Questions | Concepts | |
|---|---|---|
PHQ-2 | ||
Screening Date ␣␣-␣␣-␣␣␣␣ 📆 | ||
Little interest or pleasure in doing things 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
Feeling down, depressed or hopeless 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
PHQ-9 | ||
Trouble falling asleep, staying asleep, or sleeping too much 🔘 Not at all 🔘 Several days 🔘 More than half the days | ||
Feeling tired or having little energy 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
5. Poor appetite or overeating 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
Feeling bad about yourself - or that you’re a failure or have let yourself or your family down 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
Trouble concentrating on things, such as reading the newspaper or watching television 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
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 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
Thoughts that you would be better off dead or of hurting yourself in some way 🔘 Not at all 🔘 Several days 🔘 More than half the days 🔘 Nearly every day | ||
PHQ-9 score obtained by adding score for each question ___________________________ | ||
Notes |
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