PHQ-9 PDF: Print the Nine-Question Depression Screener
The PHQ-9 is a nine-question form that records how often depressive symptoms have bothered you over the last two weeks. This page carries the questionnaire itself, so you can print it or fill it in by hand, along with the response options, the scoring key and what each range means.
Reviewed byMichael Callans, MSWThe nine questions
- 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
How to answer
Answer for the last 2 weeks. Beside each of the nine problems, write one of the four answers: Not at all, Several days, More than half the days, or Nearly every day. Answer for how things have actually been, not how you think they should be. After the nine questions the form asks one more: '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?' Write Not difficult at all, Somewhat difficult, Very difficult, or Extremely difficult. If question 9 is true for you in any way, please tell someone today.
The four response options and their points: Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).
How to score it
- Score each of the nine questions: Not at all = 0, Several days = 1, More than half the days = 2, Nearly every day = 3.
- Add the nine scores. The total runs from 0 to 27.
- The published cutpoints are 5, 10, 15 and 20, for mild, moderate, moderately severe and severe depression. A score of 10 or greater is the commonly cited threshold for likely major depression.
- The final difficulty question is not scored and is not added to the total. It records your own impression of how much the problems interfere, and clinicians use it when weighing treatment.
- Question 9 is read on its own, whatever the total. Any answer other than 'Not at all' is followed up directly.
- If a question is left blank, leave the total incomplete and say so, rather than counting the blank as 0. This missing-answer instruction is an editorial safeguard, not part of the published scoring.
What the score means
0 to 4 is the none to minimal range. 5 to 9 is mild. 10 to 14 is moderate. 15 to 19 is moderately severe. 20 to 27 is severe.
The published guidance pairs those ranges with proposed actions rather than diagnoses: none for 0 to 4; watchful waiting and repeating the PHQ-9 at follow-up for 5 to 9; a treatment plan considering counseling, follow-up and medication for 10 to 14; active treatment for 15 to 19; and immediate treatment with expedited referral to a mental health specialist for 20 to 27.
The PHQ-9 measures symptom severity. It does not by itself diagnose depression. A diagnosis also requires ruling out normal bereavement, a history of manic episodes, and physical conditions, medications or other drugs that could be causing the symptoms. Any thoughts of being better off dead or of hurting yourself deserve attention immediately, at any total score.
Source and permission
Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.
Primary citation: Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-613. doi:10.1046/j.1525-1497.2001.016009606.x.
Severity and treatment-action guidance: Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals. 2002;32(9):509-515.
The PHQ family of measures and the official instruction manual are available free at https://www.phqscreeners.com.
Reproduced under the developers' own statement on the official PHQ Screeners site that all of the PHQ family measures are in the public domain and that no permission is required to reproduce, translate, display or distribute them, with the developers' attribution footer retained.
Related tools & tests
Score in the moderate range or higher?
A therapist can work out what is driving it and what actually helps. Searching our directory is free.
Therapists Who Work With Depression
A worksheet is a start. These licensed therapists work with the same problem; every member is matched to the federal NPI Registry and board checks are dated on the profile.
-
View profile
Hazel MoonLPC
License verified, checked Oct 27, 2026
Fayetteville, Arkansas Telehealth $99 to $177 per session
-
View profile
Jackie PrinceMSW, LCSW
License verified, checked Oct 13, 2026
“Therapy is a space where you can feel heard, understood, and supported as you navigate life’s challenges and find your way forward.”
Lancaster, Pennsylvania Telehealth $150 per session
-
View profile
James NatterPsyD
License verified, checked Oct 16, 2026
“You are a universe of one, gladly to lovingly explore.”
Newburgh, Indiana Telehealth $220 to $240 per session
About this tool
The PHQ-9 PDF on this page is the nine-item Patient Health Questionnaire, the depression module of the PHQ family. Each of the nine items maps onto one of the nine symptom criteria for a major depressive episode, and each is rated for the last two weeks on a four-point frequency scale running from Not at all to Nearly every day. That is the whole instrument: nine questions, a total between 0 and 27, and one extra unscored question about how much the problems interfere with work, home life and getting along with other people.
The form came out of the PRIME-MD program, a structured diagnostic aid built for primary care. Spitzer, Kroenke and Williams published a patient self-report version in JAMA in 1999, and the depression module was then validated on its own by Kroenke, Spitzer and Williams in the Journal of General Internal Medicine in 2001. That 2001 paper collected PHQ-9 data from 6,000 patients across 8 primary care clinics and 7 obstetrics-gynecology clinics, and compared 580 of those patients against an independent interview by a mental health professional. The developers placed the measure in the public domain, which is why copies of it are everywhere.
Most PHQ-9 use happens in primary care, where a doctor has a few minutes and wants a structured way to ask about mood. It also turns up at behavioral health intake, in collaborative care programs that track a whole caseload, and in research as an outcome measure. The useful property is repeatability: the same nine questions asked at week 0, week 6 and week 12 turn a vague impression of improvement into something you can see. Clinicians tend to read the direction of travel across several administrations rather than treating one total as the finding.
The published cutpoints are 5, 10, 15 and 20, marking mild, moderate, moderately severe and severe symptom levels, and 10 is the number most often used to decide that a fuller assessment is warranted. In the 2001 validation, a score of 10 or more gave a sensitivity of 88 percent and a specificity of 88 percent for major depression. That was one study. The individual participant data meta-analysis by Levis, Benedetti and Thombs in The BMJ in 2019 pooled 58 studies and 17,357 participants and reported sensitivity of 0.88 and specificity of 0.85 at the same cutoff against semistructured diagnostic interviews.
The bands come with proposed actions rather than labels, which is the part people miss when they look up a total online. The severity guidance Kroenke and Spitzer published in Psychiatric Annals in 2002 pairs 5 to 9 with watchful waiting and repeating the questionnaire at follow-up, 10 to 14 with a treatment plan that may include counseling, follow-up or medication, 15 to 19 with active treatment, and 20 to 27 with immediate treatment and an expedited referral to a mental health specialist. A 15 is not a different condition from a 12. It is a reason to move faster.
A total is not a diagnosis. Nine questions cannot rule out the things that change what a low mood means: a recent bereavement, a history of manic or hypomanic episodes that would point toward bipolar disorder rather than unipolar depression, a thyroid problem, anemia, a medication side effect, chronic pain, or an untreated sleep disorder. The form also never asks how long this has been going on, which is what separates a two-week episode from a years-long low-grade depression. Any of those situations can produce a 14. Working out what a particular 14 means is the job of an appointment, not of a form.
Four of the nine items ask about sleep, appetite, energy and concentration, and those four are also disturbed by physical illness, pregnancy, shift work, chemotherapy, chronic pain and ordinary exhaustion. In those situations a total can run high for reasons that have little to do with mood, which is part of why the instrument is called a screen. The Levis meta-analysis also found the PHQ-9 is similarly sensitive but somewhat less specific in younger adults, meaning more false positives in that group. None of this makes a high score meaningless. It makes the conversation afterward necessary.
Question 9 asks about thoughts of being better off dead or of hurting yourself, and it is read on its own whatever the total. Any answer other than Not at all is followed up directly, so a total of 4 with that item endorsed deserves attention that a total of 19 without it might not. If that item is true for you in any way, even faintly or only sometimes, tell someone today rather than waiting for the next appointment: a doctor, a therapist, a crisis line, or a person who will stay with you while you call one. The crisis number is in the note at the foot of this page.
Print the sheet and fill it in by hand if you want something to take to an appointment, or hand it to a patient on paper if you are the clinician. If you would rather answer on screen and have the total worked out for you, the interactive version is at Depression Test, and for a running record of mood between appointments see Mood Tracker. Whichever route you take, the result is worth bringing to a person who can ask the follow-up questions. The sheet is the opening of a conversation about your mood, not its conclusion.
References
- Kroenke K, Spitzer RL, Williams JBW. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine. 2001;16(9):606-613. doi:10.1046/j.1525-1497.2001.016009606.x
- Spitzer RL, Kroenke K, Williams JBW. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA. 1999;282(18):1737-1744. doi:10.1001/jama.282.18.1737
- Kroenke K, Spitzer RL. The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals. 2002;32(9):509-515.
- Levis B, Benedetti A, Thombs BD. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476. doi:10.1136/bmj.l1476
Cite this source
Psychology.com. (2026, November 6). PHQ-9 PDF. Psychology.com. https://psychology.com/tools/phq-9-pdf
PHQ-9 PDF FAQ
Is the PHQ-9 PDF free to download?
Yes. The PHQ-9 PDF is free, and so is reproducing it. The developers placed the whole PHQ family in the public domain and state on the official PHQ Screeners site that no permission is required to reproduce, translate, display or distribute the measures. There is no license to buy, no registration, and no per-copy fee for a clinic. Two things are expected of anyone who reprints it: keep the developers' attribution footer, and do not alter the wording of the items, because the published scoring and cutpoints only apply to the published questions.
How do I score the PHQ-9 by hand?
Scoring the PHQ-9 takes about thirty seconds. Give each of the nine questions 0 for Not at all, 1 for Several days, 2 for More than half the days and 3 for Nearly every day, then add the nine numbers for a total between 0 and 27. The final question about how difficult the problems have made work, home life and relationships is not scored and does not go into the total. If a question was left blank, do not count it as 0: note how many questions were answered and leave the total marked incomplete, so nobody later reads an artificially low number as reassurance.
What is a normal PHQ-9 score?
On the PHQ-9, 0 to 4 is described as the none to minimal range, which is where most people without current depressive symptoms land. Above that, 5 to 9 is mild, 10 to 14 moderate, 15 to 19 moderately severe and 20 to 27 severe. The word normal does some damage here, because the bands describe how much symptom load a person reported over two weeks, not how typical they are. A 7 is not an illness and a 12 is not a verdict. What makes any of these numbers worth acting on is how long it has lasted and how much it is costing you day to day.
Does the PHQ-9 diagnose depression?
No. The PHQ-9 measures the severity of reported symptoms over two weeks, and a diagnosis needs more than that. A clinician also has to rule out normal bereavement, a history of manic or hypomanic episodes that would change the diagnosis to bipolar disorder, and physical causes such as thyroid disease, anemia, medication side effects or a sleep disorder. The form does not ask how long the symptoms have lasted, whether they came after a loss, or what else is happening in your life. A high score means the conversation is worth having, not that the question is settled.
Can I use the PHQ-9 PDF with my patients?
Yes. The PHQ-9 is used routinely in primary care, behavioral health intake and collaborative care programs, and the public domain status covers clinical use as well as personal use. Print it, hand it over on paper, keep the attribution footer and score it with the published key. Two practical notes: administer it the same way each time if you are tracking change, because a form read aloud and a form filled in privately do not always produce the same answers, and read question 9 before you read the total, every time, rather than after.
What does it mean if question 9 on the PHQ-9 is not zero?
Question 9 on the PHQ-9 asks about thoughts of being better off dead or of hurting yourself, and it is handled on its own rather than as one ninth of a total. Any answer other than Not at all is a reason for a direct conversation today, whatever the other eight answers add up to. Thoughts like these are more common than people assume and having them does not mean you will act on them, but they are also not something to sit with alone or to save for an appointment in three weeks. Tell a doctor, a therapist, or someone who will stay with you while you call for help.
How often should the PHQ-9 be repeated?
The PHQ-9 was built to be repeated, and that is where most of its value sits. The published guidance suggests repeating it at follow-up for scores in the 5 to 9 range, and in practice clinicians commonly re-administer it every two to four weeks while a treatment is being adjusted, then less often once things are steady. Repeating it daily tells you little, because the questions ask about a two-week window and the answers will barely move. What matters is the direction across several administrations: a 19 that becomes a 12 is useful information even though 12 is still in the moderate band.