Form Phq 9 PDF Details

The Patient Health Questionnaire 9 (Phq 9) is a widely used tool for measuring depression. Developed by the World Health Organization, the Phq 9 is a short questionnaire that can be used to screen for depression in adults. The questionnaire consists of nine questions, each of which rated on a scale from 0 to 3, with higher scores indicating more severe depressive symptoms. The Phq 9 has been shown to be accurate and reliable in identifying depression. It can be helpful for health care providers to use when assessing patients for possible depression, and can also be useful for tracking treatment progress.

QuestionAnswer
Form NameForm Phq 9
Form Length2 pages
Fillable?No
Fillable fields0
Avg. time to fill out30 sec
Other namesphq9 fillable, phq 9 patient questionnaire, phq 9 printable, phq 9

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PHQ-9 Patient Depression Questionnaire

For initial diagnosis:

1.Patient completes PHQ-9 Quick Depression Assessment.

2.If there are at least 4 s in the shaded section (including Questions #1 and #2), consider a depressive disorder. Add score to determine severity.

Consider Major Depressive Disorder

- if there are at least 5 s in the shaded section (one of which corresponds to Question #1 or #2)

Consider Other Depressive Disorder

- if there are 2-4 s in the shaded section (one of which corresponds to Question #1 or #2)

Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient.

Diagnoses of Major Depressive Disorder or Other Depressive Disorder also require impairment of social, occupational, or other important areas of functioning (Question #10) and ruling out normal bereavement, a history of a Manic Episode (Bipolar Disorder), and a physical disorder, medication, or other drug as the biological cause of the depressive symptoms.

To monitor severity over time for newly diagnosed patients or patients in current treatment for depression:

1.Patients may complete questionnaires at baseline and at regular intervals (eg, every 2 weeks) at home and bring them in at their next appointment for scoring or they may complete the questionnaire during each scheduled appointment.

2. Add up s by column. For every : Several days = 1 More than half the days = 2 Nearly every day = 3

3.Add together column scores to get a TOTAL score.

4.Refer to the accompanying PHQ-9 Scoring Box to interpret the TOTAL score.

5.Results may be included in patient files to assist you in setting up a treatment goal, determining degree of response, as well as guiding treatment intervention.

Scoring: add up all checked boxes on PHQ-9

For every Not at all = 0; Several days = 1;

More than half the days = 2; Nearly every day = 3

Interpretation of Total Score

Total Score

Depression Severity

1-4

Minimal depression

5-9

Mild depression

10-14

Moderate depression

15-19

Moderately severe depression

20-27

Severe depression

PHQ9 Copyright © Pfizer Inc. All rights reserved. Reproduced with permission. PRIME-MD ® is a trademark of Pfizer Inc.

A2662B 10-04-2005

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