What is the PHQ-9?
The PHQ-9 is a nine-item questionnaire for depression. Each item asks how often a symptom occurred in the last two weeks.
It is the most widely used depression measure in UK primary care and NHS Talking Therapies.
PHQ-9 scoring
| Score | Severity |
|---|
| 0–4 | Minimal |
| 5–9 | Mild |
| 10–14 | Moderate |
| 15–19 | Moderately severe |
| 20–27 | Severe |
NICE NG222 groups a score below 16 as less severe depression and 16 or more as more severe. This guides treatment choice.
Item 9
Item 9 asks about thoughts of self-harm or being better off dead. Any score above 0 needs a direct risk assessment the same day.
Frequently asked questions
How is the PHQ-9 scored?
Each of nine items scores 0 to 3, for a total of 0 to 27. Higher scores mean more severe depression.
What PHQ-9 score is moderate depression?
A score of 10 to 14 is moderate. NICE NG222 treats scores below 16 as less severe depression.
What does a positive item 9 mean?
It means thoughts of self-harm. Ask directly about suicidal thoughts, plans and intent, and assess risk today.
Can the PHQ-9 diagnose depression?
No. It supports, but does not replace, a clinical assessment.
References
- Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001;16(9):606–13.
- NICE. Depression in adults: treatment and management (2022). NG222. nice.org.uk/guidance/ng222
MedToolbox supports, and does not replace, clinical judgement, national guidance and local policy.
