What does a PHQ-9 score mean?

The PHQ-9 scores depression severity from 0 to 27. Scores of 0–4 indicate minimal or no depression; 5–9 mild depression; 10–14 moderate depression; 15–19 moderately severe depression; and 20–27 severe depression. A score of 10 or above is the commonly used clinical threshold for a probable diagnosis of major depressive disorder, though clinical judgement should always accompany the score.

What is the difference between PHQ-9 and GAD-7?

The PHQ-9 (Patient Health Questionnaire) screens specifically for depression symptoms over the past 2 weeks. The GAD-7 (Generalized Anxiety Disorder scale) screens for anxiety symptoms over the past 2 weeks. Both are validated 7–9 item questionnaires recommended by NICE and USPSTF. They are frequently administered together in primary care as a combined depression and anxiety screening package.

Are these mental health screening tools a diagnosis?

No. PHQ-9, GAD-7, and similar questionnaires are validated screening tools, not diagnostic instruments. A high score indicates a need for further professional evaluation — it is not a clinical diagnosis. Diagnosis of depression, anxiety disorders, or other mental health conditions requires a comprehensive assessment by a qualified mental health professional or physician.

5 Validated Tools

Mental Health Screening Tools

Standardised, validated screening questionnaires used in primary care and psychiatry. PHQ-9, GAD-7, burnout assessment, sleep quality, and stress measurement — all completely private, with no data leaving your device.

Validated instruments Zero data stored Clinical action guidance PDF reports

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If you are in crisis or immediate danger: These are screening tools, not emergency services. Please contact emergency services or a crisis line immediately. US: Call or text 988 (Suicide & Crisis Lifeline). UK: Call 116 123 (Samaritans). International: befrienders.org lists crisis lines in 32 countries.

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Screening tools — not diagnostic instruments. PHQ-9, GAD-7, and similar questionnaires are validated for screening in clinical settings. A high score indicates a need for further professional evaluation — it is not a diagnosis. Always interpret results alongside a qualified mental health or medical professional.

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PHQ-9 Depression Screen

9-item Patient Health Questionnaire for depression screening and severity measurement. Scores 0–27 with five severity levels, clinical action thresholds, next-step recommendations, and a printable report for clinical notes.

🔥 Most Used Use tool

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GAD-7 Anxiety Scale

7-item Generalized Anxiety Disorder scale. Validated for screening, diagnosis, and monitoring anxiety severity over time. Includes clinical cut-offs, functional impairment question, and management guidance per NICE guidelines.

🔥 Popular Use tool

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Burnout Index

Occupational burnout assessment across three dimensions: emotional exhaustion, depersonalisation, and reduced personal accomplishment. Based on Maslach Burnout Inventory (MBI) framework with dimension-specific scores and recovery guidance.

✨ New Use tool

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Sleep Quality Score (PSQI)

Pittsburgh Sleep Quality Index — validated 19-item questionnaire assessing sleep quality, latency, duration, efficiency, disturbances, medication use, and daytime dysfunction over the past month. Score ≥5 indicates poor sleep quality.

✨ New Use tool

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Perceived Stress Scale (PSS-10)

10-item validated measure of perceived stress over the past month. Normed by age and gender with population reference scores, interpretation bands, and evidence-based stress reduction recommendations.

✨ New Use tool

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Score Interpretation at a Glance

Validated severity thresholds for our two most-used tools. Open either tool for full interpretation and clinical guidance.

💬 PHQ-9 Severity Bands Score 0–27

0–4 Minimal / no depression

5–9 Mild depression

10–14 Moderate depression

15–19 Moderately severe depression

20–27 Severe depression

Open PHQ-9 Screening Tool →

🧘 GAD-7 Severity Bands Score 0–21

0–4 Minimal anxiety

5–9 Mild anxiety

10–14 Moderate anxiety

15–21 Severe anxiety

≥ 10 Clinical threshold — further evaluation

Open GAD-7 Screening Tool →

When to Seek Support

Screening tools identify when professional evaluation may be helpful. Here are the appropriate next steps.

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Talk to Your GP / Primary Care Doctor

A PHQ-9 ≥10 or GAD-7 ≥10 is a good reason to book an appointment. Your doctor can provide a full assessment, rule out physical causes, and discuss treatment options including therapy and medication.

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Mental Health Professionals

Psychologists, psychiatrists, therapists, and counsellors provide evidence-based treatments including CBT, ACT, and medication management. Many offer online sessions. Ask your GP for a referral or self-refer where available.

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Crisis Lines & Online Support

If you are struggling now: US: 988 · UK: 116 123 (Samaritans) · AU: 13 11 14 (Lifeline) · International: befrienders.org. Online text support: Crisis Text Line (text HOME to 741741 in US).

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Complete Privacy

Mental health data is among the most sensitive personal information. Every questionnaire runs entirely in your browser — no answers, scores, or identifiers are ever transmitted or stored anywhere.

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Clinical-Grade Reports

Every tool generates a PDF report showing individual item responses, total score, severity interpretation, and recommended next steps — formatted for inclusion in clinical notes or for sharing with your healthcare provider.

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Track Change Over Time

PHQ-9 and GAD-7 are designed to be repeated at follow-up appointments to monitor treatment response. Our tools make it easy to re-score and compare results, with a trend indicator showing improvement or deterioration.

About Mental Health Screening Tools

Mental health conditions affect approximately 1 in 4 people globally, yet remain significantly underdiagnosed — particularly in primary care settings where time is limited and stigma can prevent patients from raising concerns unprompted. Validated screening questionnaires like the PHQ-9 and GAD-7 enable systematic, objective identification of depression and anxiety that might otherwise go undetected, facilitating earlier intervention and better outcomes.

The PHQ-9 — The Most Widely Used Depression Screen

The Patient Health Questionnaire-9 (PHQ-9) was developed by Spitzer, Kroenke, and Williams in 1999 and is now the most widely used depression screening tool globally. It maps directly to the DSM-5 criteria for major depressive disorder, asking about the nine symptoms of depression over the past two weeks on a 0–3 frequency scale. It is recommended by USPSTF for routine depression screening in adults, by NICE for depression monitoring in primary care, and by the WHO as part of the mhGAP programme for low-resource settings.

A PHQ-9 score of 10 or above has a sensitivity of approximately 88% and specificity of 88% for major depressive disorder, making it one of the most accurate screening tools available. However, it should always be interpreted alongside clinical context — grief, chronic illness, and sleep disorders can inflate scores.

The GAD-7 — Gold Standard for Anxiety Screening

The Generalized Anxiety Disorder 7-item scale (GAD-7) was developed by Spitzer et al. in 2006 and has been validated for screening generalised anxiety disorder, panic disorder, social anxiety disorder, and post-traumatic stress disorder. A score of 10 or above has 89% sensitivity and 82% specificity for GAD. The PHQ-9 and GAD-7 are frequently administered together as a 16-item combined mental health screener in primary care consultations.

Burnout — A Clinical and Organisational Issue

Occupational burnout was classified as an occupational phenomenon (not a medical condition) in ICD-11 (2019), defined as a syndrome resulting from chronic workplace stress that has not been successfully managed. The three dimensions — emotional exhaustion, depersonalisation (cynicism), and reduced professional efficacy — are measured by our burnout tool based on the Maslach Burnout Inventory (MBI) framework, the most widely validated burnout instrument with 40+ years of research.

Sleep Quality and Mental Health

Sleep disturbance is both a symptom of depression and anxiety and an independent risk factor for their development. The Pittsburgh Sleep Quality Index (PSQI) measures seven components of sleep quality over the past month. A global score above 5 distinguishes good from poor sleepers with 89.6% sensitivity and 86.5% specificity. Poor sleep quality identified by PSQI frequently warrants referral for sleep hygiene counselling, cognitive behavioural therapy for insomnia (CBT-I), or investigation for sleep disorders such as obstructive sleep apnoea.

Frequently Asked Questions

What does a PHQ-9 score of 10 or above mean? +

A PHQ-9 score of 10 or above is the commonly used clinical threshold indicating a probable major depressive episode warranting further evaluation. At this threshold, the PHQ-9 has approximately 88% sensitivity and 88% specificity for major depressive disorder. Scores in this range should prompt a clinical interview to confirm diagnosis, assess suicide risk, and discuss treatment options. The score alone is not a diagnosis.

Can I use these tools to diagnose myself? +

No. PHQ-9, GAD-7, and similar tools are screening questionnaires, not diagnostic instruments. They identify people who may benefit from a professional mental health evaluation — they cannot diagnose depression, anxiety disorders, or any other mental health condition. A formal diagnosis requires a comprehensive clinical assessment by a qualified mental health professional or physician that includes history, symptom severity, duration, functional impairment, and exclusion of physical and pharmacological causes.

How often should I complete the PHQ-9 or GAD-7? +

In clinical practice, PHQ-9 and GAD-7 are commonly repeated every 2–4 weeks during active treatment to monitor response, and every 3–6 months during maintenance to detect relapse. Both tools are sensitive to change over time, making them useful for tracking treatment progress. A reduction of 5 or more points on the PHQ-9 is generally considered a clinically meaningful response.

What is occupational burnout and how is it different from depression? +

Burnout is a state of chronic occupational stress characterised by emotional exhaustion, depersonalisation (detachment or cynicism toward work), and reduced sense of personal accomplishment. Unlike depression, burnout is context-specific — symptoms are primarily linked to work and may improve with time off, whereas depression is pervasive across all life domains and does not resolve with rest alone. However, burnout and depression frequently co-occur, and burnout can progress to clinical depression without intervention. If a burnout assessment suggests significant distress, a PHQ-9 screen is also recommended.

Are responses to these questionnaires confidential? +

On MediCalc Pro, yes — completely. All questionnaire responses are processed entirely within your browser using JavaScript. No answers, scores, or any identifying information are transmitted to any server, stored in any database, or accessible to MediCalc Pro or any third party. You can verify this by disconnecting from the internet before completing a questionnaire — it will still work perfectly. Your mental health data remains entirely private to you.

Related Tools on MediCalc Pro

Mental health intersects with physical health in many ways. For metabolic monitoring in patients on antipsychotics, see BMI Calculator and Waist-Hip Ratio. For QTc monitoring in patients on antipsychotics and antidepressants, see QTc Calculator. For renal dosing of lithium and other renally-cleared psychiatric medications, see Creatinine Clearance. For occupational burnout in healthcare workers, our Burnout Index includes profession-specific reference norms.

References & Validation Sources

Kroenke K, Spitzer RL, Williams JB. "The PHQ-9: validity of a brief depression severity measure." J Gen Intern Med. 2001;16(9):606-613.
Spitzer RL, Kroenke K, Williams JB, Löwe B. "A brief measure for assessing generalized anxiety disorder." Arch Intern Med. 2006;166(10):1092-1097.
Maslach C, Jackson SE, Leiter MP. Maslach Burnout Inventory Manual. 4th ed. Mind Garden, 2018.
Buysse DJ, et al. "The Pittsburgh Sleep Quality Index: A new instrument for psychiatric practice and research." Psychiatry Res. 1989;28(2):193-213.
Cohen S, Kamarck T, Mermelstein R. "A global measure of perceived stress." J Health Soc Behav. 1983;24(4):385-396.
World Health Organization. ICD-11 Classification: QD85 Burnout. 2019.

⚠️ Medical Disclaimer: Mental health screening tools are for educational and informational purposes only. They are not a substitute for professional clinical assessment, diagnosis, or treatment. If you are concerned about your mental health or that of someone you know, please consult a qualified healthcare professional. In an emergency, contact your local emergency services or a mental health crisis line immediately.