Home › Psychiatry & Substance Use › PHQ-9

PHQ-9 Depression Severity (Patient Health Questionnaire-9)

The PHQ-9 scores the nine DSM depression criteria from 0 (not at all) to 3 (nearly every day) over the last 2 weeks, total 0–27. Scores of 5, 10, 15 and 20 mark mild, moderate, moderately severe and severe depression; ≥10 has 88% sensitivity and specificity for major depression. Any positive answer to item 9 needs a same-day suicide risk assessment.

Little interest or pleasure in doing things: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Feeling down, depressed, or hopeless: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Trouble falling or staying asleep, or sleeping too much: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Feeling tired or having little energy: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Poor appetite or overeating: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Feeling bad about yourself, or that you are a failure or have let yourself or your family down: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Trouble concentrating on things, such as reading the newspaper or watching television: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Moving or speaking so slowly that others could notice, or being so fidgety or restless that you move around a lot more than usual: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)
Thoughts that you would be better off dead, or of hurting yourself in some way: Not at all (0); Several days (1); More than half the days (2); Nearly every day (3)

—

Interpretation

Result	Meaning
0–4	Minimal
5–9	Mild
10–14	Moderate
15–19	Moderately severe
20–27	Severe
Item 9 > 0	Assess suicide risk now

Formula

Sum of 9 items, each 0 (not at all), 1 (several days), 2 (more than half the days), 3 (nearly every day) over the past 2 weeks. Range 0–27.

Clinical pearls

The PHQ-9 is a screening and severity tool; confirm a diagnosis of major depression with a clinical interview.
A response to treatment is usually defined as a ≥50% fall in score, and remission as a score <5.
Item 9 is not a suicide risk assessment: any positive answer needs direct follow-up (e.g. Columbia or a clinician interview).

Examples

phq9 all items 2 PHQ-9: anhedonia nearly every day, low mood more than half the days, sleep several days, fatigue nearly every day, rest not at all depression score for a patient with phq-9 items 3,3,2,2,1,1,1,0,1

FAQ

What PHQ-9 score indicates depression?

A score of 10 or more is the usual cut-off for probable major depression (sensitivity and specificity about 88%). 5–9 is mild, 10–14 moderate, 15–19 moderately severe and 20–27 severe.

What should I do if item 9 is positive?

Any score above 0 on item 9 requires a same-day clinical assessment of suicide risk, regardless of the total score.

Evidence

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16:606–13.

Psychiatry & Substance Use · Reviewed 2026-10-14 · Methodology