Patient Health Questionnaire 9 (PHQ-9)
(to be completed by a subject under supervision of a trained clinician)

DATE: TIME (24hr):


Over the last 2 weeks, how often have you been bothered by any of the following problems?

Do you have any of the following: Not at all Several days More than half the days Nearly every day
0 1 2 3 4 5 6 7 8 9 10
1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling/staying asleep, 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 a lot more than usual
9. Thoughts that you would be better off dead or of hurting yourself in some way


TEXT FOR YOUR RECORDS

DATA FILE

PCL-5 for DSM-V (8/14/2013)
Weathers, Litz, Keane, Palmieri, Marx, & Schnurr - National Center for PTSD

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