The PHQ-9 is the nine item depression scale of the Patient Health Questionnaire. The PHQ-9 is a tool for assisting primary care clinicians in diagnosing depression as well as selecting and monitoring treatment. The primary care clinician and/or office staff should discuss with the patient the reasons for completing the questionnaire and how to fill it out. After the patient has completed the PHQ-9 questionnaire, it is scored by the primary care clinician or office staff. There are two components of the PHQ-9: • Assessing symptoms and functional impairment to make a tentative depression diagnosis, and • Deriving a severity score to help select and monitor treatment The PHQ-9 is based directly on the diagnostic criteria for major depressive disorder in the Diagnostic and Statistical Manual Fourth Edition (DSM-IV).

The PHQ-9 is adapted from PRIMEMDTODAY, developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues, with an educational grant from Pfizer Inc. For research information, contact Dr Spitzer at rls8@columbia.edu. The names PRIME-MD® and PRIMEMDTODAY™ are trademarks of Pfizer Inc. A footnote on the instrument states that it may be photocopied ad libitum. The MacArthur Initiative on Depression and Primary Care makes recommendations for scoring

Frequency/Level of use, dissemination, how widespread is the usage of the instrument?

Adult patients receiving primary care.

The patient completes the 9-item questionnaire, then the physician or office staff scores the responses.

Ambulatory care

Yes, the PRIME-MD

Yes

List CCD topics that the instrument covers. Mental status

Questionnaire for patients

An algorithm may calculate one or more scores based on elements of the assessment. The questionnaire is scored by the physician for diagnosing depression as well as selecting and monitoring treatment.

Unknown

Sometimes the different versions have different # of questions. Yes. The version being used for this purpose is the PHQ-9.

Is the instrument in the public domain (Y/N)?

http://www.depression-primarycare.org/clinicians/toolkits/materials/forms/phq9

1. Spitzer R, Kroenke K, Williams J. Validation and utility of a self-report version of PRIME-MD: the PHQ Primary Care Study. Journal of the American Medical Association 1999; 282: 1737-1744.

2.Kroenke K, Spitzer R L, Williams J B. The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine 2001; 16(9): 606-613

3.Rost K, Smith J. Retooling multiple levels to improve primary care depression treatment. Journal of General Internal Medicine 16: 644-645, 2001

4.Kroenke K, Spitzer RL. The PHQ-9: A new depression and diagnostic severity measure. Psychiatric Annals 2002; 32: 509-521.

5. Williams JW, Noel PH, Cordes J A, Ramirez G,Pignone M. Is this patient clinically depressed? Journal of the American Medical Association 2002; 287: 1160-1170.

6. Lowe B, Unutzer J, Callahan CM, Perkins AJ, Kroenke K. Monitoring depression treatment outcomes with the patient health questionnaire-9. Medical Care, 2004. 42(12): 1194-201.

Discussion