Early Literacy Research Library (ELRL) - Metric

Patient Health Questionnaire – 9 (PHQ-9)


Access: FREE/Open Access

Download the full text(s): PHQ-9 – APA
PHQ-9 – Prime-MD

evaluation focus

Depression Severity

applicable ages

144+ months; 12+ years

available language(s)

English, Spanish, and 50+ Others (English (international), Afrikaans, Arabic (Israel), Arabic (Tunisia), Assamese, Bengali, Bulgarian, Cebuano (Philippines), Croatian, Czech, Chinese (Traditional), Chinese (Malaysia), Danish, Dutch, English (Australia), English (Hong Kong), English (India), English (Malaysia), English (Philippines), Finnish, French (Canada), French (Belgium), French (France), French (Tunisia), German, German (Switzerland), Gujarati, Hebrew, Hindi, Hungarian, IsiZulu, Italian, Korean, Malayalam, Malaysian, Nepali, Norwegian, Odia/Oriya, Polish, Portuguese, Punjabi, Russian, Swedish, Telugu, Thai, Tingrinian, Turkish, Ukrainian, Urdu, Vietnamese, Xhosa)


FREE download through the library


The Patient Health Questionnaire 9 (PHQ-9) is the depression monitoring module of a broader diagnostic instrument, the PRIME-MD, that applies to several common mental disorders and has been validated for use in primary care. The PHQ-9 assesses nine DSM-IV criteria based on frequency from “not at all” to “nearly every day”. While not a screening tool, the PHQ-9 may aid in monitoring depression severity and informing treatment decisions.


9 Criteria Assessed:

    • Little interest or pleasure in doing things?
    • Feeling down, depressed, or hopeless?
    • Trouble falling or staying asleep, or sleeping too much?
    • Feeling tired or having little energy?
    • Poor appetite or overeating?
    • Feeling bad about yourself – or that you are a failure or have let yourself or your family down?
    • Trouble concentrating on things, such as reading the newspaper or watching television?
    • 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?
    • Thoughts that you would be better off dead, or of hurting yourself in some way?

Administration Format: self-report questionnaire

Administration Time: 3-5 minutes


Reliability (Kroenke 2001):

    • Internal Consistency: alphas of 0.89 (primary care sample) and 0.86 (Ob-Gyn sample)
    • Test-Retest: after 48 hours delay, correlation between patient completed and mental health profession completed was 0.84, with mean scores (5.08 and 5.03) that were practically identical.


Validity (Kroenke 2001): yielded 88% sensitivity and 88% specificity for major depression for scores greater than or equal to 10. Validated for use in primary care settings and over the phone.

Source: https://patient.info/doctor/patient-health-questionnaire-phq-9#:~:text=The%20PHQ-9%20is%20the%20depression%20module%2C%20which%20scores,the%20severity%20of%20depression%20and%20response%20to%20treatment.

Source: https://www.health.state.mn.us/people/womeninfants/pmad/tools.html

supporting literature

Kroenke, K., Spitzer, R.L. (2002) The PHQ-9: A New Depression Diagnostic and Severity Measure. Psychiatric Annals, 32(9), 509-515.
PDF: PHQ-9 – 1 – Kroenke 2002
Link: https://psycnet.apa.org/record/2002-04400-002

Kroenke, K., Spitzer, R.L., Wiliams, J.B. (2001) The PHQ-9: Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16(9), 606-613.
PDF: PHQ-9 – 2 – Kroenke 2001
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1495268/

Kroenke, K., Spitzer, R.L., Wiliams, J.B. (2003) The Patient Health Questionnarie-2: Validity of a Two-Item Depression Screener. Medical Care, 41(11), 1284-1292.
PDF: PHQ-9 – 3 – Kroenke 2003
Link: https://journals.lww.com/lww-medicalcare/Abstract/2003/11000/The_Patient_Health_Questionnaire_2__Validity_of_a.8.aspx