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


Interval: past 2 weeks


The instrument consists of 9-items

Frequency over the past 2 weeks


not at all


several days


more than half


nearly every day




• 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



• 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)



1 to 4


5 to 9


10 to 14


15 to 19

moderate to severe

20 to 27




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.


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