COUN 532 - Test Review Outline
Patient Health Questionnaire (PHQ-9)
Gregory Rhodes, M.S.
Regent University
I. General Information
A. Title: Patient Health Questionnaire (PHQ-9)
B. Authors: Dr. Robert J. Spitzer, Dr. Janet B.W. Williams, and Dr. Kurt Kroenke
C. Publisher: Pfizer
D. Forms: Originally validated in two groups of 3,000 patients at eight primary care
clinics and 3,000 patients at seven OB/GYN clinics (Kroenke, Spitzer, & Williams,
2001). It has been translated into over 40 languages, many of which have been
independently studied for validity and reliability.
E. Practical Features: paper and a writing utensil
F. General Type: Self-report
G. Date of Publication: 1999
H. Cost: Free
I. Time required to administer: 3 minutes
J. Purpose for which evaluated: Depression assessment
II. Purpose and Nature of the Instrument
A. Stated purpose: Assessing and monitoring depression
B. Description of test: 9 items, each measured over the past two weeks by how often they
occur. Scoring is as follows: Not at all = 0; several days = 1; more than half the days = 2;
nearly every day = 3. Items include statements such as, “Feeling down, depressed, or
hopeless,” and “Feeling tired or having little energy.” With possible scores from 0-27,
scores are interpreted as follows
0-4 = none
5-9 = mild
10-14 = moderate
15-19 = moderate/severe
20-27 = severe
C. Use in Counseling: Quick and simple to administer and score, the PHQ-9 assess for
depression and can be used to monitor treatment progress.
III. Practical Evaluation
A. Usefulness of the Manual: Instructional manual covers both the PHQ-9 and the GAD7, which is often administered at the same time to assess for anxiety. Manual is straight
forward and easy to understand
B. Adequacy of directions; training required to administer: Directions are adequately
explained in the manual. No training is required.
C. Scoring services available and cost: Counselor or self-scored at no cost.
IV. Technical Considerations
A. Normative Sample (include cultural considerations): Originally 6,000 patience from
15 health clinics. Some, but not all, of the translations into other languages have also be
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researched for their reliability and validity against different normative samples with
generally acceptable levels of reliability and validity.
B. Reliability: 0.86 - 0.89
C. Validity: 88% sensitivity, 88% specificity (Kroenke, Spitzer, & Williams, 2001)
V. Evaluation & Critique Summary
The PHQ-9 provides a quick means of measuring depression in clients and monitoring treatment
progress (Löwe, Unützer, Callahan, Perkins, & Kroenke, 2004). The speed of completing the
assessment and scoring the results has made the PHQ-9 the primary means by which medical
practitioners monitor their patience depression and the effectiveness of prescribed
pharmaceuticals (Kroenke & Spitzer, 2002). The PHQ-9 has shown a strong correlation with
Beck Depression Inventory II (BDI-II), meaning their results are basically interchangeable
(Kung, Alacorn, Williams, Poppe, Jo Moore, & Frye, 2013). Being free of charge and quicker to
administer, the PHQ-9 should be considered a viable alternative to the BDI-II.
VI. Post the link to the test, if available on-line
The PHQ-9 can be found at:
https://www.phqscreeners.com/images/sites/g/files/g10060481/f/201412/PHQ-9_English.pdf
The manual for the PHQ-9 can be found at:
https://www.phqscreeners.com/images/sites/g/files/g10016261/f/201412/instructions.pdf
References
Löwe, B., Unützer, J., Callahan, C., Perkins, A. J., & Kroenke, K. (2004). Monitoring
Depression Treatment Outcomes with the Patient Health Questionnaire-9. Medical Care, (42,12,
1194-1201). Retrieved March 20, 2020, from www.jstor.org/stable/4640875
Kroenke, K., & Spitzer, R. L. (2002). The PHQ-9: A new depression diagnostic and severity
measure. Psychiatric Annals, (32,9, 509-515). Retrieved from
http://eres.regent.edu:2048/login?url=https://search-proquestcom.ezproxy.regent.edu/docview/217052580?accountid=13479
Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2001). The PHQ-9: Validity of a brief
depression severity measure. Journal of General Internal Medicine, (16,9, 606-613).
doi:http://dx.doi.org.ezproxy.regent.edu:2048/10.1046/j.1525-1497.2001.016009606.x
Kung, S., Alacorn, R. D., Williams, M. D., Poppe, K. A., Jo Moore, M., & Frye, M. A. (2013).
Comparing the Beck Depression Inventory-II (BDI-II) and Patient Health Questionnaire (PHQ9) depression measures in an integrated mood disorders practice. Journal of Affect Disorders
(145,3, 341-343). doi: 10.1016/j.jad.2012.08.017
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