PHQ-9 Depression Screener: Score and Severity Bands

What it measures

The Patient Health Questionnaire-9 (PHQ-9) asks how often, over the last 2 weeks, the patient has been bothered by nine problems: loss of interest or pleasure, low mood, sleep change, fatigue, appetite change, feelings of failure or guilt, poor concentration, psychomotor slowing or restlessness, and thoughts of being better off dead or of self-harm. It is a screening and severity tool, not a standalone diagnostic instrument. A diagnosis still requires a clinical interview and judgment.

Items and scoring

Each item is rated 0 (Not at all), 1 (Several days), 2 (More than half the days) or 3 (Nearly every day). The total is the sum of the nine items, from 0 to 27. The calculator shows the running total and an answered count, and assigns a severity band only once all nine items are answered.

Score	Severity	Suggested action shown by the tool
0–4	None–Minimal	None indicated
5–9	Mild	Watchful waiting; repeat PHQ-9 at follow-up
10–14	Moderate	Treatment plan, considering counseling, follow-up, and/or pharmacotherapy
15–19	Moderately Severe	Active treatment with pharmacotherapy and/or psychotherapy
20–27	Severe	Immediate pharmacotherapy and, if severe impairment or poor response to therapy, expedited referral to a mental health specialist

An optional final question records how difficult the problems have made work, home life and getting along with others, from "Not difficult at all" to "Extremely difficult". It does not change the score.

Item 9 safety alert

Any response above 0 on Item 9 (thoughts of being better off dead or of self-harm) displays an alert to conduct a direct suicidal ideation assessment and safety evaluation. The flag is also printed in the report. The alert is a prompt to ask further questions; it is not a risk assessment on its own.

What the report includes

Generate Report copies a plain-text summary to the clipboard for pasting into the EMR: the date, total score out of 27, severity band and suggested action, the functional difficulty rating if selected, each item with its numeric and verbal response, any Item 9 flag, the scoring bands and the source citation (Kroenke K, Spitzer RL, Williams JBW. The PHQ-9. J Gen Intern Med. 2001;16:606-613). Reset clears all responses after a confirmation.