The Patient Health Questionnaire‑9 (PHQ‑9) is a widely used, evidence‑based screening tool for depression severity. Answer nine questions about the past two weeks, receive your total score, severity level, and personalized guidance.
The Patient Health Questionnaire‑9 (PHQ‑9) is a multipurpose instrument for screening, diagnosing, monitoring, and measuring the severity of depression. Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues, it aligns with DSM‑5 diagnostic criteria for major depressive disorder. Its brevity and high validity have made it the most widely used depression scale in primary care and mental health research.
The US Preventive Services Task Force (USPSTF) recommends screening for depression in adults, including pregnant and postpartum persons, with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow‑up. (USPSTF Grade B, 2023)
The National Institute for Health and Care Excellence (NICE) guidelines [NG222] endorse the PHQ‑9 as a validated tool for case‑finding and monitoring depression in adults.
Early recognition of depressive symptoms improves outcomes. The PHQ‑9 helps individuals reflect on their emotional wellbeing and facilitates productive conversations with clinicians. Its high test‑retest reliability and sensitivity make it a standard tool in both research and practice. This interactive version provides instant scoring, severity classification, and actionable guidance while respecting your privacy.
Each item is scored from 0 ("not at all") to 3 ("nearly every day"). The total score (0–27) guides clinical decision‑making. A score ≥10 is often used as a cutoff for probable major depression, though clinical judgment remains essential.
The PHQ‑9 has been extensively validated across diverse populations. A meta‑analysis by Moriarty et al. (2015) found strong internal consistency (α = 0.86–0.89) and criterion validity compared to structured diagnostic interviews. It is recommended by the National Institute for Health and Care Excellence (NICE), the US Preventive Services Task Force (USPSTF), and the American Psychological Association for depression screening in adults.
| Severity Level | Score Range | Typical Clinical Action |
|---|---|---|
| Minimal | 0–4 | Self‑management, follow‑up as needed |
| Mild | 5–9 | Watchful waiting, supportive counseling |
| Moderate | 10–14 | Psychotherapy, possible pharmacotherapy |
| Moderately Severe | 15–19 | Active treatment (therapy +/‑ medication) |
| Severe | 20–27 | Immediate clinical evaluation, intensive treatment |
A 2022 study in the Journal of Affective Disorders reported that routine PHQ‑9 screening in primary care increased depression detection rates by 43% and improved treatment engagement. Self‑administered digital versions maintain equivalent accuracy to paper‑based formats, making this tool a reliable proxy for clinical screening when followed by professional assessment.
While the PHQ‑9 is widely validated, cultural factors may influence symptom expression and reporting. Some populations may express distress somatically, and certain items (e.g., appetite changes) may be interpreted differently across cultures. The PHQ‑9 is a screening tool, not a diagnostic instrument; it does not replace a comprehensive clinical interview. A positive screen should always be followed by a professional evaluation that considers individual context, medical history, and cultural background.