PATIENT HEALTH QUESTIONNAIRE – Zambezi Mental Health

PATIENT HEALTH QUESTIONNAIRE (PHQ-9)

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ID# *

Date / Time *

Over the last 2 weeks, how often have you been bothered by any of the following problems? (use ✓ to indicate your answer)

Likert Scale *

	Not at all (0)	Several days (1)	More than half the days (2)	Nearly every day (3)
Little interest or pleasure in doing things	Not at all (0)Little interest or pleasure in doing things Not at all (0)	Several days (1)Little interest or pleasure in doing things Several days (1)	More than half the days (2)Little interest or pleasure in doing things More than half the days (2)	Nearly every day (3)Little interest or pleasure in doing things Nearly every day (3)
Feeling down, depressed, or hopeless	Not at all (0)Feeling down, depressed, or hopeless Not at all (0)	Several days (1)Feeling down, depressed, or hopeless Several days (1)	More than half the days (2)Feeling down, depressed, or hopeless More than half the days (2)	Nearly every day (3)Feeling down, depressed, or hopeless Nearly every day (3)
Trouble falling or staying asleep, or sleeping too much	Not at all (0)Trouble falling or staying asleep, or sleeping too much Not at all (0)	Several days (1)Trouble falling or staying asleep, or sleeping too much Several days (1)	More than half the days (2)Trouble falling or staying asleep, or sleeping too much More than half the days (2)	Nearly every day (3)Trouble falling or staying asleep, or sleeping too much Nearly every day (3)
Feeling tired or having little energy	Not at all (0)Feeling tired or having little energy Not at all (0)	Several days (1)Feeling tired or having little energy Several days (1)	More than half the days (2)Feeling tired or having little energy More than half the days (2)	Nearly every day (3)Feeling tired or having little energy Nearly every day (3)
Poor appetite or overeating	Not at all (0)Poor appetite or overeating Not at all (0)	Several days (1)Poor appetite or overeating Several days (1)	More than half the days (2)Poor appetite or overeating More than half the days (2)	Nearly every day (3)Poor appetite or overeating Nearly every day (3)
Feeling bad about yourself or that you are a failure or have let yourself or your family down	Not at all (0)Feeling bad about yourself or that you are a failure or have let yourself or your family down Not at all (0)	Several days (1)Feeling bad about yourself or that you are a failure or have let yourself or your family down Several days (1)	More than half the days (2)Feeling bad about yourself or that you are a failure or have let yourself or your family down More than half the days (2)	Nearly every day (3)Feeling bad about yourself or that you are a failure or have let yourself or your family down Nearly every day (3)
Trouble concentrating on things, such as reading the newspaper or watching television	Not at all (0)Trouble concentrating on things, such as reading the newspaper or watching television Not at all (0)	Several days (1)Trouble concentrating on things, such as reading the newspaper or watching television Several days (1)	More than half the days (2)Trouble concentrating on things, such as reading the newspaper or watching television More than half the days (2)	Nearly every day (3)Trouble concentrating on things, such as reading the newspaper or watching television Nearly every day (3)
Moving or speaking so slowly that other people could have noticed. Or the opposite being so figety or restless that you have been moving around a lot more than usual	Not at all (0)Moving or speaking so slowly that other people could have noticed. Or the opposite being so figety or restless that you have been moving around a lot more than usual Not at all (0)	Several days (1)Moving or speaking so slowly that other people could have noticed. Or the opposite being so figety or restless that you have been moving around a lot more than usual Several days (1)	More than half the days (2)Moving or speaking so slowly that other people could have noticed. Or the opposite being so figety or restless that you have been moving around a lot more than usual More than half the days (2)	Nearly every day (3)Moving or speaking so slowly that other people could have noticed. Or the opposite being so figety or restless that you have been moving around a lot more than usual Nearly every day (3)
Thoughts that you would be better off dead, or of hurting yourself	Not at all (0)Thoughts that you would be better off dead, or of hurting yourself Not at all (0)	Several days (1)Thoughts that you would be better off dead, or of hurting yourself Several days (1)	More than half the days (2)Thoughts that you would be better off dead, or of hurting yourself More than half the days (2)	Nearly every day (3)Thoughts that you would be better off dead, or of hurting yourself Nearly every day (3)

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(Healthcare professional: For interpretation of TOTAL, please refer to accompanying scoring card)

Total:

Likert Scale *

	Not difficult at all	Somewhat difficult	Very difficult	Agree	Extremely difficult
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people	Not difficult at allIf you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people Not difficult at all	Somewhat difficultIf you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people Somewhat difficult	Very difficultIf you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people Very difficult	AgreeIf you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people Agree	Extremely difficultIf you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people Extremely difficult

Copyright © 1999 Pfizer Inc. All rights reserved. Reproduced with permission. PRIME-MD© is a trademark of Pfizer Inc. A2663B 10-04-2005

PHQ-9 Patient Depression Questionnaire

For initial diagnosis:

Patient completes PHQ-9 Quick Depression Assessment.
If there are at least 4 ✓ S in the shaded section (including Questions #1 and #2), consider a depressive
disorder. Add score to determine severity.

PHQ-9 Scoring Information

Consider Major Depressive Disorder – if there are at least 5 ✔ in the shaded section (one of which corresponds to Question #1 or #2)

Consider Other Depressive Disorder – if there are 2-4 ✔ in the shaded section (one of which corresponds to Question #1 or #2)

Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician, and a definitive diagnosis is made on clinical grounds taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient.

Diagnoses of Major Depressive Disorder or Other Depressive Disorder also require impairment of social, occupational, or other important areas of functioning (Question #10) and ruling out normal bereavement, a history of a Manic Episode (Bipolar Disorder), and a physical disorder, medication, or other drug as the biological cause of the depressive symptoms.

To monitor severity over time for newly diagnosed patients or patients in current treatment for depression:

Patients may complete questionnaires at baseline and at regular intervals (eg, every 2 weeks) at home and bring them in at their next appointment for scoring or they may complete the questionnaire during each scheduled appointment.
Add up ✔ by column. For every ✔: Several days = 1 More than half the days = 2 Nearly every day = 3
Add together column scores to get a TOTAL score.
Refer to the accompanying PHQ-9 Scoring Box to interpret the TOTAL score.
Results may be included in patient files to assist you in setting up a treatment goal, determining degree of response, as well as guiding treatment intervention.

Scoring: add up all checked boxes on PHQ-9

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

Interpretation of Total Score

Total Score	Depression Severity
1-4	Minimal depression
5-9	Mild depression
10-14	Moderate depression
15-19	Moderately severe depression
20-27	Severe depression

A2662B 10-04-2005