PHQ-9 Depression Screening Score

What Is the PHQ-9? The PHQ-9 (Patient Health Questionnaire-9) is a validated clinical tool for screening, diagnosing, and monitoring depression. It was developed by Drs. Robert Spitzer, Janet Williams, and Kurt Kroenke in 1999 in the United States. It is one of the most widely used depression screening instruments in primary care worldwide.

Scoring scale

Each of the nine items asks how often you have been bothered by that problem over the past two weeks. The four answers score 0 to 3:

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

The maximum total is 27. Answer for the last two weeks specifically, not for how you feel in general. That window is part of the instrument, and stretching it changes what the score means.

Interpretation

These cutoffs come from Kroenke, Spitzer and Williams (2001). A score of 10 or above is the commonly used threshold for further assessment, with roughly 88% sensitivity and 88% specificity for major depression at that cutoff.

The tenth question

The full instrument ends with an unscored question about how difficult the symptoms have made daily functioning. It does not go into the total, and it is not decorative either. Two people can both score 14 while one is working normally and the other has stopped leaving the house, and that difference changes what happens next more than a point or two on the total does. This calculator includes it and reports it alongside the score.

Question 9 is reviewed separately

Question 9 asks about thoughts of self-harm. It is always looked at on its own, whatever the total. Any answer above “not at all” warrants prompt clinical follow-up, including when the total lands in the minimal range. A person can score 3 overall with a 1 on question 9, and that is not a minimal-risk result.

What this is and is not

The PHQ-9 is a validated screening and severity-monitoring tool. It is not a diagnostic instrument. A high score does not mean you have depression: it means a conversation with a professional is worth having. Physical illness, grief, medication side effects and thyroid problems all produce scores in the same range.

Where it is genuinely good is tracking. Repeating it every few weeks during treatment shows direction, and a drop of 5 points or more is the conventional marker of meaningful improvement.

If you are in crisis right now, in the United States you can call or text 988 for the Suicide and Crisis Lifeline, free and confidential, 24 hours a day. Elsewhere, your country almost certainly has an equivalent free line; searching for “crisis line” plus your country name will find it, and emergency services will help if you cannot.