Hawaii Ketamine 2 - PHQ-9 Screening Instrument for Depression

PHQ-9 Screening Instrument for Depression

Over the past two weeks, how often have you been bothered by any of the following problems?

0 = Not at all
1 = Several Days
2 = More than half the days
3 = Nearly every day

	NOT AT ALL	SEVERAL DAYS	MORE THAN HALF THE DAYS	NEARLY EVERY DAY
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
Trouble falling or staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite or overeating
Feeling bad about yourself- or that you are a failure or have let yourself or your family down
Trouble concentrating on things, such as reading the newspaper or watching television
Moving or speaking so slowly that other could have noticed; or the opposite- being so fidgety or restless that you have been moving around a lot more than usual
Thoughts that you would be better off dead or hurting yourself in some way

Scoring: 1 to 4 points = minimal depression, 5 to 9 points = mild depression, 10 to 14 points = moderate depression, 15 to 19 points = moderatley severe depression, 20 to 27 points = severe depression.

PHQ: Patient Health Questionnaire.

Adapted from Patient Health Questionnaire (PHQ) screeners, http://www.phqscreeners.com. Accessed February 8, 2018.

Name

First NameLast Name

Email

example@example.com

Date