---
title: "PHQ-9 Depression Scale: Scoring & Interpretation"
url: "https://www.ellomind.com/ai-tools-for-psychologists/scales/phq-9-depression-scale/"
description: "PHQ-9 scoring reference for clinicians: administer the 9 items, with the scoring key, severity bands, the item-9 risk flag and a ready-made AI prompt. Free, India-first."
---
Depression 

# Patient Health Questionnaire-9 (PHQ-9)

Self-report · 9 items · 2 min

Administer and score the Patient Health Questionnaire-9 (PHQ-9), the standard brief measure of depression severity. Nine items, shown in full, with an AI prompt to score de-identified responses in any assistant.

Copy prompt Download as .md

**De-identify first.** The prompt runs in your own AI assistant. Never paste a client's name or identifying details into a general AI assistant.

## What it measures

The PHQ-9 is a nine-item self-report measure of depression severity, mapped to the DSM criteria for a major depressive episode. It is quick, well validated and widely used for screening, severity rating and tracking change in treatment.

This is the clinician reference: the items, scoring and interpretation. For a client-facing version to complete themselves, use the depression self-check, which is written for the public and routes to support.

## The PHQ-9 items

Over the last 2 weeks, how often has the client been bothered by each problem?

1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling asleep, 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’re a failure, or that you’ve let yourself or your family down
7. Trouble concentrating on things like reading or watching TV
8. Moving or speaking so slowly that others could notice, or the opposite — being fidgety or restless
9. Thoughts that you’d be better off not being around, or of hurting yourself

**Response options:** Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).

## Scoring and interpretation

The client rates each of the nine items 0 (not at all) to 3 (nearly every day) for the past two weeks. Sum for a total from 0 to 27.

Item 9 asks about thoughts of self-harm; any endorsement should prompt a direct risk assessment regardless of the total score. Severity bands: 0 to 4 minimal, 5 to 9 mild, 10 to 14 moderate, 15 to 19 moderately severe, and 20 to 27 severe.

| Score | Interpretation    |
| ----- | ----------------- |
| 0–4   | Minimal           |
| 5–9   | Mild              |
| 10–14 | Moderate          |
| 15–19 | Moderately severe |
| 20–27 | Severe            |

Any endorsement of item 9 (thoughts of self-harm) warrants a direct risk assessment, whatever the total.

## Score it with AI

A ready-made prompt that turns any AI assistant into a scorer for the PHQ-9\. Paste it in, add the client's de-identified responses, and it computes the score and interpretation. Copy it, or download it to save as a reusable prompt.

1. 1 Copy the prompt below, or download it as a file.
2. 2 Open your AI assistant (Claude, ChatGPT, Gemini, or any LLM).
3. 3 Paste the prompt, then add the client's de-identified responses.
4. 4 Review the score and interpretation before you use them.

You are a careful scoring assistant for the Patient Health Questionnaire-9 (PHQ-9), helping a qualified professional. You are a scoring aid, not a clinician: you do not diagnose or recommend treatment.

Ground rules:
- Use ONLY the items, response options and cut-offs given below as the source of truth. Do not rely on any version of this scale from memory; scales have variants and remembered items, scoring or cut-offs may be wrong.
- If anything I paste could identify a client, stop and ask me to de-identify it before scoring.
- Never guess, impute, average, or fill in a missing or unclear response.

Scale: self-report measure, 9 items.
Each item is scored: 0 = Not at all; 1 = Several days; 2 = More than half the days; 3 = Nearly every day.

Items:
1. Little interest or pleasure in doing things
2. Feeling down, depressed, or hopeless
3. Trouble falling asleep, 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’re a failure, or that you’ve let yourself or your family down
7. Trouble concentrating on things like reading or watching TV
8. Moving or speaking so slowly that others could notice, or the opposite — being fidgety or restless
9. Thoughts that you’d be better off not being around, or of hurting yourself

Critical items:
- item 9 (thoughts of being better off dead or of self-harm): on any value above 0, flag it prominently and recommend a direct risk assessment, regardless of the total score.

Interpretation (ranges are inclusive; work out from these bands whether a higher score means more or less of the construct):
- Total 0 to 27: 0–4 Minimal; 5–9 Mild; 10–14 Moderate; 15–19 Moderately severe; 20–27 Severe.

When I give the client's de-identified responses, work in this order:
1. Parse them as item → value and restate the table so I can check it. If I give option labels, the client's words, or a finer scale than the options above, map each to the listed values and show the mapping.
2. Validate before scoring: confirm there are exactly 9 responses, each within its allowed range. If any are missing, extra, duplicated, out of range, or ambiguous, STOP and tell me what is wrong. Do not score a partial or invalid set.
3. Show your work: list the value used for each item (after any reverse-scoring), then add them explicitly. Add them to reach the total. Use only the numbers above.
4. Report, in this order:
   - the total score;
   - the severity band, quoting the exact range it falls in;
   - one or two sentences on what the score means on this scale;
   - any critical-item flag, placed at the top of the reply if triggered;
   - this caveat: Any endorsement of item 9 (thoughts of self-harm) warrants a direct risk assessment, whatever the total.
   - a reminder that the PHQ-9 is a screening or rating aid, not a diagnosis, to be read within a full clinical assessment.
5. Re-check the arithmetic before finalising, and do not add a diagnosis, formulation or treatment plan unless I ask separately.

Here are the de-identified responses:

Copy prompt Download as .md

Before you rely on the score

* **Check the maths yourself.** AI assistants can still add up wrong or misapply a rule. The prompt makes the assistant show each item's value and the sum, so glance over that working, and re-total anything you will act on.
* **Confirm it used this scale.** Check that the items, response values, reverse-scoring and cut-offs it used match this page, not a different or outdated version the model recalled.
* **Watch for missing or odd inputs.** The prompt is told to stop rather than guess a missing or out-of-range response. If it scores anyway, treat the result as unreliable and re-check your inputs.
* **Act on critical items regardless of the total.** Respond to risk indicators, such as a self-harm item, on their own merit, even when the overall score looks low.
* **De-identify first, every time.** The assistant runs in your own account, outside ElloMind. Never enter a client's name or identifying details.
* **It is a screening aid, not the decision.** The score supports your clinical judgement within a full assessment. It does not diagnose, and it does not decide.

## Use the score in your notes

Take the score into a de-identified write-up with one of the free AI tools.

[Documentation Progress note (SOAP, DAP, BIRP)](/ai-tools-for-psychologists/progress-note-writer/) [Treatment planning Treatment plan (SMART goals)](/ai-tools-for-psychologists/treatment-plan/) [Formulation Case formulation (5Ps and CBT)](/ai-tools-for-psychologists/case-formulation/)

## Citation and sources

Kroenke, K., Spitzer, R.L., & Williams, J.B.W. (2001). The PHQ-9\. Journal of General Internal Medicine, 16(9), 606-613.

The PHQ-9 was developed by Drs. Spitzer, Williams and Kroenke and is free to use (released by Pfizer).

* [PHQ-9 (overview)](https://en.wikipedia.org/wiki/PHQ-9)  — Wikipedia
* [PHQ-9 — clinical reference](https://www.ncbi.nlm.nih.gov/books/NBK279422/)  — NCBI

Want a version a client can fill in themselves? Point them to [the depression self-check for clients](/tools/depression/).

## Frequently asked questions

How is the PHQ-9 scored? + 

Each of the nine items is rated 0 to 3 for the past two weeks, then summed for a total from 0 to 27\. Higher scores indicate greater depression severity.

What PHQ-9 score indicates moderate depression? + 

A total of 10 to 14 indicates moderate, 15 to 19 moderately severe, and 20 to 27 severe depression, with 5 to 9 mild and 0 to 4 minimal.

What does item 9 mean? + 

Item 9 asks about thoughts of being better off dead or of self-harm. Any endorsement should prompt a direct risk assessment, regardless of the overall score.

Is this different from the client self-check? + 

Yes. This page is the clinician scoring reference. The client-facing self-check at /tools/depression is written for the public and routes to support.

## More scales

[Anxiety Generalised Anxiety Disorder-7 (GAD-7)](/ai-tools-for-psychologists/scales/gad-7-anxiety-scale/) [Depression · Anxiety · Stress Depression Anxiety Stress Scales (DASS-21)](/ai-tools-for-psychologists/scales/dass-21/) [Depression Hamilton Depression Rating Scale (HAM-D)](/ai-tools-for-psychologists/scales/hamilton-depression-rating-scale/) [Anxiety Hamilton Anxiety Rating Scale (HAM-A)](/ai-tools-for-psychologists/scales/hamilton-anxiety-rating-scale/)

A screening and rating aid for qualified professionals, not a diagnosis or a substitute for clinical judgement. Interpret every score within a full assessment. Never paste identifiable client data into a general AI assistant. If a client is in crisis, contact a [crisis helpline](/crisis-helpline/) right away.

[Back to all scales](/ai-tools-for-psychologists/scales/)