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Patient Health Questionnaire
*
required
*
required
1. Little interest or pleasure in doing things.
*
Required
Not at all
Several days
More than half the days
Nearly every day
2. Feeling down, depressed, or hopeless
*
Required
Not at all
Several days
More than half the days
Nearly every day
3. Trouble falling or staying asleep, or sleeping too much.
*
Required
Not at all
Several days
More than half the days
Nearly every day
4. Feeling tired or having little energy.
*
Required
Not at all
Several days
More than half the days
Nearly every day
5. Poor appetite or overeating.
*
Required
Not at all
Several days
More than half the days
Nearly every day
6. Feeling bad about yourself – or that you are a failure or have let yourself or your family down.
*
Required
Not at all
Several days
More than half the days
Nearly every day
7. Trouble concentrating on things, such as reading the newspaper or watching television.
*
Required
Not at all
Several days
More than half the days
Nearly every day
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.
*
Required
Not at all
Several days
More than half the days
Nearly every day
9. Thoughts that you would be better off dead, or of hurting yourself in some way.
*
Required
Not at all
Several days
More than half the days
Nearly every day
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