The PHQ-9 is the most widely used depression screening tool in clinical practice. Nine questions, three minutes, and a clearer picture of where you stand.
Quick answer
The PHQ-9 is scored 0 to 27. 0-4 is minimal depression, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe. The standard clinical cutoff for major depression is 10 (Kroenke et al., 2001).
The PHQ-9 is scored on a 0-27 scale. Each of the 9 items is rated on a 4-point frequency scale (0 = Not at all, 1 = Several days, 2 = More than half the days, 3 = Nearly every day). Your total score is the sum of all 9 item scores.
A 10th item asking about functional impairment is administered alongside but is not counted in the 0-27 total — it provides clinical context. Higher total scores indicate more severe depression. The five standard severity bands below are the same cutoffs used by the AAFP, APA, NICE, and primary care clinicians worldwide.
Important: any non-zero answer on item 9 (thoughts of self-harm or being better off dead) warrants immediate attention regardless of the total score. If this applies to you, call or text 988 now.
| Score | Severity | What it means | Clinical note |
|---|---|---|---|
| 0-4 | None / minimal | Typical range for adults without clinical depression. | No treatment usually needed. Average US adult scores around 3. |
| 5-9 | Mild depression | Noticeable symptoms. Clinical judgment determines next steps. | Monitor over 2-4 weeks. Consider watchful waiting, counseling, or lifestyle interventions. Use context (symptom duration, functional impact). |
| 10-14 | Moderate depression | Depression is likely interfering with daily life. | Standard clinical threshold for probable major depressive disorder (88% sensitivity, 88% specificity at cutoff 10). Counseling, therapy, or pharmacotherapy typically warranted. |
| 15-19 | Moderately severe depression | Depression is having a significant impact on functioning. | Active treatment recommended — psychotherapy (CBT, IPT), medication, or both. |
| 20-27 | Severe depression | Depression is severely impairing quality of life and function. | Immediate initiation or change of treatment warranted. Medication plus psychotherapy typically recommended; evaluate for safety. |
Want to score yourself right now? Answer the questions below to see which band your total falls into.
Important: The PHQ-9 is a screening instrument, not a diagnostic tool. Only a qualified mental health professional can diagnose depression. If you're having thoughts of self-harm, please call 988 immediately.
Over the last 2 weeks, how often have you been bothered by the following problems?
9 questions · Takes about 3 minutes
The PHQ-9 (Patient Health Questionnaire-9) is the gold-standard depression screening tool used in clinical settings worldwide. It was developed in the late 1990s as part of the PRIME-MD diagnostic instrument and has since been validated in hundreds of studies across diverse populations.
The nine items map directly to the DSM-5 diagnostic criteria for Major Depressive Disorder: depressed mood, loss of interest, sleep changes, fatigue, appetite changes, guilt/worthlessness, concentration problems, psychomotor changes, and suicidal ideation.
Unlike many self-help quizzes, the PHQ-9 has strong psychometric properties. It has a sensitivity of 88% and specificity of 88% for detecting major depression at a cutoff score of 10. This means it's good at catching depression when it's present and good at not flagging it when it's not.
Each question maps to one of the nine diagnostic criteria for Major Depressive Disorder, covering mood, interest, sleep, energy, appetite, self-worth, concentration, psychomotor function, and suicidal ideation.
The 4-point response scale (0-3) measures symptom frequency over the past two weeks, not just presence/absence. This captures severity and creates a continuous score for tracking changes over time.
Scores map to five severity levels: minimal (0-4), mild (5-9), moderate (10-14), moderately severe (15-19), and severe (20-27). Each tier has distinct clinical implications and recommended actions.
The PHQ-9 was developed and validated by Kroenke, Spitzer, and Williams (2001) in a landmark study published in the Journal of General Internal Medicine. It has since been cited over 30,000 times and translated into over 80 languages.
The tool's nine questions correspond to the nine symptom criteria for Major Depressive Disorder in the DSM-5. Each question asks about symptom frequency over the past two weeks, using a 4-point scale from 'not at all' (0) to 'nearly every day' (3), producing scores from 0 to 27.
Research consistently shows the PHQ-9 is both reliable and valid across different clinical settings, age groups, and cultural contexts. A meta-analysis by Levis et al. (2019) in BMJ confirmed its diagnostic accuracy, particularly at the 10-point cutoff threshold.
The PHQ-9 is unique among screening tools because it can serve double duty: it screens for the presence of depression AND monitors treatment response over time. Many clinicians administer it at every visit to track whether treatment is working.
This tool is a screening instrument, not a diagnostic tool. Only a qualified mental health professional can diagnose depression. If you're having thoughts of self-harm, please contact 988 (Suicide & Crisis Lifeline) immediately.
Each of the 9 items is scored 0-3: Not at all = 0, Several days = 1, More than half the days = 2, Nearly every day = 3. Add all nine item scores together for a total between 0 and 27. The PHQ-9 also has a 10th item asking about functional impairment (how much symptoms interfere with daily life), but that item is not counted in the 0-27 total — it's used as clinical context only.
The PHQ-9 has five severity bands: 0-4 None / minimal (typical range), 5-9 Mild depression (use clinical judgment, monitor), 10-14 Moderate depression (clinical threshold — counseling and/or follow-up warranted), 15-19 Moderately severe depression (active treatment recommended), 20-27 Severe depression (immediate initiation or change of treatment is warranted). These cutoffs were established in Kroenke et al. 2001 and are used in AAFP, APA, and NICE guidelines.
A score of 0-4 is considered minimal depression and is the typical range for adults without clinical depression. The average PHQ-9 score in the general US adult population is approximately 3. Scores of 5 or higher indicate symptoms worth monitoring; 10 or higher is the standard clinical threshold for further evaluation and possible treatment.
A PHQ-9 score of 10 is the standard clinical cutoff for probable major depressive disorder. At this score the PHQ-9 has a sensitivity of 88% and specificity of 88% for major depression (Kroenke 2001). Providers typically recommend counseling, therapy referral, or pharmacotherapy follow-up at or above this threshold.
A PHQ-9 score of 17 falls in the moderately severe depression band (15-19). At this level, active treatment with psychotherapy (such as CBT or IPT), medication, or both is typically recommended. If you scored in this range on a self-assessment, reach out to a healthcare provider — your primary care doctor is a good starting point — to discuss next steps.
Both are short self-report screening tools from the same research group (Kroenke, Spitzer, Williams). The PHQ-9 measures depression severity (9 items, 0-27 scale). The GAD-7 measures anxiety (7 items, 0-21 scale). They are commonly administered together because depression and anxiety frequently co-occur. You can take our GAD-7 at /tools/anxiety-calculator alongside this PHQ-9.
Item 9 asks about thoughts of self-harm or being better off dead. In clinical practice, any non-zero score on this item (1, 2, or 3) prompts immediate clinical attention regardless of the total score. If this applies to you right now, please reach out: call or text 988 (Suicide & Crisis Lifeline), text HOME to 741741 (Crisis Text Line), or go to your nearest emergency room. These services are free, confidential, and available 24/7.
Clinicians typically re-administer the PHQ-9 every 2-4 weeks when monitoring depression treatment, and sometimes at every appointment during active treatment. For personal tracking, every 2-4 weeks captures meaningful change without noise. A score change of 5+ points is generally considered clinically significant.
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