Patient Health Questionnaire (PHQ-9)
This article is for Medical Professionals
Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines, so you may find the language more technical than the condition leaflets.
This easy to use patient questionnaire is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders.[1] The PHQ-9 is the depression module, which scores each of the nine DSM-IV criteria as “0” (not at all) to “3” (nearly every day). It has been validated for use in primary care.[2]
It is not a screening tool for depression but it is used to monitor the severity of depression and response to treatment. However, it can be used to make a tentative diagnosis of depression in at-risk populations – eg, those with coronary heart disease or after stroke.[3, 4]
When screening for depression the Patient Health Questionnaire (PHQ-2) can be used first (it has a 97% sensitivity and a 67% specificity).[5]If this is positive, the PHQ-9 can then be used, which has 61% sensitivity and 94% specificity in adults.
| Patient Health Questionnaire (PHQ-9) |
|---|
Depression Severity:
0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.
Validity has been assessed against an independent structured mental health professional (MHP) interview. PHQ-9 score ≥10 had a sensitivity of 88% and a specificity of 88% for major depression.[1] It can even be used over the telephone.[6]
Note about credits
The copyright for the PHQ-9 was formerly held with Pfizer, who provided the educational grant for Drs Spitzer, Williams and Kroenke who originally designed it.[1] This is no longer the case and no permission is required to reproduce, translate, display or distribute the PHQ-9.