What the PHQ-9 measures
The Patient Health Questionnaire-9 (PHQ-9) was developed as a brief, self-administered screening tool to detect, diagnose, and measure the severity of depression. It is directly based on the nine diagnostic criteria for Major Depressive Disorder (MDD) found in the Diagnostic and Statistical Manual of Mental Disorders (DSM). Because it maps directly to DSM criteria, it holds immense clinical utility for both initial screening and ongoing treatment monitoring.
The dimensions it assesses
- Cognitive-Affective Symptoms: Anhedonia (loss of interest), depressed mood, feelings of worthlessness/guilt, concentration difficulties, and suicidal ideation.
- Somatic Symptoms: Sleep disturbances, fatigue/loss of energy, appetite changes, and psychomotor agitation/retardation.
Already have a PHQ-9 score from somewhere else? Look it up without retaking the questionnaire.
What your score means
(Theoretical Range: 0 to 27) Critical Flag: Any score ≥ 1 on Question 9 (Suicidal Ideation) requires immediate clinical risk assessment regardless of total score.
| Score | Interpretation | What it suggests |
|---|---|---|
| 0 – 4 | Minimal / No Depression | Normal baseline. No formal clinical intervention required. |
| 5 – 9 | Mild Depression | Mild depressive burden. Recommend watchful waiting, lifestyle interventions, and repeat screening at follow-up. |
| 10 – 14 | Moderate Depression | Clinically significant symptom burden. Consider counseling, psychotherapy (e.g., CBT), and ongoing monitoring. |
| 15 – 19 | Moderately Severe Depression | High clinical burden. Active multimodal treatment (Psychotherapy + Pharmacotherapy evaluation) strongly recommended. |
| 20 – 27 | Severe Depression | Very severe depression. Immediate specialist referral, rigorous safety assessment, and rapid intervention required. |
These ranges describe groups of people, not individuals. A score near a boundary is not meaningfully different from one just across it, and no range on this table is a diagnosis.
What to do with your result
- For Mild Scores (5-9): Focus on behavioral activation—ensuring regular sleep hygiene, daily physical activity, and social engagement to prevent symptom escalation.
- For Moderate Scores (10-14): Introduce structured cognitive restructuring (CBT techniques) to challenge feelings of worthlessness and hopelessness. Professional therapy is a strong catalyst for recovery at this stage.
- For Severe Scores (15+): This is a medical condition requiring professional support. Prioritize scheduling a psychiatric or psychological evaluation. Do not attempt to rely solely on self-help.
- Safety Protocol: If Q9 was endorsed, immediately contact a local crisis line, a mental health professional, or go to the nearest emergency room.
How reliable is the PHQ-9?
Internal consistency was measured at Cronbach's α = 0.89 in the PHQ Primary Care Study and α = 0.86 in the PHQ Ob-Gyn Study, across 6,000 patients in 15 clinics. Scores taken 48 hours apart — self-completed in clinic, then re-administered by telephone — correlated at r = 0.84. Among the 580 patients who also received a structured interview by a mental health professional, a score of ≥ 10 had a sensitivity of 88% and a specificity of 88% for major depression. All figures from Kroenke, Spitzer & Williams (2001).
Common questions about the PHQ-9
- What does the PHQ-9 measure?
- Gold-standard 9-item diagnostic depression severity assessment mapping directly to the DSM-5 criteria for Major Depressive Disorder.
- Can the PHQ-9 diagnose me?
- No. Depression Screening (PHQ-9) is a screening questionnaire, not a diagnostic tool. It can flag that something may need a closer look. It cannot tell you what is causing it. Grief, burnout, a thyroid problem, medication side effects, chronic pain and months of bad sleep are not among its questions, and any of them can move a score. Telling those apart is what a professional assessment is for.
- What is considered a high score on the PHQ-9?
- Scores of 20 – 27 fall in the range described as "Severe Depression", while 0 – 4 is described as "Minimal / No Depression". Those labels describe bands of scores rather than people, and a score sitting one point either side of a boundary is not meaningfully different from one just across it.
- How long does the PHQ-9 take?
- 9 questions, which most people finish in 3 – 5 minutes. There is no time limit, and answering honestly matters more than answering quickly. The results page checks for patterns suggesting the questions were rushed.
- Is this PHQ-9 test really free?
- Yes. No account, no email address, no payment. Psychometrics Today is funded by donations rather than advertising, which is also what allows us to publish instruments whose authors permit free but non-commercial use.
- Are my answers stored or shared?
- No. Your answers are scored inside your browser and never sent to us. There is no database of responses, because we never receive any. Closing the tab erases them, which is why results cannot be recovered afterwards.
- How often should I retake the PHQ-9?
- Most of these questionnaires ask about the past one to two weeks, so retaking sooner than that mostly measures the same period twice. Every two to four weeks is a reasonable rhythm if you are tracking change. A direction of travel over several weeks tells a doctor far more than any single score.
- Who created the PHQ-9, and is this the real version?
- It was published by Pfizer Inc. (developed via an educational grant). Carries the explicit notice: "No permission required to reproduce, translate, display or distribute." The items here are the published ones rather than a paraphrase, and the scoring follows the original rules. Both are documented on this page so they can be checked.
- How accurate is the PHQ-9?
- Internal consistency was measured at Cronbach's α = 0.89 in the PHQ Primary Care Study and α = 0.86 in the PHQ Ob-Gyn Study, across 6,000 patients in 15 clinics. Scores taken 48 hours apart — self-completed in clinic, then re-administered by telephone — correlated at r = 0.84. Among the 580 patients who also received a structured interview by a mental health professional, a score of ≥ 10 had a sensitivity of 88% and a specificity of 88% for major depression. All figures from Kroenke, Spitzer & Williams (2001).
Sources
Rights held by Pfizer Inc. (developed via an educational grant). Developed and validated by the researchers cited below.
- Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606-613.
- American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.).
- Manea, L., Gilbody, S., & McMillan, D. (2012). Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire (PHQ-9): a meta-analysis. CMAJ, 184(3), E191-E196.
Licensing
Public domain. Carries the explicit notice: "No permission required to reproduce, translate, display or distribute."