Mental Health

PHQ-9 Depression Screening

The Patient Health Questionnaire-9 is the most widely validated depression screening tool in primary care. Score all 9 items based on the past 2 weeks and get instant severity classification with treatment guidance.

Kroenke et al. 2001 DSM-5 aligned PDF export
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Clinical screening tool. The PHQ-9 is designed for clinical use by healthcare professionals to screen for depression. It is not a diagnostic test. Results should always be interpreted in clinical context. If you are in crisis, please contact a mental health professional or crisis service immediately.
PHQ-9 — Over the past 2 weeks

How often have you been bothered by any of the following problems over the last 2 weeks?

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PHQ-9 Result
⚠️ Item 9 — Thoughts of self-harm or suicide detected
This patient endorsed item 9 (thoughts of being better off dead or self-harm). Clinical assessment of suicide risk is required. Do not leave this patient alone. Contact mental health services or emergency services if immediate risk is present.

Crisis resources: National Suicide Prevention Lifeline: 988 (US) | Samaritans: 116 123 (UK) | Crisis Text Line: Text HOME to 741741
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Severity bands:

0-4
None-Minimal
5-9
Mild
10-14
Moderate
15-19
Mod-Severe
20-27
Severe
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About the PHQ-9

The Patient Health Questionnaire-9 was developed by Kroenke, Spitzer, and Williams (2001) and is licensed for free clinical use. It scores the 9 DSM criteria for major depressive disorder from 0 (not at all) to 3 (nearly every day), giving a maximum of 27 points. It's validated across primary care, hospital, and community settings.

Severity classification and treatment guidance

ScoreSeveritySuggested Action
0-4None-minimalMonitor. Watchful waiting.
5-9MildWatchful waiting, repeat in 2-4 weeks. Consider guided self-help.
10-14ModerateTreatment plan. Consider counselling, CBT, and antidepressants.
15-19Moderately severeActive treatment with antidepressants and/or psychotherapy. Follow up closely.
20-27SevereImmediate initiation of pharmacotherapy. Referral to mental health specialist.

Item 9 and suicide risk

Item 9 asks about thoughts of being better off dead or of hurting yourself. Any positive response requires direct clinical assessment. The PHQ-9 score itself doesn't predict suicide risk — it flags that a conversation must happen. Ask directly, assess lethality, and document your assessment.

PHQ-2 as an initial screen

The PHQ-2 uses only items 1 and 2 (anhedonia and depressed mood). A score of 3 or above on the PHQ-2 warrants full PHQ-9 assessment. Sensitivity 83%, specificity 92% for major depression at this cutoff.

Related tools

For anxiety screening, see GAD-7 Anxiety Scale. For occupational burnout, see Burnout Index. For sleep quality assessment, see Sleep Quality Score. For overall stress measurement, see Perceived Stress Scale.

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.
  • NICE Guideline CG90. Depression in adults: recognition and management. NICE, 2009 (updated 2022).
Important: The PHQ-9 is a screening aid, not a diagnostic instrument. A positive screen does not mean depression is present; a negative screen does not rule it out. All results must be interpreted by a qualified clinician in the context of the full clinical picture.
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