Clinical Calculators

PHQ-9 (Patient Health Questionnaire-9)

Frequency of depressive symptoms over the last 2 weeks: nine items scored 0 to 3, total 0 to 27

9 items left

1. Little interest or pleasure in doing things

For all nine items, choose how often you have been bothered by the problem over the last 2 weeks

2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down
7. Trouble concentrating on things, such as reading the newspaper or watching television
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. Thoughts that you would be better off dead or of hurting yourself in some way

See the cautions for what to do when any answer other than "Not at all" is chosen

10. (Not part of the total) 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?(optional)

Asked when any of the nine items applies. It does not add to the score, so it can be left empty

Cautions

  • The total of nine items scored 0 to 3 (0 to 27) is a guide to the severity of depressive symptoms. The cut points of 5, 10, 15 and 20 mark mild, moderate, moderately severe and severe.
  • If item 9 (thoughts that you would be better off dead or of hurting yourself in some way) is answered with anything other than "Not at all", a clinical interview is needed for the final decision about the risk of self-harm or suicide. Do not decide from the total score alone (PHQ instruction manual).
  • Item 10 (difficulty) is used neither for the total score nor for diagnosis. It records the self-rated impairment of work, home and social life caused by the symptoms in a person who has any of the nine problems (PHQ instruction manual).
  • The original paper used a total of 10 or more as the cut point for screening for major depression (sensitivity 88% and specificity 88% against interviews by mental health professionals, n = 580). The severity categories complement, and do not replace, the diagnostic algorithm (discussion of the original paper).
  • In a single-site study of outpatients of a general medicine clinic at a university hospital in Japan (n = 521), the best cut point for detecting major depression was 11 or more (a score of 10 or more had a sensitivity of 0.79 and a specificity of 0.77). The best cut point can differ with the population and the setting.
  • The items on this screen use the English wording of the PHQ-9 published on PHQ Screeners, the version that was validated against an independent structured interview. The instruction manual states that few of the translated versions have been validated against such an interview.

References

  1. 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. (Methods, Table 2, Table 3, Appendix) PMID: 11556941, https://pmc.ncbi.nlm.nih.gov/articles/PMC1495268/[Original article]
  2. PHQ and GAD-7 Instructions (Instruction Manual for Patient Health Questionnaire (PHQ) and GAD-7 Measures). PHQ Screeners. (Coding and Scoring section, Table 4 (p. 7), description of item 9 and item 10 (p. 2), translated versions (p. 7)) https://www.phqscreeners.com/images/sites/g/files/g10016261/f/201412/instructions.pdf[Guideline]
  3. PHQ-9, Japanese version ("Patient Health Questionnaire-9"; developed with an educational grant from Pfizer Inc.). PHQ Screeners, file "PHQ9_Japanese for Japan" (in Japanese). (The questionnaire and the note at its end) https://www.phqscreeners.com/images/sites/g/files/g10060481/f/201412/PHQ9_Japanese%20for%20Japan.pdf[Review article]
  4. Suzuki K, et al. Screening for major depressive disorder with the Patient Health Questionnaire (PHQ-9 and PHQ-2) in an outpatient clinic staffed by primary care physicians in Japan: a case control study. PLoS One. 2015;10(3):e0119147. (Results, Table 3) https://pmc.ncbi.nlm.nih.gov/articles/PMC4366166/[Original article]

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.

Checked on: 2026-10-21

Disclaimer

This calculation is intended to support the judgment of healthcare professionals. Results are for reference only; decisions about diagnosis and treatment must be made by the responsible healthcare professional. The values you enter never leave your device.