Depression Checklist

Depression Checklist
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Patient Health Questionnaire (PHQ-9)

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



Little interest or pleasure in doing things?

Not at all                             0

Several days                       1

More than half the days    2

Nearly every day                3


Feeling down, depressed, or hopeless?

Not at all                              0

Several days                        1

More than half the days     2

Nearly every day                 3


Trouble falling or staying asleep, or sleeping too much?

Not at all                               0

Several days                         1

More than half the days      2

Nearly every day                 3


Feeling tired or having little energy?

Not at all                            0

Several days                      1

More than half the days   2

Nearly every day               3


Poor appetite or overeating?

Not at all                             0

Several days                       1

More than half the days    2

Nearly every day                3


Feeling bad about yourself - or that you are a failure or have let yourself or your family down?

Not at all                              0

Several days                        1

More than half the days     2

Nearly every day                 3


Trouble concentrating on things, such as reading the newspaper or watching television?

Not at all                               0

Several days                         1

More than half the days      2

Nearly every day                  3


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?

Not at all                                0

Several days                          1

More than half the days       2

Nearly every day                   3


Thoughts that you would be better off dead, or of hurting yourself in some way?

Not at all                                0

Several days                          1

More than half the days      2

Nearly every day                  3


Total =  ___


Depression Severity: 0-4 none, 5-9 mild, 10-14 moderate, 15-19 moderately severe, 20-27 severe.

Get In Touch

316-260-4587
Info@ICTPsych.com
727 N. Waco, Suite 255
Wichita KS 67203

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