PHQ-9 Depression Screening
Patient Health Questionnaire-9: validated screening tool for depression severity with clinical recommendations.
Over the last 2 weeks, how often have you been bothered by…
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Über dieses Tool
What Is the PHQ-9?
The Patient Health Questionnaire-9 (PHQ-9) is a self-administered, 9-item screening instrument derived from the full PHQ developed by Drs. Robert Spitzer, Janet Williams, and Kurt Kroenke. Each item maps directly to one of the nine DSM-5 diagnostic criteria for major depressive disorder. Patients rate how often they have been bothered by each symptom over the past two weeks on a 0–3 Likert scale (0 = not at all, 1 = several days, 2 = more than half the days, 3 = nearly every day), yielding a total score from 0 to 27.
Clinical Application
The PHQ-9 serves dual purposes: as a screening tool and as a severity measure for monitoring treatment response. The USPSTF recommends screening all adults for depression in primary care when adequate systems are in place for diagnosis, treatment, and follow-up. A score of ≥10 is the most commonly used threshold for identifying probable major depression, with a sensitivity and specificity each of approximately 88%. However, a positive screen should always be followed by a clinical interview to confirm the diagnosis.
Interpreting PHQ-9 Scores
Scores are categorized into five severity levels: minimal (0–4), mild (5–9), moderate (10–14), moderately severe (15–19), and severe (20–27). Treatment recommendations generally suggest watchful waiting for mild depression, consideration of counseling or pharmacotherapy for moderate depression, and active treatment with antidepressants ± psychotherapy for moderately severe to severe depression. A decrease of ≥5 points from baseline is considered a clinically meaningful response, and a score <5 suggests remission.
🔑 Klinische Hinweise
- Question 9 asks about suicidal ideation — always follow up on a positive response, even if the total score is low.
- The PHQ-9 is free to use without permission and has been validated in over 30 languages.
- Consider the PHQ-2 (questions 1 and 2 only) as an ultra-brief initial screen; if positive (≥3), complete the full PHQ-9.
- PHQ-9 is validated in medical, psychiatric, and obstetric populations but may overestimate depression in patients with significant somatic illness.
Schlüsselreferenzen
- 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.
- USPSTF. Screening for Depression in Adults: US Preventive Services Task Force Recommendation Statement. JAMA. 2016;315(4):380-387.
- Manea L, Gilbody S, McMillan D. Optimal cut-off score for diagnosing depression with the PHQ-9. CMAJ. 2012;184(3):E191-E196.
Formel zuletzt überprüft: Februar 2026