PHQ-9 Test Online — Patient Health Questionnaire (9-Item Depression Scale)

The 9 PHQ-9 questions

The questionnaire asks how often, over the past 2 weeks, you have been bothered by each of the following:

1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling or staying asleep, or sleeping too much
4. Feeling tired or having little energy
5. Poor appetite or overeating
6. Feeling bad about yourself — or that you are a failure, or have let yourself or your family down
7. Trouble concentrating on things, such as reading the newspaper or watching television
8. Moving or speaking so slowly that other people could have noticed — or the opposite, being so fidgety or restless that you have been moving around a lot more than usual
9. Thoughts that you would be better off dead, or of hurting yourself in some way (safety item — see crisis information above)

Each item is scored on a 4-point scale: 0 = Not at all · 1 = Several days · 2 = More than half the days · 3 = Nearly every day. The nine scores are summed for a total in the range 0-27.

PHQ-9 score interpretation

Score	Severity	What it means	Suggested next step
0-4	Minimal depression	Symptoms typical for everyday life	Continue self-monitoring
5-9	Mild depression	Some symptoms but mostly functioning	Lifestyle, therapy if persistent; retake in 2-4 weeks
10-14	Moderate depression	Symptoms causing impairment	Clinical evaluation; therapy with or without medication
15-19	Moderately severe	Significant symptoms and clear impairment	Clinical evaluation; combination therapy + medication often indicated
20-27	Severe depression	Major symptoms, often impairing core function	Urgent clinical evaluation; intensive treatment usually required

Special rule: any response other than "Not at all" on Question 9 (self-harm) requires same-day clinical contact regardless of total score. A score of 8 with a positive Question 9 is more clinically urgent than a score of 18 without it.

These bands describe symptom severity; they are not a diagnosis. If you want the plain-English version of what your score means, see Am I depressed?. For what depression is and how it is treated, read our depression guide.

How the PHQ-9 was developed

The PHQ-9 was developed by Kurt Kroenke, Robert L. Spitzer and Janet B. W. Williams as the depression module of the Patient Health Questionnaire (PHQ), a self-administered version of the PRIME-MD diagnostic instrument. Each of its nine items maps onto one of the nine DSM-IV criteria for major depression, which is why it can be used both to screen and to track severity.

Validation and evidence

The validation study, published in the Journal of General Internal Medicine in 2001, gave the PHQ-9 to 6,000 patients in 8 primary-care and 7 obstetrics-gynaecology clinics in the US and checked it against an independent mental-health-professional interview in 580 of them. A score of 10 or more had 88% sensitivity and 88% specificity for major depression, and scores of 5, 10, 15 and 20 marked mild, moderate, moderately severe and severe depression. In 2019 a BMJ individual-participant-data meta-analysis pooled 58 studies (17,357 people) and confirmed that 10 or more gave the best overall balance: 88% sensitivity and 85% specificity against semi-structured interviews, regardless of age. In India, an 18-site study validated the Brief Patient Health Questionnaire, whose depression module is the PHQ-9, against psychiatrist diagnosis in English and 10 Indian languages. A Goa primary-care study found the PHQ-9 discriminated well between people with and without common mental disorders, but, like every short screener tested, its positive predictive value was modest, which is why a high score leads to a clinical interview rather than a label.

References

1. Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-613. PubMed
2. Levis B, Benedetti A, Thombs BD, et al. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476. PubMed
3. Kochhar PH, Rajadhyaksha SS, Suvarna VR. Translation and validation of brief patient health questionnaire against DSM IV as a tool to diagnose major depressive disorder in Indian patients. J Postgrad Med. 2007;53(2):102-107. PubMed
4. Patel V, Araya R, Chowdhary N, et al. Detecting common mental disorders in primary care in India: a comparison of five screening questionnaires. Psychol Med. 2008;38(2):221-228. PubMed

PHQ-9 vs other depression tests

Test	Items	Time	Best for	Administered by
PHQ-9	9	3 min	General screening, treatment monitoring	Self-report
HAM-D	17	4 min	Clinician-administered detailed assessment	Clinician
MADRS	10	3 min	Clinician-administered; sensitive to medication response	Clinician
EPDS	10	3 min	Postnatal depression	Self-report
DASS-21	21	4 min	Combined depression + anxiety + stress	Self-report

The PHQ-9 is the standard first-line test. Use HAM-D or MADRS for clinician-administered detailed assessment, EPDS if perinatal depression is the concern, and DASS-21 for a combined depression-anxiety-stress picture.

When to act on your result

• Score 0-4: No action needed. Continue self-monitoring if low mood is a recent concern.
• Score 5-9: Behavioural activation, sleep hygiene, mindfulness. The CBT Thought Record and Behavioural Activation worksheets in the adult worksheets library are evidence-based for this band. Retake the PHQ-9 in 2-4 weeks.
• Score 10-14: Clinical evaluation recommended. Book a Mindtalk psychiatrist or clinical psychologist. Cognitive behavioural therapy, IPT, and Behavioural Activation are first-line therapies; medication may or may not be needed depending on history and preference.
• Score 15-19: Clinical evaluation needed. Combination therapy + medication is often indicated.
• Score 20-27: Urgent clinical evaluation. Intensive treatment is usually required.
• Question 9 positive (any "Several days" or higher): Same-day clinical contact regardless of total score. Crisis helplines are listed above.

After the PHQ-9

• Track over time. Retake every 2-4 weeks during treatment; the Mindtalk app charts response automatically.
• Start a structured programme. The 90-day Depression-Anxiety-Stress Rehabilitation journey is designed for PHQ-9 scores in the 10-19 band.
• CBT toolkit. The Thought Record and Cognitive Distortions worksheet are the workhorses; Behavioural Activation is in the adult worksheets library.
• Daily mood tracking. The Mindtalk app's daily mood log pairs well with PHQ-9 monitoring — patterns emerge faster than from PHQ-9 scores alone.
• Book a specialist. Mindtalk's psychiatrists and clinical psychologists treat depression across Bangalore, Hyderabad, Mysore, and online for anywhere in India.