PHQ-9 & GAD-7
by Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues
Name
First Name
First and last letter of last name
Date
-
Year
-
Month
Day
Date
Over the last 2 weeks, how often have you been bothered by the following problems?
Rows
Not at all
Several Days
More than half the days
Nearly every day
1. Little interest or pleasure in doing things
1
2
3
4
2. Feeling down, depressed or hopeless
5
6
7
8
3. Trouble falling or staying asleep, sleeping too much
9
10
11
12
4. Feeling tired or having little energy
13
14
15
16
5. Poor appetite or overeating
17
18
19
20
6. Feeling bad about yourself-or that you are a failure or have let yourself or your family down
21
22
23
24
7. Trouble concentrating on things, such as reading the newspaper or watching television
25
26
27
28
8. Moving or speaking so slowly that other people could have noticed. Or the opposite-being so figety or restless that you have been moving around a lot more than usual
29
30
31
32
9. Thoughts that you would be better off dead, or of hurting yourself
33
34
35
36
Over the last 2 weeks, how often have you been bothered by the following problems?
Rows
Not at all
Several Days
More than half the days
Nearly every day
1. Feeling nervous, anxious, or on edge
37
38
39
40
2. Not being able to stop or control worrying
41
42
43
44
3. Worrying too much about different things
45
46
47
48
4. Trouble relaxing
49
50
51
52
5. Being so restless that it is hard to sit still
53
54
55
56
6. Becoming easily annoyed or irritable
57
58
59
60
7. Feeling afraid as if something awful might happen
61
62
63
64
Submit
PHQ-9 Score (0-4 Minimal) (5-9 Mild) (10-14 Moderate) (15-19 Moderately-Severe) (20+ Severe)
GAD-7 Score (0-5 Minimal) (6-10 Mild) (11-15 Moderate) (16-21 Severe)
Should be Empty: