## Summary: The Patient Health Questionnaire-9 (PHQ-9) is a validated instrument frequently utilized in primary care and mental health settings for the purpose of identifying and quantifying the severity of depressive symptoms. Central to its design is a focus on the diagnostic criteria for major depressive disorder as outlined in the DSM-IV. It is a self-report tool that consists of nine questions, each corresponding to a symptom of depression. The simplicity of the PHQ-9 makes it an accessible and effective means for clinicians to screen for depression, monitor changes in severity over time, and make informed decisions regarding further psychological evaluation, treatment, and follow-up.
## Administration Instructions: Clinicians administering the PHQ-9 should ensure that the patient is aware that the questionnaire pertains to their experiences over the prior two weeks. Each item on the PHQ-9 correlates with a symptom of depression, and the patient is asked to indicate the frequency with which they have experienced each symptom. It is crucial to provide an environment that supports honest and candid responses, as the results will guide potential treatment options. Upon completion, clinicians should review the responses and score the questionnaire following the established scoring guidelines.
## Scoring Methodology: The scoring system for the PHQ-9 is straightforward: each of the nine items is scored on a scale of 0 to 3, based on the frequency of occurrence of the symptoms (0 being "not at all" and 3 being "nearly every day"). To obtain the total score, simply add the scores of all nine items. The total score can range from 0 to 27 and provides an estimation of depression severity. Scoring distinctions categorize depression levels as minimal, mild, moderate, moderately severe, or severe. Additionally, the tenth item of the PHQ-9, which assesses suicidal thoughts and ideation, should be given special consideration in the clinical assessment, as a positive response may indicate a need for immediate action.
## Authors and Citations: Developers of the PHQ-9 include Dr. Kurt Kroenke, Dr. Robert L. Spitzer, and Dr. Janet B.W. Williams, notable for their contributions to the field of psychiatry and psychological assessment. For further information and evidence pertaining to the validity and clinical utility of the PHQ-9, one may consult the following sources: - Kroenke, K., Spitzer, R.L., Williams, J.B. (2001). The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16(9), 606-613. - Kroenke, K., Spitzer, R.L. (2002). The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatric Annals, 32(9), 509-521. - Kroenke, K., Spitzer, R.L., Williams, J.B. (2003). The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener. Medical Care, 41(11), 1284-1292.
Please verify
Item No. | Item Description | Not at all | Several days | More than half the days | Nearly Every Day |
1 | Little interest or pleasure in doing things | 0 | 1 | 2 | 3 |
2 | Feeling down, depressed, or hopeless | 0 | 1 | 2 | 3 |
3 | Trouble falling asleep, staying asleep, or sleeping too much | 0 | 1 | 2 | 3 |
4 | Feeling tired or having little energy | 0 | 1 | 2 | 3 |
5 | Poor appetite or overeating | 0 | 1 | 2 | 3 |
6 | Feeling bad about yourself - or that you're a failure or have let yourself or your family down | 0 | 1 | 2 | 3 |
7 | Trouble concentrating on things, such as reading the newspaper or watching television | 0 | 1 | 2 | 3 |
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 | 0 | 1 | 2 | 3 |
9 | Thoughts that you would be better off dead or of hurting yourself in some way | 0 | 1 | 2 | 3 |
FOR OFFICE CODING | 0 | ___+ | ___+ | ____=____ |