What is the PHQ-9 cut-off score for major depression?

A score of 10 or above is the standard cut-off for major depressive disorder, with sensitivity of 88% and specificity of 88%. Scores of 5, 10, 15, and 20 represent mild, moderate, moderately severe, and severe depression respectively.

How often should I administer the PHQ-9?

For active treatment, every 2–4 weeks allows you to track treatment response. For stable maintenance patients, monthly or at each session is appropriate. More frequent administration (weekly) may be useful during medication titration.

Can patients self-administer the PHQ-9?

Yes — the PHQ-9 was designed as a self-report instrument. Patients can complete it in the waiting room or via a digital check-in tool before the session, making it practical for routine outcome monitoring.

PHQ-9 for Therapists: A Complete Clinical Guide

What is the PHQ-9?

The PHQ-9 (Patient Health Questionnaire-9) is a 9-item self-report scale that measures the severity of depressive symptoms over the past two weeks. It maps directly onto the DSM-5 criteria for major depressive disorder, making it one of the most clinically valid brief depression instruments available.

Each item is scored 0–3 (not at all / several days / more than half the days / nearly every day), giving a total range of 0–27.

Scoring and Interpretation

Score	Severity	Suggested action
0–4	Minimal	Monitor; no treatment likely needed
5–9	Mild	Watchful waiting; repeat in 2–4 weeks
10–14	Moderate	Treatment plan; consider therapy or medication
15–19	Moderately severe	Active treatment with therapy and/or medication
20–27	Severe	Immediate treatment; consider psychiatric referral

Item 9 — Suicidality Screen

Item 9 asks about thoughts of self-harm or suicide. Any score above 0 on item 9 requires direct clinical follow-up, regardless of the total score. The PHQ-9 is a screening tool, not a suicide risk assessment — a positive item 9 triggers clinical judgment, not a mechanical protocol.

Limitations to Communicate to Patients

The PHQ-9 captures self-reported symptom frequency, not distress severity or functional impairment per se. Two patients with identical PHQ-9 scores can present very differently. Use it as one data point alongside your clinical observation, not as a substitute for it.

Using the PHQ-9 for Outcome Monitoring

A reduction of 5 points is considered a clinically meaningful response. Remission is typically defined as a score below 5. Track scores longitudinally — the trajectory matters as much as any single score.

Emotrek automates PHQ-9 administration on a schedule you define, surfaces the score trend before each session, and flags patients whose scores have increased by 5 or more points since the last assessment.