What a PHQ-9 result can show
Depression symptoms can make it hard to think, work, study, eat, sleep, or care for yourself. PHQ-9 shows how often each symptom happened. The same total can come from different answers. Sleep problems, pain, grief, trauma, anxiety, bipolar symptoms, medicine, substances, anemia, thyroid disease, pregnancy, illness, and brain conditions can cause similar problems.
Time window
How often nine symptoms appeared in two weeks
The questions cover interest, mood, sleep, energy, appetite, self-worth, concentration, movement, and thoughts of death or self-harm.
Burden
Which symptoms carried the total
Two people can have the same score through different answers. Keep all nine answers and the separate daily-difficulty response.
Follow-up
Whether a fuller depression assessment is needed
A score of 10 often leads to a full review. A lower score still matters when one symptom, safety, or daily function is serious.
Limit
What the questionnaire does not decide
A clinician still checks the diagnosis, bipolar signs, psychosis, suicide risk, physical causes, and treatment choices.
Read the total with every answer, daily difficulty, item 9 follow-up, safety, medicine, substances, sleep, physical health, and the full interview.
Save this test
Save it after item 9 and the score have been reviewed
Keep the nine answers, total, daily impact, safety action, health details, and follow-up plan together. This makes repeat scores easier to compare.
The saved form supports direct care. It does not contact emergency services.
Who needs a different PHQ-9 form or interpretation
Adult men and women use the same item scores. Age, language, pregnancy, illness, and access needs can change the form and follow-up.
Children age 11 or younger
USPSTF says there is not enough evidence for routine screening at age 11 or younger. A 2026 study adds early PHQ-9A evidence for ages 10 to 12. A child still needs a child-based tool, safety questions, and review of development, family, school, bullying, trauma, and health.
Teenagers age 12 to 18
US guidance supports screening when the service can diagnose, treat, and follow up. Use PHQ-A or the form chosen by the child-health service. Review anger, school, sleep, substances, family input, privacy, and suicide risk.
Adult women and men
A 2025 study supports comparing totals across sex and age groups. How a person shows distress can differ. Anger, pulling away, substance use, physical symptoms, stress, or hormone changes still deserve review.
Pregnancy and the first postpartum year
PHQ-9 can be used during pregnancy and after birth. EPDS is another tested form. Item 9 or another safety concern needs a same-day plan. Review bipolar signs, psychosis, unwanted harm thoughts, sleep, support, baby care, medicine, breastfeeding, pregnancy symptoms, and physical illness.
Adults age 65 and older
PHQ-9 is one option for older adults. Some services use GDS. Grief, pain, sleep, food, frailty, medicine, hearing, sight, reading, memory, brain disease, isolation, and lost function can change the answers and next check.
Chronic illness, disability, and access needs
Sleep, fatigue, food, movement, and focus can change because of depression, illness, treatment, disability, or several causes. Answer what you felt. Ask for a language and format you can use, then review mental and physical causes together.
How to complete PHQ-9 without losing the context
Check the form name. PHQ-9, PHQ-2, PHQ-8, and the teen PHQ-A are different forms. Save the form, language, place, and date.
Answer for the past 14 days. Use 0 for not at all, 1 for several days, 2 for more than half the days, and 3 for nearly every day.
Keep all nine answers. Sleep, energy, focus, movement, self-worth, and item 9 may change what needs help first.
Answer the separate difficulty question if it is on the form. It is not part of the 0 to 27 total. It shows how symptoms affected daily life.
Ask who will review item 9 and when. Any answer above 0 needs direct safety questions. Current intent, a plan, or being unable to stay safe needs urgent help.
Before the visit, note sleep, pain, food or weight changes, illness, pregnancy, recent birth, and periods or menopause. Add alcohol, drugs, nicotine, withdrawal, and medicine changes or side effects.
Tell your doctor about any clear period with little need for sleep, a very high or angry mood, or fast speech or thoughts. Also mention extra activity, risky acts, seeing or hearing things, or a bipolar diagnosis.
Do not stop medicine, suddenly stop a substance, lose sleep, skip meals, or repeat the form just to change the score.
Use the exact previous two weeks
Write the start and end dates, form, language, and setting. Keep those the same when you plan to compare a later score.
Score each item from 0 to 3
Use the printed frequency choices. Add the nine answers only after checking that every item is complete.
Save all nine answers with the total
The total can range from 0 to 27. Record which symptoms carried the score and which daily tasks changed.
Handle item 9 separately
Any response above 0 needs prompt direct safety questions. Immediate intent, a plan, inability to stay safe, or a life-threatening situation needs urgent help now.
Add function and possible look-alikes
Mention sleep, pain, illness, medicines, substances, pregnancy, postpartum timing, grief, trauma, anxiety, bipolar symptoms, psychosis, and physical-health signs.
Choose the next assessment, not a treatment from a number
A positive or rising score should lead to a clinical review, safety plan, and care choice based on the person, not an automatic prescription or diagnosis.
How to understand a PHQ-9 score
First check the form, two-week dates, missing answers, item 9, and immediate safety. Then review each symptom, daily difficulty, the total, other possible causes, and what comes next.
Incomplete, wrong form, or not comparable
You can't compare this score as usual. An item may be missing, or the form, language, time window, or way you completed it may have changed. Keep the answers and ask whether to repeat it.
0 to 4, minimal symptom band
Few symptoms happened often during these two weeks. Still report a crisis, safety concern, trauma, grief, bipolar signs, or a physical illness.
5 to 9, mild symptom band
Some symptoms were present. Review each answer, daily impact, changes over time, support, medicine, and possible physical causes.
10 to 14, moderate symptom band
A score of 10 is a common point for a full depression check. Bring every answer, daily impact, safety needs, the longer timeline, bipolar or psychosis history, medicine, substances, sleep, and physical health.
15 to 19, moderately severe symptom band
Arrange a timely review. Tell the clinician if symptoms are harming work, school, caregiving, food, sleep, driving, relationships, or self-care.
20 to 27, severe symptom band
Many symptoms happened often or nearly every day. Arrange a prompt check of safety, daily function, food, sleep, psychosis, mania, medicine, substances, and physical health.
Any total with item 9 or an immediate safety concern
Any item 9 answer above 0 needs prompt follow-up. Get urgent help if you have current intent, a plan, access to a method, or cannot stay safe. Danger from another person, psychosis, severe mania, or another life-threatening problem also needs urgent help.
Item 9 and safety are not score bands
Any item 9 answer above 0 needs direct safety questions. The item alone cannot grade risk. Current intent, a plan, inability to stay safe, psychosis, severe mania, abuse, or fast loss of basic care needs action now.
See research details
The research details explain scoring, repeat changes, item 9 limits, age, pregnancy, older adults, and crisis pathways.
Keep every answer, total, date, language, setting, two-week dates, and the function response. Keep the total with the rest.
Use the bands to describe symptom burden and 10 as a common assessment prompt.
A result above 10 contains false positives and a result below 10 can miss depression. Use a clinical interview, function, safety, and the person's setting.
Compare the same form and conditions, then read the change beside function, safety, treatment timing, adverse effects, and clinical review. The published five-point change threshold is not a universal treatment target.
The total is useful, but language, setting, administration, culture, and why the form was used still belong with interpretation.
Pay attention to a repeated score, but one small change shouldn't outweigh item-level symptoms, function, safety, side effects, and the person's account of what changed.
Any response above 0 needs direct follow-up. Use a suicide-specific screen and a brief safety assessment to judge risk, not item 9 or the total. A 0 does not guarantee safety.
Use PHQ-A or the pediatric service's chosen instrument, direct suicide screening, confidentiality, family and school context, and an age-appropriate assessment. Review any adult cutoff before using it.
A pediatric assessment needs an age-appropriate tool. It should also cover development, communication, family and school context, physical illness, bullying, trauma, substance use, confidentiality, and safety.
Keep bipolar symptoms, psychosis, item 9, intrusive harm thoughts, infant care, sleep, support, medicines, obstetric symptoms, and physical safety beside the score. Use the total only with these.
Use hearing, vision, reading, cognition, grief, pain, sleep, medicines, frailty, appetite, neurological change, and function. Choose the tool and cutoff for the service and population.
Use PHQ-9 to describe depression symptoms. Use history, sleep and medicine review, neurological assessment, and cognitive testing when the question is memory, attention, processing speed, head injury, or another cognitive cause.
Keep the exact service, cutoff, function, safety plan, and follow-up. Countries use different cutoffs. None is your personal target, and none makes the score a diagnosis.
What you can do after a PHQ-9 result
You can use simple support before the full review is complete. Pick one small, safe thing to do that fits your energy.
Make one task smaller and scheduled
Choose one task, such as taking a shower, opening the curtains, eating breakfast, answering one message, or taking a short walk. Pick a time and make the first step small. Notice how you feel afterward.
Keep wake time and meals visible
Try to wake and eat at regular times when it is safe. Tell a clinician about vomiting, no food or drink, fast weight change, or several days with almost no sleep.
Use movement, daylight, and connection as support
A short safe walk, daylight, a simple activity, or time with someone you trust may help mood and sleep. Start below your physical limit if you have pain, dizziness, illness, pregnancy, or worse symptoms after effort.
Tell one person what help would be useful
Ask for clear help. For example, ask someone to sit with you while you call, bring food, or drive you to the visit. You could also ask them to check in tonight or hold your notes while you speak.
Review medicines, substances, and treatment choices
List alcohol, drugs, nicotine, pain medicine, steroids, hormone and thyroid medicine, mental-health medicine, supplements, missed doses, side effects, and withdrawal from the same two weeks. Bring the list to the prescriber. Do not stop treatment from the score. Ask which care options fit your health, pregnancy or breastfeeding, past response, and safety.
Call or text 988 in the US for suicidal thoughts or an emotional crisis, and call 911 for immediate danger or a life-threatening situation. UK readers can use NHS 111, a local crisis team, or 999 in immediate danger. Australian readers can call Lifeline 13 11 14 or 000 in immediate danger. Get urgent care for psychosis, severe mania, or being unable to eat or drink. You also need urgent care after several days with almost no sleep and a major change in behavior. Abuse, danger from another person, or being unable to manage basic care needs urgent assessment regardless of the total.
What to save from PHQ-9
Keep these together
- Exact form, adult or adolescent version, language, setting, date, and the start and end of the 14-day window
- All nine item answers, 0 to 27 total, published score band, missing items, and separate daily-difficulty response
- Item 9 answer, who followed it up, direct suicide-specific screen if used, safety assessment, safety action, crisis contact, and follow-up owner
- Sleep, energy, appetite, weight, concentration, movement, interest, mood, self-worth, work, school, caregiving, relationships, driving, and self-care
- Mania or hypomania, psychosis, trauma, grief, anxiety, abuse, alcohol, cannabis, nicotine, other substances, medicines, missed doses, side effects, and withdrawal
- Pain, illness, recovery from infection, anemia or iron, B12, thyroid, glucose, hormones, pregnancy or postpartum timing, head injury, neurological symptoms, the clinician's reading, the care choice, and the reason to repeat
Question for the visit
“Which answers matter most, what safety or diagnostic questions remain open, what physical contributors need review, and what support or treatment choice should happen next?”
Sources for PHQ-9 Depression Questionnaire
Current instrument identity, two-week time window, available languages, research use, and copyright status.
US adult, pregnancy, postpartum, and older-adult screening, cutoff accuracy, follow-up, and screening-frequency limits.
Ages 12 to 18 recommendation, age 11 and younger evidence gap, and need for diagnosis, treatment, and follow-up systems.
Youth and adult suicide-specific screening, brief safety assessment, age limits, and combined PHQ-9 or PHQ-A pathways.
Adolescent form, safety questions, and pediatric use context.
Symptoms, cognition, medical look-alikes, diagnosis, treatment options, and crisis guidance.
Function-first self-care, limits, professional help, and direct crisis action.
PHQ-9 and EPDS options, screening timing, scoring workflow, item 9 alert, and response planning.
Perinatal depression, bipolar, psychosis, suicide, intrusive-thought, and follow-up context.
UK score context, full assessment, function, bipolar review, treatment choice, and the limit on symptom counts alone.
UK PHQ-9 or EPDS use as part of a full perinatal assessment and referral pathway.
Routine, meals, activity, support, talking therapies, medicine discussion, and UK urgent help.
Australian GP and therapy pathways, exercise, food, sleep, connection, medicine safety, Lifeline, and 000.
US support, treatment preparation, low-cost options, national helpline, and 988 access.
Current US call, text, and chat crisis support.
Original 6,000-person validation, 580-person interview subset, scoring, bands, cutoff accuracy, and function.
Updated 44,503-participant individual-data meta-analysis, cutoff performance, interview-standard effects, age, and sex.
Treatment responsiveness, older-adult trial population, repeat reliability, and the limited five-point change anchor.
Review of 98 psychometric studies, summed-score structure, reliability, and demographic measurement invariance.
Historical review and clinical-sample challenge to between-group and across-time measurement invariance.
Sixty-study reliability meta-analysis, 232,147 participants, pooled reliability, and high heterogeneity.
Item 9 comparison with C-SSRS in 841 patients and the limit on using it alone for suicide-risk assessment.
Thirty-five-study perinatal review, cutoff accuracy, EPDS comparison, and screening limits.
Adolescent validation in 442 youth aged 13 to 17, cutoff performance, function, and interview comparison.
Older Chilean primary-care validation, cutoff tradeoffs, and limited positive-screen utility.
PHQ-9A validation evidence for youth aged 10 to 12 and the boundary around pediatric assessment.
Cross-sectional depression and perceived-cognition network in 655 healthcare workers without objective-test or causal validation.
See each claim's sources
range
PHQ-9 scores nine symptoms from 0 to 3 over the previous two weeks for a 0 to 27 total, with published symptom bands beginning at 5, 10, 15, and 20.interpretation
The original 6,000-person validation and 580-person interview subset reported 88 percent sensitivity and 88 percent specificity at a total of 10 or higher.interpretation
An updated individual-participant-data meta-analysis with 44,503 participants found pooled sensitivity and specificity of 0.85 at the common cutoff of 10 against semistructured interviews, with performance varying by reference standard and subgroup.limitation
A five-point minimal important change estimate came from 434 participants in a late-life depression treatment trial and should not be used as a universal recovery target.interpretation
A 2025 review of 98 psychometric studies supported a one-factor summed PHQ-9 score and measurement invariance across several demographic groups.limitation
A 2025 study of 3,384 clinical participants did not establish measurement invariance between treatment groups or convincingly across time and warned against reading every score change as clinical change.safety
Item 9 is an important prompt for direct follow-up but is not sufficient as a suicide-risk assessment; a suicide-specific screen and clinical pathway are needed when risk is suspected.limitation
In 442 adolescents aged 13 to 17, a cutoff of 11 had sensitivity 89.5 percent and specificity 77.5 percent, while US screening guidance requires diagnosis, treatment, and follow-up systems.limitation
A perinatal meta-analysis found pooled sensitivity 0.84 and specificity 0.81 at 10 in seven criterion studies, while ACOG requires screening to be linked with assessment, treatment, monitoring, and follow-up.limitation
Older-adult validation shows useful screening performance but different cutoff tradeoffs and limited ability to confirm cases, so setting, cognition, physical health, and function remain necessary.limitation
PHQ-9 includes one concentration question but does not objectively measure attention, memory, processing speed, head injury, or the cause of brain fog.procedure
US adult depression screening produces benefit only when positive results receive further diagnostic evaluation and access to evidence-based care.