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Clinical assessment scale

PHQ-9

A nine-item screening scale that assesses the presence and intensity of depressive symptoms over the past two weeks. It is one of the most validated and widely used clinical assessment tools in psychology and primary care globally.

Definition

The PHQ-9 (Patient Health Questionnaire-9) is a nine-item self-report instrument designed to screen for and monitor major depression symptoms. Its items correspond directly to the nine diagnostic criteria for major depressive episode in DSM-5. Each item is scored from 0 (not at all) to 3 (nearly every day), with a total score of 0 to 27.

Cut-off scores

ScoreSeverity
0-4Minimal or none
5-9Mild depression
10-14Moderate depression
15-19Moderately severe depression
20-27Severe depression

A cut-off of 10 or above has 88% sensitivity and 88% specificity for major depressive episode (Kroenke, Spitzer & Williams, 2001).

When it is used

When it is not sufficient on its own

The PHQ-9 does not diagnose depression. It screens. An elevated score indicates that a full clinical evaluation is warranted. It does not replace the diagnostic interview or clinical judgment. It is also not designed to evaluate bipolar disorders (a high score during a hypomanic episode could produce a false positive for depression).

Item 9: suicide risk detection

Item 9 specifically asks about thoughts of death or self-harm. Any response greater than zero activates the need for a more detailed risk assessment within the same session. A positive response does not equal imminent risk. It is information the clinician must explore.

Example of use in session

A therapist administers the PHQ-9 in the first session. The client scores 13 (moderate), with item 9 at 1 ("several days"). The therapist explores item 9 directly, documenting the exploration in the clinical note. The score of 13 points toward a diagnosis of moderate depressive episode pending full evaluation.

How CauceOS supports this

CauceOS can record scale results administered in session and link them automatically to the Objective section of the SOAP note or to the assessment field of the post-session report. Item 9 with a score greater than zero triggers an attention note in the professional's dashboard.

References

Put it into practice

Put this concept to work live with CauceOS

CauceOS is the live co-pilot that helps you apply clinical frameworks and HR methodologies during every session, not after.