PHQ-9 Modified for Teens

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Today's Date* This field is required.

Date

2

Your Name* This field is required.

3

Your Date of Birth* This field is required.

Date

4

TOTAL SCORE (Interpret the score using the table below):INTERPRETATION OF SCORES: 0–4: Minimal or no depression, 5–9: Mild depression, 10–14: Moderate depression, 15–19: Moderately severe depression, 20–27: Severe depression.

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Total Score	Interpretation
0 - 4	Minimal or no depression
5 - 9	Mild depression,
10 - 14	Moderate depression,
15 - 19	Moderately severe depression
20 - 27	Severe depression.

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DIRECTIONS: In the next 9 items, please indicate how often you've experienced each symptom over the past two weeks. Choose the option that best reflects how frequently you've felt each one.

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1. Feeling down, depressed, irritable, or hopeless?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

8

2. Little interest or pleasure in doing things?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

9

3. Trouble falling asleep, staying asleep, or sleeping too much?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

10

4. Poor appetite, weight loss, or overeating?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

11

5. Feeling tired, or having little energy?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

12

6. Feeling bad about yourself – or feeling that you are , or that you have let yourself or your family down?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

13

7. Trouble concentrating on things like school work, reading, or watching TV?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

14

8. Moving or speaking so slowly that other people could have noticed? Or the opposite – being so fidgety or restless that you were moving around a lot more than usual?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday

15

9. Thoughts that you would be better off dead, or of hurting yourself in some way?* This field is required.

Not at all

Several days

More than half the days

Nearly everyday