Over the last 2 weeks, how often have you been bothered by any of the following problems?
How it's calculated
Each of the 9 items is scored 0 (not at all) to 3 (nearly every day), for a total of 0-27. A positive response to item 9 (thoughts of self-harm) needs direct follow-up regardless of the total score.
Severity bands
| Score | Severity |
|---|---|
| 0–4 | Minimal |
| 5–9 | Mild |
| 10–14 | Moderate |
| 15–19 | Moderately severe |
| 20–27 | Severe |
If you are having thoughts of harming yourself, please reach out for help right away. In India, the KIRAN mental health helpline is available 24/7 on 1800-599-0019 (toll-free). If you are in immediate danger, contact local emergency services now.
Clinical use
- PHQ-9 is a screening tool, not a diagnostic instrument — a high score should prompt further clinical assessment for major depressive disorder, not an automatic diagnosis or treatment decision on its own.
- Item 9 (thoughts of self-harm) needs a direct, immediate safety assessment whenever it is scored above 0, regardless of the total score — this item should never be skipped or its response minimised.
- PHQ-9 is also used to monitor treatment response over time — a falling score with treatment supports continuing the current approach, while a static or rising score suggests reassessing the treatment plan.
- Some symptoms overlap with physical illness (fatigue, appetite/sleep change, concentration difficulty) — clinical judgement is needed to interpret the score in patients with significant comorbid physical illness.
Frequently asked questions
What is the PHQ-9 used for?
It's a widely used, validated screening tool for depression severity, scoring nine symptoms over the past two weeks to give a total score from 0 to 27.
What should happen if item 9 (thoughts of self-harm) is positive?
Any positive response to this item needs a direct, immediate safety assessment regardless of the total score — this should never be dismissed as part of a routine screening result, and immediate support should be sought if there is any risk of imminent harm.
Is a high PHQ-9 score the same as a diagnosis of depression?
No — PHQ-9 is a screening tool that flags the likelihood and severity of depressive symptoms; a formal diagnosis of major depressive disorder still requires full clinical assessment by a qualified professional.
Can PHQ-9 be used to track treatment progress?
Yes — it's commonly re-administered over time to monitor response to treatment; a falling score suggests improvement, while a static or worsening score suggests the current approach may need review.
References
- Kroenke K, et al. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606-613.
- Spitzer RL, et al. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282:1737-1744.
- National Institute for Mental Health and Neurosciences (NIMHANS) / Ministry of Health and Family Welfare, Government of India — KIRAN Mental Health Rehabilitation Helpline.