PHQ-9
Name
First Name
Last Name
Date
-
Month
-
Day
Year
Date
Over the last 2 weeks, how often have you been bothered by any of the following problems?
*
Not at all
Several days
More than half the days
Nearly every day
1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself- or that you are a failure or have let yourself, or your family, down
7. Trouble concentrating on things, such as reading the newspaper or watching television
8. Moving or speaking so slowly that other people could have noticed? Or the Opposite- being so fidgety or restless that you have been moving around a lot more than usual
9. Thoughts that you would be better off dead or hurting yourself in some way
Total Score
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