Free Depression Test (PHQ-9)

The Patient Health Questionnaire-9 (PHQ-9) is a 9-item self-report depression screen developed by Kurt Kroenke, Robert Spitzer, and Janet Williams as part of the PRIME-MD primary-care assessment system. The original validation paper appeared in JAMA in 1999 (Spitzer, Kroenke & Williams) and the standalone PHQ-9 validity paper in the Journal of General Internal Medicine in 2001 (Kroenke, Spitzer & Williams). It is the most widely used depression screen in primary care worldwide. It asks how often, over the past two weeks, you have been bothered by each of the nine DSM-5 depressive symptoms. Total score ranges from 0 to 27, with established severity bands at 5 (mild), 10 (moderate), 15 (moderately severe), and 20 (severe). At the cutoff ≥ 10, the PHQ-9 has sensitivity and specificity around 88% for major depressive disorder.

No. The PHQ-9 is a screening instrument, not a diagnostic interview. A formal diagnosis of Major Depressive Disorder or Persistent Depressive Disorder requires a clinician — typically a GP, psychologist, or psychiatrist — to interview you, rule out medical and substance-related causes, and apply DSM-5 criteria in full. A high PHQ-9 score is the signal that this conversation would be informative. Conversely, a low PHQ-9 score doesn't entirely rule out depression — particularly persistent depressive disorder, where the chronicity can lead to under-endorsement of items because the symptoms feel like baseline rather than illness.

At PHQ-9 ≥ 10 the standard primary-care recommendation is to discuss the result with a clinician — your GP first if you're in the UK, a psychologist or psychiatrist if you have direct access. Bring the actual score to the appointment; the PHQ-9 is the number primary care uses to guide treatment planning. At moderate-to-severe scores (15+), combined CBT or IPT plus an SSRI is the evidence-based first-line treatment. At any score, if you answered anything other than 'Not at all' to item 9 (thoughts of being better off dead or of hurting yourself), please contact a clinician or crisis line — 988 in the US/Canada, 116 123 in the UK/Ireland (Samaritans), 13 11 14 in Australia (Lifeline), 112 in the EU, findahelpline.com worldwide.

The PHQ-9 takes most people 2–4 minutes. It is 9 items on a 4-point scale ('not at all', 'several days', 'more than half the days', 'nearly every day'), all anchored to the past 2 weeks, plus one optional functional-impact item that is displayed alongside the result but not added to the score.

Yes. The PHQ-9 itself was released by Pfizer without licensing restrictions — it is free for clinical, research, and educational use. The Mindshape implementation is free, requires no sign-up, and runs in your browser. Your answers and result stay local unless you choose to save them to a Mindshape account, in which case they are encrypted at rest. No third-party trackers or affiliate networks see your responses.

Any PHQ-9 score ≥ 10 is the conventional primary-care cutoff for considering active treatment. Score ≥ 15 typically warrants a referral to a psychologist or psychiatrist within 1–2 weeks. Score ≥ 20 warrants prompt clinical attention. Independent of the total score, any non-zero answer on item 9 (suicidal ideation) warrants same-day contact with a clinician or crisis line — this is the most important single signal the PHQ-9 produces. If depression has been present for two years or more (persistent depressive disorder), the chronicity itself is worth flagging directly to the clinician, because treatment planning shifts.

Sadness is a normal emotional response to loss, disappointment, or difficulty — it is bounded in time, has a clear referent, and naturally resolves as circumstances change or the person processes the event. Depression is a clinical syndrome: persistent low mood and/or loss of interest lasting at least two weeks (for MDD) or two years (for PDD), accompanied by changes in sleep, appetite, energy, concentration, self-worth, psychomotor activity, and sometimes thoughts of death. Depression often has no specific referent — the low mood is there even when nothing has 'caused' it. It does not resolve simply by waiting. The PHQ-9 captures the difference by asking about frequency over the past two weeks across the nine core symptoms — sadness alone, even significant sadness, will not produce a high PHQ-9 score; clinical depression typically does.