PHQ-9 Depression Questionnaire

The PHQ-9 asks nine questions about the last two weeks. Its total, from 0 to 27, screens for depression and tracks how severe it is over time. Answer the questions to score it, see what each band means, and record the result with the free template.

  • Scores as you answer
  • Recording template to copy
  • Two recorded examples

PHQ-9 result template

Free
PHQ-9 RESULT

Date: [Date]
Patient: [Name or ID, age]
Completed by: [Patient on paper, patient online, or read aloud by clinician; interpreter if used]
Reason: [Screening, follow-up of known depression, or treatment review]

SCORES
Items 1 to 9: [Score for each item, 0 to 3]
Total: [0 to 27]
Band: [Minimal, mild, moderate, moderately severe, or severe]
Item 9: [Score, and the risk assessment done if above 0]
Difficulty, item 10: [Not difficult at all, somewhat, very, or extremely difficult]

TREND
Previous scores: [Dates and totals]
Change from baseline: [Points and percent; response or remission if it applies]

CLINICAL PICTURE
Interview findings: [What the conversation added: duration, impairment, other causes considered]
Impression: [Working diagnosis or screen result]

PLAN
Next step: [Watch and repeat, start or change treatment, refer]
Repeat PHQ-9: [Date or interval]

Clinician: [Name, credentials]

Score the PHQ-9 as you answer.

Every item as published. The total and what it means update with each answer; nothing you choose leaves this page.

Over the last 2 weeks, how often have you been bothered by any of the following problems?

  1. 1.Little interest or pleasure in doing things

  2. 2.Feeling down, depressed, or hopeless

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

  4. 4.Feeling tired or having little energy

  5. 5.Poor appetite or overeating

  6. 6.Feeling bad about yourself — or that you are a failure or have let yourself or your family down

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

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

  10. If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? Not added to the total.

Use it for

  • Primary care screening
  • Therapy intake
  • Measurement-based care
  • Postpartum follow-up
  • Telehealth visits

What the score means. 0 to 27.

0 to 4: Minimal

Depression is unlikely. No treatment for depression is usually needed on the score alone.

5 to 9: Mild

Watch and support: talk it through, and repeat the PHQ-9 at the next visit.

10 to 14: Moderate

Confirm the diagnosis in an interview, and agree a plan: therapy, medication, or both, with follow-up.

15 to 19: Moderately severe

Start active treatment with therapy, medication, or both, and follow up closely.

20 to 27: Severe

Start treatment promptly, and refer to mental health care when impairment is severe or the response is poor.
  • Add the nine item scores for the total. Item 10, on difficulty, is not added; record it as a sign of how much the symptoms affect daily life.
  • A total of 10 or more is the usual cutoff for likely major depression in screening.
  • For follow-up, a fall of 50% or more from baseline is a response, and a total under 5 is remission.
  • The score screens and measures severity; the diagnosis comes from the interview.

How to give it, score it, and read it.

Giving it

The patient answers on paper, online, or aloud; the questions cover the last two weeks.

  • Let the patient answer on their own where possible
  • Read the items aloud word for word when reading is hard, and use a validated translation where one exists
  • Ask item 10 when any problem was checked

Avoid: Rewording the items as you read them. Small changes in wording change how people answer.

Scoring

Each of the nine items scores 0 to 3; add them for a total from 0 to 27.

  • Record every item score, not only the total
  • Note item 9 on its own
  • If one or two items are missing, ask them before the patient leaves

Avoid: Leaving item 9 unread because the total is low. A low total can hide a positive item 9.

Reading the score

The band gives the likely severity; the interview confirms it.

  • Check how long symptoms have lasted and how much they affect daily life
  • Consider other causes: thyroid disease, medicines, substance use, grief, bipolar disorder
  • Ask about past episodes of mania before starting an antidepressant

Avoid: Diagnosing major depression from the total alone.

Item 9

Any answer above 0 means the patient has had thoughts of death or self-harm; follow up the same day.

  • Ask directly about thoughts, plans, intent, and past attempts
  • Ask about access to means, such as firearms and stored medicines
  • Record the risk assessment and the plan, including a safety plan if needed

Avoid: Treating item 9 as a yes or no for suicide. Many people who answer above 0 have passive thoughts only; the assessment tells them apart.

Tracking over time

Repeat the PHQ-9 at follow-up visits to see whether treatment is working.

  • Use the same version and the same way of giving it each time
  • Compare with the baseline: 50% lower is a response, under 5 is remission
  • Change the plan when the score hasn’t improved after 8 to 12 weeks

Two recorded results. Every part, filled in.

Each one follows the recording template. Use them to judge how much to write.

PHQ-9 result: positive screen in primary care

Family practice, annual visit, completed on a tablet in the waiting room

Scores

Items 1 to 9: 2, 2, 3, 2, 1, 2, 1, 0, 0. Total 13, moderate. Item 9: 0. Difficulty: very difficult.

Trend

PHQ-2 of 1 last year. No earlier PHQ-9.

Clinical picture

44-year-old man. Low mood and poor sleep for about 3 months since a layoff; still working part-time but avoiding friends. No past episodes of depression or mania. No alcohol increase. Thyroid tests normal in the spring. Impression: major depressive disorder, single episode, moderate.

Plan

Discussed options; he chose therapy first. Referral to a counselor, with a sleep plan. Repeat PHQ-9 in 4 weeks; discuss medication if it hasn’t fallen by then.

Common mistakes, and how to avoid them.

Missing a positive item 9

A total of 6 with item 9 at 1 still needs the same-day risk assessment. Read item 9 every time.

Diagnosing from the score

The PHQ-9 screens and measures. Confirm the diagnosis in the interview, and rule out other causes.

Recording only the total

Item scores show which symptoms are driving the total, and item 9 must be visible on its own.

Not tracking it

One score is a snapshot. Repeat it at follow-up, and change the plan when it hasn’t moved.

Where it comes from, and how you may use it.

Who holds it

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc.

How you may use it

No permission is needed to reproduce, translate, display, or distribute it. The official versions and translations are on the PHQ Screeners site.

Talk through the result. Review the note.

Vero Scribe records the PHQ-9 result in your template from the visit, with the patient’s consent, or from your dictation: the scores, the trend, item 9 and what you did about it. You review and edit every line, then copy it into your record. Vero works in 60+ languages.

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Frequently asked questions.

How do you score the PHQ-9?

Each of the nine items scores 0 for not at all, 1 for several days, 2 for more than half the days, and 3 for nearly every day. Add them for a total from 0 to 27. Item 10, on difficulty, is not added.

What PHQ-9 score means depression?

A total of 10 or more is the usual screening cutoff for likely major depression. The bands are 0 to 4 minimal, 5 to 9 mild, 10 to 14 moderate, 15 to 19 moderately severe, and 20 to 27 severe. The diagnosis still comes from a clinical interview.

What should I do if item 9 is positive?

Assess suicide risk the same day: thoughts, plans, intent, past attempts, access to means, and protective factors. Record the assessment and the plan, including a safety plan when needed. The 988 crisis line takes calls and texts.

What is the difference between the PHQ-2 and the PHQ-9?

The PHQ-2 is the first two items of the PHQ-9, on low interest and low mood. It’s a quick first screen; a score of 3 or more is followed by the full PHQ-9.

Is the PHQ-9 free to use?

Yes. No permission is needed to reproduce or use it, and the official versions and translations are on the PHQ Screeners site. The recording template on this page is free to copy or download too.

More mental health tools, and templates.

PHQ-2

Two questions on interest and mood: a quick first screen for depression, scored 0 to 6.

Open the PHQ-2

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C-SSRS

Up to six questions on suicidal thoughts and behavior; the highest yes sets low, moderate, or high risk.

Open the C-SSRS

PCL-5

Twenty items on the past month: PTSD screening and symptom tracking, scored 0 to 80.

Open the PCL-5

EPDS

Ten self-report items on the past 7 days: depression screening in pregnancy and after birth, scored 0 to 30.

Open the EPDS

Suicide risk assessment template

For a positive item 9: ideation, plan, intent, means, and the formulation.

Learn more about Suicide risk assessment template

Treatment plan review template

Goal by goal, with scores over time.

Learn more about Treatment plan review template

Mental health diagnosis codes

Common codes for depression and anxiety.

Learn more about Mental health diagnosis codes

All screening tools

Every tool, by area, with what its scores mean.

Learn more about All screening tools

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