The Patient Health Questionnaire Module for Depression (PHQ-9) was developed for the evaluation of patients in primary care for evidence of depression. It is based on the diagnostic criteria of the DSM-IV. It was developed as part of the PRIME-MD project (see 18.25.01).
NOTE: PRIME-MD is a trademark of Pfizer Inc, which also holds the copyright. A web resource is www.depression-primarycare.org/ap1.html
Interval: past 2 weeks
The instrument consists of 9-items
Frequency over the past 2 weeks |
Points |
not at all |
0 |
several days |
1 |
more than half |
2 |
nearly every day |
3 |
where:
• The first 2 questions are from the Patient Questionnaire for PRIME-MD and are used in the PHQ-2 depression screen (next section).
total score =
= SUM(points for all 9 questions)
If any of the responses are non-zero, then the patient is asked how difficult it is to get along with others:
(1) not difficult at all
(2) somewhat difficult
(3) very difficult
(4) extremely difficult
Interpretation:
• minimum total score: 0
• maximum total score: 27
• The higher the score the greater the risk for some form of depression.
Total Score |
Level of Depression Severity (Kroenke et al) |
0 |
none |
1 to 4 |
minimal |
5 to 9 |
mild |
10 to 14 |
moderate |
15 to 19 |
moderate to severe |
20 to 27 |
severe |
Total Score |
Action (Nease and Malouin, page 126) |
0 - 4 |
The patient probably does not need therapy for depression. |
5 - 14 |
Therapy for depression may be indicated depending on functional impairment, symptom duration, etc. |
15 - 27 |
Therapy for depression warranted. |
Criteria for major depression - both of the following:
(1) Either item #1 or #2 is scored >= 2.
(2) 5 or more of the items are scored >= 2.
Criteria for other depressive syndrome - both of the following:
(1) Either item #1 or #2 is scored >= 2.
(2) 2 to 4 of the items are scored >= 2.
Purpose: To evaluate a patient in primary care for evidence of depression using the Patient Health Questionnaire (PHQ-9).
Specialty: Psychiatry
Objective: criteria for diagnosis
ICD-10: F31, F32, F33, F34,