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PATIENT HEALTH QUESTIONNAIRE-9  (PHQ-9) 

Please fill out the following form.

Date
Month
Day
Year

Over the last 2 weeks, how often have you been bothered  

by any of the following problems?  

Not at all Several days  More than half  the days   Nearly every day  

1. Little interest or pleasure in doing things
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
2. Feeling down, depressed, or hopeless
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
3. Trouble falling or staying asleep, or sleeping too much
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
4. Feeling tired or having little energy
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
5. Poor appetite or overeating
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
7. Trouble concentrating on things, such as reading the newspaper or watching television
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
8. Moving or speaking so slowly that other people could have noticed? Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
9. Thoughts that you would be better off dead or of hurting yourself in some way
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
9. Thoughts that you would be better off dead or of hurting yourself in some way
0-Not at all
1-Several days
2-More than half  the days
3-Nearly  every  day
If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from  Pfizer Inc. No permission required to reproduce, translate, display or distribute. 

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