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PHQ9 GAD7 Combined

The document contains two assessment tools: the Patient Health Questionnaire-9 (PHQ-9) for evaluating depression and the Generalized Anxiety Disorder 7-item (GAD-7) scale for assessing anxiety. Each tool includes a series of questions regarding symptoms experienced over the last two weeks, with a scoring system to quantify the severity of the issues. Additionally, there are questions regarding the impact of these problems on daily functioning.

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97 views2 pages

PHQ9 GAD7 Combined

The document contains two assessment tools: the Patient Health Questionnaire-9 (PHQ-9) for evaluating depression and the Generalized Anxiety Disorder 7-item (GAD-7) scale for assessing anxiety. Each tool includes a series of questions regarding symptoms experienced over the last two weeks, with a scoring system to quantify the severity of the issues. Additionally, there are questions regarding the impact of these problems on daily functioning.

Uploaded by

Patrick_Teodos_247
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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PATIENT HEALTH QU EST ION N AI R E - 9

(PHQ-9)
Over the last 2 weeks, how often have you been bothered More Nearly
by any of the following problems? Several than half every
(Use “✔” to indicate your answer) Not at all days the days day

1. Little interest or pleasure in doing things 0 1 2 3

2. Feeling down, depressed, or hopeless 0 1 2 3

3. Trouble falling or staying asleep, or sleeping too much 0 1 2 3

4. Feeling tired or having little energy 0 1 2 3

5. Poor appetite or overeating 0 1 2 3

6. Feeling bad about yourself — or that you are a failure or


0 1 2 3
have let yourself or your family down

7. Trouble concentrating on things, such as reading the


0 1 2 3
newspaper or watching television

8. Moving or speaking so slowly that other people could have


noticed? Or the opposite — being so fidgety or restless 0 1 2 3
that you have been moving around a lot more than usual

9. Thoughts that you would be better off dead or of hurting


0 1 2 3
yourself in some way

FOR OFFICE CODING 0 + + +


=Total Score:

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?

Not difficult Somewhat Very Extremely


at all difficult difficult difficult

■   

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from
Pfizer Inc. No permission required to reproduce, translate, display or distribute.
Generalized Anxiety Disorder 7-item (GAD-7) scale

Date: _______________ Name: _____________________________________ DOB: _______________

Over the last 2 weeks, how often have you been Not at Several Over half Nearly
bothered by the following problems? all days the days every day

1. Feeling nervous, anxious, or on edge 0 1 2 3

2. Not being able to stop or control worrying 0 1 2 3

3. Worrying too much about different things 0 1 2 3

4. Trouble relaxing 0 1 2 3

5. Being so restless that it's hard to sit still 0 1 2 3

6. Becoming easily annoyed or irritable 0 1 2 3

7. Feeling afraid as if something awful might 0 1 2 3


happen
Add the score for each column + + +

Total Score (add your column scores) =

If you checked off any problems, how difficult have these made it for you to do your work, take
care of things at home, or get along with other people?

Not difficult at all


Somewhat difficult
Very difficult
Extremely difficult

Source: Spitzer RL, Kroenke K, Williams JBW, Lowe B. A brief measure for assessing generalized anxiety
disorder. Arch Inern Med. 2006;166:1092-1097.

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