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http://g4.psychcentral.com/blog/wp-content/uploads/2009/02/phq9.pdf

DEPRESSION? 

PHQ-9 — Nine Symptom Checklist

Patient Name Date

1.

Over the last 2 weeks, how often have you been bothered by any of the following problems? Read each item carefully, and circle your response.

2.

f. Feeling bad about yourself, feeling that you are a failure, or feeling that you have let yourself or your family down
Not at all Several days More than half the days Nearly every day
g. Trouble concentrating on things such as reading the newspaper or watching television
Not at all Several days More than half the days Nearly every day
h. Moving or speaking so slowly that other people could have noticed. Or being so fidgety or restless that you have been moving around a lot more than usual
Not at all Several days More than half the days Nearly every day
i. Thinking that you would be better off dead or that you want to hurt yourself in some way
Not at all Several days More than half the days Nearly every day
If you checked off any problem on this questionnaire so far, 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 Difficult at All Somewhat Difficult Very Difficult Extremely Difficult
Copyright held by Pfizer Inc, but may be photocopied ad libitum

1

Tools May be printed without permission

a. Little interest or pleasure in doing things
Not at all Several days More than half the days
b. Feeling down, depressed, or hopeless
Not at all Several days More than half the days
c. Trouble falling asleep, staying asleep, or sleeping too much
Not at all Several days More than half the days
d. Feeling tired or having little energy
Not at all Several days More than half the days
e. Poor appetite or overeating
Not at all Several days More than half the days

Nearly every day
Nearly every day
Nearly every day
Nearly every day
Nearly every day

PHQ-9 — Scoring Tally Sheet

Patient Name Date
1. Over the last 2 weeks, how often have you been bothered by any of the following problems? Read each item carefully, and circle your response.

a. Littleinterestorpleasureindoingthings

Not at all

Several days

More than half the days

Nearly every day

0

1

2

3

b. Feelingdown,depressed,orhopeless

c. Troublefallingasleep,stayingasleep,or sleeping too much

d. Feelingtiredorhavinglittleenergy

e. Poorappetiteorovereating

f. Feeling bad about yourself, feeling that you are a failure, or feeling that you have let yourself or your family down

g. Troubleconcentratingonthingssuchas reading the newspaper or watching television

h. Movingorspeakingsoslowlythatother people could have noticed. Or being so fidgety or restless that you have been moving around a lot more than usual

i. Thinking that you would be better off dead or that you want to hurt yourself in some way

Totals

2. If you checked off any problem on this questionnaire so far, 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?
Copyright held by Pfizer Inc, but may be photocopied ad libitum

Not Difficult At All	Somewhat Difficult	Very Difficult	Extremely Difficult
0	1	2	3

2

Tools May be printed without permission

How to Score PHQ-9

Scoring Method For Diagnosis

Major Depressive Syndrome is suggested if:

• Of the 9 items, 5 or more are circled as at least "More than half the days"
  
• Either item 1a or 1b is positive, that is, at least "More than half the days"
  Minor Depressive Syndrome is suggested if:
  

• Of the 9 items, b, c, or d are circled as at least "More than half the days"
  
• Either item 1a or 1b is positive, that is, at least "More than half the days"
  Question One
  
  • To score the first question, tally each response by the number value of each response:
    Not at all = 0
    Several days = 1
    More than half the days = 2 Nearly every day = 3
    
  • Add the numbers together to total the score.
    
  • Interpret the score by using the guide listed below:
    

Scoring Method For Planning And Monitoring Treatment

Score	Action
<4	The score suggests the patient may not need depression treatment.
> 5-14	Physician uses clinical judgment about treatment, based on patient’s duration of symptoms and functional impairment.
>15	Warrants treatment for depression, using antidepressant, psychotherapy and/or a combination of treatment

3 Tools

How to Score PHQ-9

Question Two
In question two the patient responses can be one of four: not difficult at all, somewhat difficult, very difficult, extremely difficult. The last two responses suggest that the patient's functionality is impaired. After treatment begins, the functional status is again measured to see if the patient is improving.