MDCalc

PHQ-9 (Patient Health Questionnaire-9)

Objectifies degree of depression severity.

MDCalc provides tools and content intended for use by healthcare professionals, and is not meant for use by patients. While these may be surveys or questions intended for patients, they are meant to be answered in the context of a clinician’s medical care and not on their own to diagnose or treat any disease.

Ask the patient: how often have they been bothered by the following over the past 2 weeks?

Little interest or pleasure in doing things?

Feeling down, depressed, or hopeless?

Trouble falling or staying asleep, or sleeping too much?

Feeling tired or having little energy?

Poor appetite or overeating?

Feeling bad about yourself - or that you are a failure or 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 so fidgety or restless that you have been moving a lot more than usual?

Thoughts that you would be better off dead, or thoughts of hurting yourself in some way?

Result:

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Advice

Final diagnosis should be made with clinical interview and mental status examination including assessment of patient’s level of distress and functional impairment.

Management

PHQ-9 Management Summary

ScoreDepression severityComments
0-4Minimal or noneMonitor; may not require treatment
5-9MildUse clinical judgment (symptom duration, functional impairment) to determine necessity of treatment
10-14Moderate
15-19Moderately severeWarrants active treatment with psychotherapy, medications, or combination
20-27Severe
Critical Actions
  • Perform suicide risk assessment in patients who respond positively to item 9 “Thoughts that you would be better off dead or of hurting yourself in some way.”
  • Rule out bipolar disorder, normal bereavement, and medical disorders causing depression.
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