patient health questionniare 9 (PHQ9)

Indications

• screening for depression

Procedure

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

Part 1

Select & score each of the 9 items from the following:

0 = Not at all

1 = Several days

2 = More than half the days

3 = Nearly every day

• Little interest or pleasure in doing things
• Feeling down, depressed, or hopeless
• Trouble falling asleep, staying asleep, or sleeping too much
• Feeling tired or having little energy
• Poor appetite or overeating
• Feeling bad about yourself, feeling that you are a failure, or feeling that you have let yourself or your family down
• Trouble concentrating on things such as reading the newspaper or watching television
• 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
• Thinking that you would be better off dead or that you want to hurt yourself in some way

Interpretation

Major Depressive Syndrome is suggested if:

• Of the 9 items, 5 or more are circled as 2 or 3
• Either item 1 or 2 is positive, that 2 or 3

Minor Depressive Syndrome is suggested if:

• Of the 9 items, 2, 3, or 4 are circled 2 or 3
• Either item 1 or 2 is positive, that is, 2 or 3

Total score:

<4 suggests the patient may not need depression treatment

<5 is goal of treating major depression

> 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 &/or a combination of treatment

>19: severe major depression warrants treatment for depression, using antidepressant & psychotherapy

a cutoff score of >= 10 maximizes sensitivity & specificity

Part 2

For items scored 1-3, 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?

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

A 2 or 3 suggests that the patient's functionality is impaired.

After treatment begins, the functional status is again measured to see if the patient is improving.

Notes

• administered by a health care provider
• includes question about suicidal ideation
• asks about sleep & appetite thus is influenced by comorbities
• can be used to assess treatment efficacy

More general terms

• patient health questionniare (PHQ)

Additional terms

• depression