This finding is consistent with a metaanalysis which reported that the phq9 has acceptable diagnostic properties for detecting mdd for cut off scores between eight and eleven. The recommended cut point is a score of 3 or greater. A score of 10 or greater is considered major depression, 20 or more is. Brief description selfadministered 9item instrument based on the nine dsmv criteria listed under criterion a for major depressive disorder. The phq9 and phq2 are both reliable and valid screening instruments for mdd in patients with migraine. The suggested interpretations of phq9 scores in the general primary care adult population are shown in tables 1 and 2. See website for additional information and translations. Phq9 questionnaire for depression scoring and interpretation. Validating the patient health questionnaire9 phq9 for. Phq9 quick depression assessment for initial diagnosis.
Metanalysis of cut off scores for diagnosing depression with phq9 for detecting major depression, suggest cut off scores between 811. Elevated scores on two or more scales suggest comorbidity. Reprinted with permission from kroenke k, spitzer rl, williams jb. Scores of 5, 10, and 15 are taken as the cutoff points for mild, moderate and severe anxiety, respectively. Results may be included in patient files to assist you in setting up a treatment goal, determining degree of response, as well as guiding treatment intervention. We summarized the psychometric properties of the phq9 across a range of studies and cut off scores to select the optimal cut off for detecting depression. Results the reliability coefficient, cronbachs alpha, for the phq9 total score was 0. How often have you been bothered by each of the following symptoms during the past two weeks. This study aimed to explore cut off scores of the 9item patient health questionnaire phq9 and 2item patient health questionnaire phq2 for depression screening in chinese rural. Validation of the patient health questionnaire9 phq9 and. The patient health questionnaire phq 9 overview the phq9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. The phq9 was found to have acceptable diagnostic properties for detecting major depressive disorder for cut off scores between 8 and 11. Phq9 total score over the last 2 weeks, on how many days have you been bothered by any of the following problems.
The other measures are principally used to derive severity scores phq9 and. Metanalysis of cutoff scores for diagnosing depression with phq9 for detecting major depression, suggest cutoff scores between 811. The objectives of the study were to generate normative data and to further investigate the construct validity of the phq15 in the general population. Patient health questionnaire phq9 rehabmeasures database.
Clinicians can quickly score the phq9 once the patient has completed its 9 questions. Feb 21, 2012 the brief patient health questionnaire phq9 is commonly used to screen for depression with 10 often recommended as the cut off score. Patient health questionnaire2 phq2 mental disorders. The patient health questionnaire9 phq9 is a brief tool to assess the presence and severity of depressive symptoms. Interpretation of total score and treatment suggestions score range treatment 04 normal no action 59 mild watchful waiting. Keeping the goal of the assessment in mind, it may make sense to lower the cut point score to maximize the. Cutoff scores of 5, 10, and 15 indicate mild, moderate, and. We summarized the psychometric properties of the phq 9 across a range of studies and cutoff scores to select the optimal cutoff for detecting depression. The patient health questionnaire phq is a selfadministered version of the primemd tool for common mental health disorders administered by health care professionals. Phq 9 scoring instructions and interpretation scoring add the scores indicated for each item in each column and add the columns together for the total score. The factor structure of the phq9 remains stable over time allowing change in specific symptoms to be observed.
Add score to determine severity wendy n davis, phd 2012. First, cut off scores from other settings may not apply to tanzania. An amharic, hospitalbased phq9 validation study in ethiopia showed that a threshold of. Methods a crosssectional study was conducted on 839 residents aged 60 years and above in rural areas of liuyang county. Instruction manual instructions for patient health. We summarized the psychometric properties of the phq9 across a range of studies and cut off scores to select the. To score the instrument, tally the numbers of all the checked responses under each heading not at all0, several days1, more than half the days2, and nearly every day3.
Optimal cutoff score for diagnosing depression with. Patient completes phq 9 quick depression assessment. We searched embase, medline and psycinfo from 1999 to august 2010 for studies that reported the diagnostic accuracy of phq 9 to diagnose major depressive. Add the numbers together to total the score on the bottom of the questionnaire. Nineitem patient health questionnaire phq9 the phq9 was originally designed to improve detection of depression in primary care and nonpsychiatric settings kroenke et al.
Insomnia severity index the insomnia severity index has seven questions. By using the cut off scores described below, the total prevalence of somatization syndromes at a moderate to high level was estimated to be 9. We summarized the psycho metric properties of the phq 9 across a range of studies and cutoff scores to select the optimal cutoff for detecting depression. The authors identify a cutoff score of 3 as the optimal cut point for screening purposes, and stated that a cut point of 2 would enhance sensitivity. The authors identified a score of 3 as the optimal cutpoint when using the phq2 to screen for depression. Depression severity is graded based on the phq9 score. Not at all several days more than half the days nearly. Pdf optimal cutoff score for diagnosing depression with the. Optimal cutoff score for diagnosing depression with the patient. When you have your total score, look at the guidelines for scoringinterpretation below to see where your sleep difficulty fits. Its short, taking just a couple of minutes to complete. These findings indicate that the phq9 is a highly satisfactory tool that can be used for screening mdd in the pc setting. Clinical cut offs and reliable change index outcome measure caseness scores listed below are considered clinical cases reliable change index patient health questionnaire 9 phq9.
Download a pdf form here you can fill out easily and then check below the action you need to take. Further work is required to identify reasons for the 17% discordant scores as well as to provide definitive recommendations for phq9 scores of 5 to 9. The pooled analysis revealed that specificity estimates summarized across 11 published studies ranged from 73% to 96% for phq9 cut off scores between 7 and 15. The improving access to psychological therapies manual. For each symptom put an x in the box beneath the answer that best describes how you have been feeling. Its free, and its been shown to be effective in multiple settings and situations. Validation of the patient health questionnaire phq9 as a. Pdf the brief patient health questionnaire phq9 is commonly used to screen for depression with 10 often recommended as the cutoff score. Phq 9 and gad 7 fillable forms fill online, printable. The patient health questionnaire phq9 is a simpletoadminister, effective screening tool specifically designed to assess symptoms of major depressive disorder, but commonly used to assess symptoms of ppd. There were no substantial differences in the pooled sensitivity and specificity for a range of cut off scores 811. This easy to use patient questionnaire is a selfadministered version of the primemd diagnostic instrument for common mental disorders.
Multiply that number by the value indicated below, then add the subtotal to produce a total score. Refer to the accompanying phq9 scoring box to interpret the total score. It is not only an efficient screening tool but also a way to track patients response to treatment gilbody et al. The numbers attached to the patients 10 responses are added up and the total score is the score on the kessler psychological distress scale k10. Results may be included in patient files to assist you in setting up a treatment goal, determining degree of. However, the best psychometric properties were obtained with the dsmiv diagnostic algorithm for depression. We searched embase, medline and psycinfo from 1999 to august 2010 for studies that reported the diagnostic accuracy of phq9 to diagnose major depressive. Depression screening by a nineitem patient health questionnaire phq9 in adults. Patient health questionnaire phq9 university of michigan. Changes in phq9 scores over the course of time were evaluated with respect to change scores of the scl20 depression scale as well as 2 independent structured diagnostic interviews for. A cutoff score of 2 or higher is recommended for optimum sensitivity, resulting in more depressed individuals being correctly identified. The phq2, comprising the first 2 items of the phq9, inquires about the degree to which an individual has experienced depressed mood and anhedonia over the past two weeks. A conventional phq9 metaanalysis from 2015 36 studies, 21 292 participants evaluated sensitivity and specificity for cutoff scores 715 by combining accuracy results for each cutoff score that were published in included primary studies.
Over the last two weeks, how often have you been bothered by any of the following problems. The phq9 is the depression module, which scores each of the 9 dsmiv criteria as 0 not at all to 3 nearly every day. It also does not require significant training to administer or score, making it a simple and effective way to evaluate depression. For each question, please circle the number that best describes your answer. Postpartum depression screening is feasible in primary care practices, and for most women the epds and phq9 scores were concordant. Insomnia severity index ons oncology nursing society. The brief patient health questionnaire phq9 is commonly used to screen for depression with 10 often recommended as the cut off score. Personal health questionnaire depression scale phq8. Optimal cutoff score for diagnosing depression with the. The brief patient health questionnaire phq9 is commonly used to screen for depression with 10 often recommended as the cutoff score. Both the agreement and consistency intraclass correlation coefficients icc for the oneweek testretest reliability were 0. The additional steps below will be followed based on the clients phq9 score.
Total score is determined by adding together the scores of each of the 4 items. Recommended actions for persons scoring 3 or higher are one of the following. The factor structure of the phq9 in palliative care. Using the threshold score of 10, the gad7 has a sensitivity of 89% and a specificity of 82% for gad. Patient completes phq9 quick depression assessment. A conventional phq9 metaanalysis from 2015 36 studies, 21 292 participants evaluated sensitivity and specificity for cut off scores 715 by combining accuracy results for each cut off score that were published in included primary studies. None 04 mild 59 moderately 1014 moderately severe 1519 severe 2027 validity and reliability the phq9 has been tested for validity and reliability in a range of languages. Utility of the phq9 to identify major depressive disorder in. Phq9 and phq2 for screening depression in chinese rural elderly. Scores are rated as normal 02, mild 35, moderate 68, and severe 912. From the primary care evaluation of mental disorders patient health questionnaire primemd phq. Also, alternative or abbreviated versions of the phq 9 and gad7 are sometimes used in certain screening or research settings 1014.
Patients who screen positive should be further evaluated with the phq9, other diagnostic instruments, or direct interview to determine. The phq15 is widely used as an open access screening instrument for somatization syndromes in different health care settings, thus far, normative data from the general population are not available. Determining cut off scores many of the validation studies recommend different cut off score for optimal sensitivity. As a screening instrument, the phq9 performed better with a cut off value of 12 versus the standard cut off of 10. Validation of the patient health questionnaire phq9 as.
Scores of 5, 10, and 15 represent cut points for mild, moderate, severe respectively on all three scales somatic symptoms, generalized anxiety, depression. We summarized the psychometric properties of the phq9 across a range of studies and cutoff scores to select the optimal cutoff for detecting depression. Concordance of edinburgh postnatal depression scale epds. Describe the main aspects of screening for maternal depression.
Patient health questionnaire phq9 british columbia. Optimal cutoff score for diagnosing depression with the patient health questionnaire phq9. Phq 9 patient depression questionnaire for initial diagnosis. Describe how the phq9 can be used to screen for and track maternal depression. Metanalysis of cutoff scores for diagnosing depression with phq 9 for detecting major depression, suggest cutoff scores between 811. The general rule is that the higher the number, the more severe the case is. People seen in primary care who score under 20 are likely to be well. The authors identify a cut off score of 3 as the optimal cut point for screening. Patient completes phq9 quick depression assessment on accompanying tear off pad. Other studies have demonstrated that validating psychometric scales for different cultural contexts can result in varying cut off scores betancourt et al. The brief patient health questionnaire phq 9 is commonly used to screen for depression with 10 often recommended as the cutoff score.
Personal health questionnaire depression scale phq 8 over the last 2 weeks. The fouritem patient health questionnaire for anxiety and depression over the last two weeks, how often have you been. Phq9 scoring instructions and interpretation scoring. The phq9 is the depression module, which scores each of the nine dsmiv criteria as 0 not at all to 3 nearly every day. Personal health questionnaire depression scale phq 8 over the last 2 weeks, how often have you been bothered by any of the following problems. Standardization of a screening instrument phq15 for. How to score the phq9 and gad7 for anxiety and depression.
The depression module of the patient health questionnaire phq9 has. Over time, the severity scores have been a particularly popular use of the measures, and are now used much more commonly than the provisional diagnoses. A recommended cut point for further evaluation is a score of 10 or greater. Pdf validation of the patient health questionnaire phq9. The phq9 was completed by 6,000 patients in 8 primary care clinics and 7 obstetricsgynecology clinics. In accordance with the american psychological associations ethical guidelines, this instrument is intended for use by qualified health professionals and researchers.
This is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of not at all. Scores of 5, 10, and 15 are taken as the cut off points for mild, moderate and severe anxiety, respectively. This measure was developed by staff at vas national center for ptsd and is in the public domain and not ed. When used as a screening tool, further evaluation is recommended when the score is 10 or greater.
Phq9 patient health questionnaire maternal depression. If the score is 3 or greater, major depressive disorder is likely. Perinatal depression and phq9 screening objectives. This study aimed to validate and calibrate the phq9 to determine appropriate cutoff points for different degrees of. Given the popularity of the phq9 for assessing and monitoring depression. The instrument aids in guiding criteria based diagnosis of depressive symptoms, can assist in identifying treatment goals, determining severity of symptoms, as well as.
Phq9 questionnaire for depression scoring and interpretation guide for physician use only scoring. Validating the phq9 in tanzania is useful from several vantage points. Phq9 patient depression questionnaire for initial diagnosis. Jul 15, 2015 the scores of the phq9 and phq2 well correlated with the bdiii score, the midas score, the hit6 score, and the msqol score. We summarized the psycho metric properties of the phq9 across a range of studies and cutoff scores to select the optimal cutoff for detecting depression. Work and social adjustment scale wsas nhs networks. Pdf optimal cutoff score for diagnosing depression with. Interpret the score by using the guide listed below. Consider scheduling a followup visit in a few weeks, patient. A conventional phq9 metaanalysis from 2015 36 studies, 21. The phq2 inquires about the frequency of depressed mood, with a score ranging from 0 to 6. Scores between 10 and 20 are associated with significant functional impairment but less severe clinical symptomatology. Phq 9 questionnaire for depression scoring and interpretation guide for physician use only scoring.
The semicentralized promotion system supports filling authorized enlisted positions with the best qualified soldiers and is dependent on realizing promotions when soldiers meet the announced cutoff scores. Pdf establishing a common metric for depressive symptoms. Scores lower than 33 may indicate the patient either has subthreshold symptoms of ptsd or does not meet criteria for ptsd, and this information should be incorporated into treatment planning. Adapted from the patient health questionnaire phq screeners. The cutoff point of a summed score of eight resulted in a sensitivity of 80. Since this scale is selfadministered in our studies, question. Mar 15, 2016 objectives this study aimed to explore cut off scores of the 9item patient health questionnaire phq9 and 2item patient health questionnaire phq2 for depression screening in chinese rural elderly. Further studies are required to replicate these findings and recommendations to.
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