PATIENT HEALTH QUESTIONNAIRE (PHQ-9)

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Patient name or initial
Gender
Over the last 2 weeks, how often have you been bothered by any of the following problems? (use "✓" to indicate your answer)
Not at all (0)Several days (1)More than half the days (2)Nearly every day (3)
1. Little interest or pleasure in doing things
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
2. Feeling down, depressed, or hopeless
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
3. Trouble falling or staying asleep, or sleeping too much
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
4. Feeling tired or having little energy
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
5. Poor appetite or overeating
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
7. Trouble concentrating on things, such as reading the newspaper or watching television
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
8. Moving or speaking so slowly that other people could have noticed. Or the opposite being so figety or restless that you have been moving around a lot more than usual
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
9. Thoughts that you would be better off dead, or of Thoughts that you would be better off dead, or of hurting yourself
Not at all (0)
Several days (1)
More than half the days (2)
Nearly every day (3)
(PHQ-9)
Not difficult at allSomewhat difficultVery difficultExtremely difficult
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult