Updated phq9 Test

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Over the last ​2 weeks​, how often have Not at all Several More than Nearly

days half of the everyday


you been bothered by any of the days
following problems?

1. Feeling down, depressed, irritable, 0 1 2 3


or hopeless?

2. Little interest or pleasure in doing 0 1 2 3


things?

3. Trouble falling asleep, staying 0 1 2 3


asleep, or sleeping too much?

4. Poor appetite, weight loss, or 0 1 2 3


overeating?

5. Feeling tired, or having little energy? 0 1 2 3

6. Feeling bad about yourself - Not 0 1 2 3


succeeding in school,

7. Trouble concentrating on activities 0 1 2 3


you typically completely normally?

8. Moving or speaking so slowly that 0 1 2 3


other people could have noticed? Or
the opposite – being so fidgety or
restless that you were moving around a
lot more than usual?

9.Thoughts that you would be better of 0 1 2 3


dead or hurting yourself in some way

Expanded Questions:

Describe your school experience for the past two weeks?


____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________

Describe any other factors that have been affecting you mentally (bullying, family life, grades,
etc.)?
____________________________________________________________________________
____________________________________________________________________________
____________________________________________________________________________
Have you in the past six months attempted to hurt or end your life?

❏ Yes
❏ No

Have you ever attempted to hurt or end your life?

❏ Yes
❏ No
*Yes to any or both of these question should immediately refer to a doctor*
Grading Guidelines

PHQ -9 Score Depression severity Treatment Plan

0-4 None-minimal Program acceptance

5-9 Mild Program acceptance;


repeat PHQ-9 test

10-14 Moderate Program acceptance,


repeat PHQ-9 test and
speak to a professional,
and program acceptance

15-19 Moderately Severe Urgent recommendation to


physician/treatment

20-27 Severe Immediate


recommendation to
physician/treatment

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