PHQ-9 Depression Scale Questionnaire

The PHQ-9 is a measurement tool providers can use to ensure measurement-based treatment to target within Collaborative Care. This concise nine-item health questionnaire can function as a screening tool, aids in diagnosis, and measures treatment response.

Advantages of the PHQ-9

Patient filling out PHQ-9

  • It is shorter than other depression rating scales
  • Multiple administration options (in person by a clinician, by telephone, or self-administered by the patient)
  • Facilitates diagnosis of major depression
  • Assesses symptom severity
  • Well-validated and documented in a variety of populations
  • Directly based on the nine diagnostic criteria for major depressive disorder in the DSM-5
  • Valid for use in adolescents as young as 12 years of age

How to Use the PHQ-9

At the initial visit, the PHQ-9 aids in the diagnosis and identification of potential depressive symptoms. At follow-up visits, it measures treatment response. The Questionnaire can be clinician or self-administered.

Scoring the PHQ-9

The PHQ-9 is a tool to assist clinicians in identifying and diagnosing major depression. It has a maximum score of 27. Elevated scores strongly correlate with a major depression diagnosis. However, it’s essential to remember that not everyone with a high PHQ-9 score will have major depression. Trained clinicians must make the final diagnosis.

Patient Health Questionnaire 2 (PHQ-2)

The Patient Health Questionnaire 2 (PHQ-2) effectively screens large groups for depression. It consists of the first two questions on the PHQ-9. If the patient responds affirmatively to either question on the PHQ-2, the PHQ-9 should be administered. No permission is required to reproduce, translate, display, or distribute the PHQ-2.

PHQ-9 Questionnaire and Translations

The PHQ-9, translations of the measure, and an instruction manual are available at www.phqscreeners.com. No permission is required to reproduce, translate, display, or distribute the PHQ-9.

Protocols for Suicide Prevention

The PHQ-9 asks about suicidal ideation, and clinics should have a plan in place for when a patient scores positive on this question. The Protocols for Suicide Prevention in Primary Care assists clinics in refining existing protocol(s) for responding to patients who present with suicidality or violent behavior.

PHQ-9 Aids

Introducing the PHQ-9

To increase staff comfort in discussing the PHQ-9 with patients, the AIMS Center provides the Helping Clinic Staff Talk about the PHQ-9 tool. This resource equips clinic staff to administer the PHQ-9 by addressing commonly asked patient questions.

PHQ-9 Visual Answer Aid 

This answer aid visually represents the PHQ-9 answer scale: English | Spanish.

AUDIT-C

The AUDIT-C is a 3-item alcohol screen that can help identify persons who are hazardous drinkers or have active alcohol use disorders (including alcohol dependence). The AUDIT-C is a modified version of the 10-question AUDIT instrument.

Generalized Anxiety Disorder subscale (GAD-7)

The Generalized Anxiety Disorder (GAD) subscale of the Patient Health Questionnaire (GAD-7) is a quick and easy tool to help identify patients with anxiety and monitor treatment response. The GAD-7 is available free for clinical use in a variety of languages at the link below.

Patient Health Questionnaire 2 (PHQ-2)

The Patient Health Questionnaire 2 (PHQ-2) is used by some clinicians and organizations to screen patients for undiagnosed depression. The PHQ-2 consists of the first two questions asked on the PHQ-9. If the patient responds affirmatively to either of the two items on the PHQ-2, the following seven questions on the PHQ-9 are asked. This can be a particularly effective way to screen large groups of people for depression. *
* Li, MM, Friedman, B, Conwell, Y, Fiscella, K. Validity of the Patient Health Questionnaire 2 (PHQ-2) in Identifying Major Depression in Older People. Journal of the American Geriatric Society. 2007; 55:596-602

PHQ-9 Visual Answer Aid

This answer aid is a visual representation of the PHQ-9 answer scale.  Behavioral Health Care Managers can use this resource alongside the PHQ-9 during screening to get a fuller understanding of how their patient is feeling.

PHQ-9 Visual Answer Aid (Spanish)

This answer aid is a visual representation of the PHQ-9 answer scale in Spanish. Behavioral Health Care Managers can use this resource alongside the PHQ-9 during screening to get a fuller understanding of how their patient is feeling.