PHQ-9 Depression Screening

PHQ-9 Depression Screening

Patient Health Questionnaire-9 for assessing depression symptoms
Purpose: Evaluates the presence of depressive symptoms over the past 2 weeks based on (DSM) The Diagnostic Statistical Manual criteria.
Patient Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Date of Assessment

MonthDayYear
Date
Over the last 2 weeks, how often have you been bothered by any of the following problems?
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 of hurting yourself in some way
Total PHQ-9 Score (sum of items 1-9)
Should be Empty: