PHQ-9 & GAD-7 Questionnaire

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Personal Details

May be used to identify you

Patient Health Questionnaire (PHQ-9)

PHQ-9 Assessment Over the last 2 weeks, how often have you been bothered by any of the following problems?

(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 so fidgety or restless that you have been moving a lot more than usual?: *

(9) Thoughts that you would be better off dead, or thoughts of hurting yourself in some way?: *

If you checked off any problems, 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? : *

PHQ-9 Result 1 - 4 (Minimal Depression)

MINIMAL DEPRESSION - you have a score of

Scores < 4 suggest minimal depression which may not require treatment.

PHQ-9 Result 5 - 9 (Mild Depression)

MILD DEPRESSION - you have a score of

Scores 5 - 9 suggest mild depression.

PHQ-9 Result 10 -14 (Moderate Depression)

MODERATE DEPRESSION - you have a score of

Scores 10 - 14 suggest moderate depression severity.

PHQ-9 Result 15 - 19 (Moderately Severe Depression)

MODERATELY SEVERE DEPRESSION - you have a score of

Scores 15 - 19 suggest moderately severe depression.

PHQ-9 Results 20 - 27 (Severe Depression)

SEVERE DEPRESSION - you have a score of

Scores 20 and greater suggest severe depression.

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Generalised Anxiety Disorder 7 (GAD-7)

GAD-7 AssessmentOver the last two weeks how often have you been bothered by the following problems?

(1) Feeling nervous, anxious, or on edge: *

(2) Not being able to stop or control worrying: *

(3) Worrying too much about different things: *

(4) Trouble relaxing: *

(5) Being so restless that it is hard to sit still: *

(6) Becoming easily annoyed or irritable: *

(7) Feeling afraid, as if something awful might happen: *

If you checked off any problems, 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? : *

GAD-7 Result 0 - 4 (No Anxiety Disorder)

NO ANXIETY DISORDER - you have a score of

Scores < 4 suggest No Anxiety Disorder.

GAD-7 Result 5 - 9 (Mild Anxiety)

MILD ANXIETY - you have a score of

Scores 5 - 9 suggest Mild Anxiety.

GAD-7 Result 10 - 14 (Moderate Anxiety)

MODERATE ANXIETY - you have a score of

Scores 10 - 14 suggest Moderate Anxiety.

GAD-7 Result 15 - 21 (Severe Anxiety)

SEVERE ANXIETY - you have a score of

Scores 15 - 21 suggest Severe Anxiety.

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