reading the newspaper or watching television?
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?
Thoughts that you would be better off dead, or of hurting yourself in some way?
Total = /27
Depression Severity: 0-4 None, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.

Validity has been assessed against an independent structured mental health professional (MHP) interview. PHQ-9 score ≥10 had a sensitivity of 88% and a specificity of 88% for major depression.^[1]^[2] It can even be used over the telephone.^[4]

Note about Credits

PHQ9 is ©Pfizer.
May only be reprinted with permission, courtesy of Pfizer Limited."
PRIME-MD ® is a trademark of Pfizer.

Further reading & references

Kroenke K, Spitzer RL, Williams JB; The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001 Sep;16(9):606-13.
Dietrich AJ, Oxman TE, Burns MR, et al; Application of a depression management office system in community practice: a demonstration. J Am Board Fam Pract. 2003 Mar-Apr;16(2):107-14.
Use of the PHQ-9 to make a tentative diagnosis of depression; The Macarthur Initiative on Depression in Primary Care Website.
Pinto-Meza A, Serrano-Blanco A, Penarrubia MT, et al; Assessing depression in primary care with the PHQ-9: can it be carried out over the telephone? J Gen Intern Med. 2005 Aug;20(8):738-42.

Original Author: Dr Tim Kenny	Current Version: Dr Tim Kenny	Peer Reviewer: Hilary Cole
Last Checked: 09/11/2010	Document ID: 2582 Version: 27	© EMIS

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. EMIS has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.