David Howard - Psychologist
     
Psychology Practice

PHQ-9 Questionnaire

 
   

PHQ-9

My Name:
Street Address:
Phone Number:
Email Address:
Date:

Over the last two weeks, how often have you been bothered by any of the following?

 
       
1   Little interest or pleasure in doing things
2   Feeling down, depressed or hopeless
3   Trouble falling or staying asleep, or sleeping too much
4   Feeling tired or having little energy
5   Poor appetite or overeating
6   Feeling bad about yourself; or that you are a failure; or have let yourself or your family down
7   Trouble concentrating on things, such as reading the newspaper or watching television
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 more than usual.
9   Thoughts that you would be better off dead or of hurting yourself in some way.
10   If you checked off any problem on this questionnaire so far, 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?