Content of the questionnaire
Target audienceAdults
ApplicationThe Patient Health Questionnaire (PHQ) is the most used screening questionnaire for mental health issues in primary care. It is also gaining increasing acceptance in secondary care. Because of its sensitivity to change, the PHQ is not only relevant for use in screening, but can also be applied for outcome monitoring. In essence, the PHQ captures the psychological and somatoform disorders with the highest prevalence. There are many different versions of the PHQ available:

• PHQ. The full version of the PHQ is the most complete measure of all different PHQ versions. In essence, it contains all of them as scales. The different subparts of the full PHQ and thus the different, more specialized versions of it, are outlined in the following.
• GAD-7. Generalized Anxiety Disorder – 7. This seven-item scale from the full PHQ measures anxiety symptoms.
• PHQ-9. Patient Health Questionnaire – 9. This PHQ subscale, and standalone test, measures depressive symptoms. It has been validated as a standalone measure, and compared to for example the BDI.
• PHQ-15. Patient Health Questionnaire – 15. This 15-item PHQ scale asks for different forms of somatoform disorders. It has also been investigated as a standalone measure.
• Brief PHQ. This version of the PHQ is a more economical, shortened version of the overall PHQ.
• PHQ-SADS. This version contains only the somatic, anxiety and depression subscales of the full PHQ. That is, the PHQ-15, PHQ-9 and GAD-7.

CompositionThe different versions of the PHQ contain different amounts of items, the answer options also differ per scale.
Psychometric properties
Reliability & ValidityThe psychometric properties of the different versions of the PHQ have been investigated in many different studies from a considerable research grant Pfizer Inc. The properties are in the range of good to excellent, concerning the different scales. Overall, the PHQ is a very good and economical instrument that has been proven effective in clinical use.
Literature and copyright

Löwe, B., Gräfe, K., Zipfel, S., Spitzer, R. L., Herrmann-Lingen, C., Witte, S., & Herzog, W. (2003). Detecting panic disorder in medical and psychosomatic outpatients: comparative validation of the Hospital Anxiety and Depression Scale, the Patient Health Questionnaire, a screening question, and physicians’ diagnosis. Journal of psychosomatic research, 55(6), 515-519.

Löwe, B., Gräfe, K., Zipfel, S., Witte, S., Loerch, B., & Herzog, W. (2004). Diagnosing ICD-10 depressive episodes: superior criterion validity of the Patient Health Questionnaire. Psychotherapy and psychosomatics, 73(6), 386-390.

Löwe, B., Kroenke, K., Herzog, W., & Gräfe, K. (2004). Measuring depression outcome with a brief self-report instrument: sensitivity to change of the Patient Health Questionnaire (PHQ-9). Journal of affective disorders, 81(1), 61-66.

Löwe, B., Spitzer, R. L., Gräfe, K., Kroenke, K., Quenter, A., Zipfel, S., … & Herzog, W. (2004). Comparative validity of three screening questionnaires for DSM-IV depressive disorders and physicians’ diagnoses. Journal of affective disorders, 78(2), 131-140.

© Pfizer Inc., Löwe B, Spitzer RL, Zipfel S, Herzog W.

PHQ Instructions

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