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🌧️ PHQ-9 Depression Test

💙 PHQ-9 Depression Test — Clinically Validated Screening

9 questions based on the official PHQ-9 scale used by doctors worldwide. Takes under 2 minutes. Get your score with a plain-English explanation of what it means.

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This is a screening tool, not a diagnosis. Results indicate whether symptoms are present — only a qualified healthcare professional can diagnose depression. If you are in crisis or having thoughts of self-harm, please contact Samaritans on 116 123 (UK) or text HOME to 741741 (US) immediately.

0 / 9

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Please answer all questions before viewing your score.

What PHQ-9 Measures

Loss of interest
Anhedonia — reduced ability to feel pleasure
Depressed mood
Persistent feelings of hopelessness or emptiness
Sleep disturbance
Insomnia, hypersomnia, or non-restorative sleep
Fatigue
Persistent low energy not explained by activity
Appetite changes
Significant increase or decrease in appetite
Self-worth
Feelings of worthlessness or excessive guilt
Concentration
Difficulty thinking, deciding, or remembering
Psychomotor changes
Slowed movement or agitated restlessness
Suicidal ideation
Thoughts of self-harm or death — handled sensitively

Based on the DSM-5 criteria for major depressive disorder. Validated by Kroenke K et al. (2001).

Understanding Your PHQ-9 Score

PHQ-9 severity scale showing depression score ranges from minimal to severe

Scores range from 0 to 27. Higher scores indicate greater depression symptom severity.

0–4
Minimal

Depressive symptoms are minimal or absent. Normal mood fluctuations. No clinical action required.

5–9
Mild

Mild symptoms present. Self-help strategies and lifestyle changes are a good starting point. Monitor closely.

10–14
Moderate

Moderate depression likely affecting daily life. Clinical guidelines recommend professional assessment at this level.

15–19
Mod. Severe

Moderately severe depression with significant daily impairment. Prompt professional assessment is strongly recommended.

20–27
Severe

Severe depression. Please speak to a doctor urgently. Effective treatments exist — this is not a permanent state.

Depression vs Sadness — Key Differences

Understanding the distinction between ordinary sadness and clinical depression is important — both for recognising when to seek help and for reducing unnecessary self-stigma. Sadness is a healthy and adaptive emotion. Depression is a medical condition that changes brain function in ways that require more than willpower to resolve.

😢 Sadness (Normal)
Triggered by a specific event or loss
Responds to positive news and comfort
Usually resolves within days to weeks
Motivation and pleasure can still be accessed
Does not typically impair ability to function
Self-esteem remains broadly intact
🔵 Clinical Depression
May have no clear external trigger
Does not lift in response to positive events (anhedonia)
Persists for 2+ weeks, most of the day
Loss of interest in previously enjoyable activities
Significant impairment in work, relationships, or self-care
Often accompanied by guilt, worthlessness, or hopelessness

If your low mood falls in the "depression" column for most of the above, a PHQ-9 score of 10 or above, or if you have been struggling for more than 2 weeks, speaking to your GP is the most productive step you can take. Depression is highly treatable — approximately 70–80% of people with depression respond to treatment.

What Is the PHQ-9?

The PHQ-9 (Patient Health Questionnaire-9) was developed by Kroenke, Spitzer, and Williams and published in the Journal of General Internal Medicine in 2001. It was created to give primary care physicians a brief, validated tool for screening depression in everyday practice — a condition that is both highly prevalent and frequently under-detected.

The questionnaire directly maps to the 9 diagnostic criteria for a major depressive episode in the DSM-5, making it one of the most clinically grounded screening tools available. Each item is scored 0–3 (Not at all / Several days / More than half the days / Nearly every day), with a maximum score of 27.

The PHQ-9 has been validated in over 100 clinical studies across diverse settings and populations. At a cut-off score of 10, it achieves 88% sensitivity and 88% specificity for major depressive disorder in primary care. It is now embedded in standard electronic health records in the UK NHS, US Veterans Affairs system, and healthcare systems across more than 80 countries.

Beyond initial screening, the PHQ-9 is also used to monitor treatment response. A reduction of 5 or more points typically indicates a clinically meaningful improvement. A score below 5 is commonly used as a remission threshold in clinical trials.

Treatment Options for Depression

Depression is one of the most treatable mental health conditions. Around 70–80% of people respond to treatment.

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Cognitive Behavioural Therapy (CBT)

CBT is the gold-standard psychological treatment for depression. It works by identifying and restructuring negative thought patterns (cognitive distortions) and increasing engagement with rewarding activities (Behavioural Activation). CBT produces durable improvements — people who complete a course of CBT have significantly lower relapse rates than those who use medication alone.

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Antidepressant Medication

SSRIs (selective serotonin reuptake inhibitors) are typically first-line antidepressants. They take 2–6 weeks to produce full effects and should be taken under medical supervision. For moderate to severe depression, the combination of medication and therapy is more effective than either alone. Always discuss starting, adjusting, or stopping antidepressants with your doctor.

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Aerobic Exercise

Multiple meta-analyses show aerobic exercise has antidepressant effects comparable to medication for mild to moderate depression. 30 minutes of moderate-intensity exercise (brisk walking, cycling, swimming) 3–5 times per week significantly reduces PHQ-9 scores within 4–8 weeks. Exercise increases BDNF, serotonin, and dopamine, and reduces inflammatory markers implicated in depression.

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Mindfulness-Based Cognitive Therapy (MBCT)

MBCT combines mindfulness practices with cognitive therapy techniques. It is particularly effective at preventing relapse in people who have experienced 3 or more depressive episodes, reducing relapse rates by approximately 44% compared to usual care. MBCT is now recommended by NICE (UK) for recurrent depression.

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Interpersonal Therapy (IPT)

IPT focuses on improving interpersonal relationships and communication patterns that may be contributing to or maintaining depression. It is particularly effective when depression is linked to grief, role transitions (new job, divorce, becoming a parent), or relationship conflicts. IPT typically involves 12–16 structured sessions.

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Lifestyle and Social Connection

Sleep quality, physical activity, diet quality, alcohol reduction, and social connection all independently affect depression outcomes. Regular social contact — even brief, low-effort interactions — has measurable antidepressant effects. Reducing alcohol intake is particularly important: alcohol is a CNS depressant that worsens mood and disrupts sleep, creating a compounding negative cycle.

Note: The treatment options above are for informational purposes. Do not start, stop, or change any treatment without speaking to a qualified healthcare professional. If you are in crisis, contact your GP, go to your nearest A&E, or call Samaritans on 116 123 (UK) / Crisis Text Line at 741741 (US).

Frequently Asked Questions

The PHQ-9 (Patient Health Questionnaire-9) is a validated clinical screening tool developed from the PRIME-MD project. It assesses the 9 core criteria for a major depressive episode as defined in the DSM-5. It is one of the most widely used depression screening instruments in primary care worldwide, with strong evidence for reliability and validity across diverse populations.

Clinical thresholds: 0–4 = minimal depression; 5–9 = mild; 10–14 = moderate; 15–19 = moderately severe; 20–27 = severe. A score of 10 or above is typically the clinical cut-off for major depressive disorder screening, with sensitivity and specificity both around 88% in primary care populations.

No. The PHQ-9 is a screening tool, not a diagnostic instrument. A high score indicates depressive symptoms at a level warranting clinical evaluation — not a confirmed diagnosis. Diagnosis requires a clinical interview by a qualified healthcare professional who can rule out other causes and assess the full picture.

Sadness is a normal response to loss or difficult circumstances. Clinical depression is characterised by persistent low mood or loss of interest in nearly all activities, occurring most of the day, nearly every day, for at least two weeks, alongside other symptoms (sleep changes, appetite changes, energy loss, cognitive changes, worthlessness, or suicidal thoughts) causing significant impairment. The key distinctions are duration, pervasiveness, severity, and inability to recover in response to positive events.

The most effective treatments include: Cognitive Behavioural Therapy (CBT) — strongest evidence base; antidepressant medication (SSRIs as first-line); and the combination of both for moderate to severe cases. Other evidence-supported approaches include Interpersonal Therapy (IPT), Behavioural Activation, aerobic exercise, and mindfulness-based cognitive therapy (MBCT) for preventing relapse.

Yes — for mild to moderate depression, psychotherapy alone (especially CBT) can be as effective as medication. Regular aerobic exercise has comparable effects to antidepressants in mild-moderate cases. Lifestyle factors — sleep quality, social connection, and routine — significantly affect outcomes. For moderate to severe depression, the combination of therapy and medication is typically most effective.

Question 9 asks about thoughts of self-harm or being better off dead. A score above 0 does not mean you are in immediate danger — passive thoughts differ from active planning. However, any score above 0 warrants compassionate attention and professional support. If you are experiencing distressing thoughts, contact Samaritans on 116 123 (UK) or text HOME to 741741 (US).

In clinical settings, the PHQ-9 is typically administered every 2–4 weeks to monitor treatment. For personal monitoring, monthly use is appropriate. If your score is 10 or above, speak to your GP rather than continuing to self-monitor — earlier treatment consistently leads to better outcomes.

At a cut-off of 10, the PHQ-9 has sensitivity of ~88% and specificity of ~88% for major depressive disorder in primary care settings. It has been validated across dozens of countries and populations and is one of the most thoroughly researched mental health screening instruments available.