PHQ-9 Depression Questionnaire
Over the last two weeks, how often have you been bothered by each of the following? Answer all nine items to see the total and its severity band.
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What the PHQ-9 Measures
The PHQ-9 is the nine-item depression module of the Patient Health Questionnaire. Each item maps onto one of the nine DSM criteria for a major depressive episode, is scored from 0 to 3 according to how many days in the past two weeks the problem was present, and contributes to a total from 0 to 27. It is one of the most widely validated screening instruments in medicine and is used both to detect depression and to track response to treatment.
Severity Bands
- 0–4: minimal — no treatment indicated on the score alone
- 5–9: mild — watchful waiting with reassessment
- 10–14: moderate — the conventional threshold for clinically significant depression
- 15–19: moderately severe — active treatment generally indicated
- 20–27: severe — prompt assessment and treatment
A cut-off of 10 or more gives roughly 88 % sensitivity and 88 % specificity for major depression in the original validation studies, which is why it is so widely used. Repeating the questionnaire is often more informative than a single value: a change of five points or more is generally taken as clinically meaningful.
Item 9 and Safety
Item 9 asks about thoughts of being better off dead or of self-harm, and it needs handling differently from the other eight. Any answer above zero — even “several days” — warrants asking directly about suicidal thoughts, intent and plan, and assessing safety, regardless of what the total score says. A low total does not make a positive item 9 safe to ignore, and a high total does not by itself establish risk. This page flags item 9 whenever it is answered above zero, but the conversation, not the number, is what matters.
If you are having thoughts of harming yourself, please seek help immediately: contact your local emergency number, a crisis helpline in your country, or go to the nearest emergency department. Do not wait for a routine appointment.
Limitations
- It is a screening tool, not a diagnosis. Major depression is diagnosed by clinical interview, using the score as supporting information.
- Somatic items overlap with physical illness. Fatigue, poor appetite and sleep disturbance inflate the score in people with medical conditions, chronic pain or thyroid disease.
- It is not a substitute for asking about mania, psychosis or substance use, which change the diagnosis and the treatment.
- Cultural and language factors affect how symptoms are reported, and validated translations should be used.
- A normal score does not exclude depression, particularly in people who minimise symptoms.
Frequently Asked Questions
What score on the PHQ-9 means I am depressed?
No single score means that. A total of 10 or more suggests clinically significant symptoms that should be assessed properly, and 15 or more makes moderate to severe depression likely — but only a clinical interview can establish the diagnosis.
Should I answer thinking about the last two weeks only?
Yes. The two-week recall window is part of how the instrument was validated, and it matches the duration criterion for a major depressive episode.
Can I use the PHQ-9 to see if my treatment is working?
Yes, that is one of its main uses. Repeat it at intervals and look at the change rather than the absolute number, alongside how you actually feel and function.