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PATIENT HEALTH QUESTIONNAIRE & GENERALIZED ANXIETY DISORDER (PHQ‐9 & GAD‐7)
Over the last 2 weeks, how often have you been bothered by any of the following problems? (use √ to indicate your answer)

                                                                                                                       More
                                                                                                           Several                 Nearly
                                                                                            Not at all                 than half
                                                                                                           days                    every day
                                                                                                                       the days

Low Mood

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/staying asleep, 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 ‐
                                                                                            0              1           2           3
   or that you are a failure or have let yourself or your family down

7. Trouble concentrating on things, such as reading the newspaper or watching
                                                                                            0              1           2           3
television

8. Moving or speaking so slowly that other people could have noticed. Or the opposite
                                                                                            0              1           2           3
being so fidgety /restless that you have been moving around a lot more than usual


9. Thoughts that you would be better off dead, or of hurting yourself in some way.          0              1           2           3

Anxiety
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 is 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 happen
                                                                                            0              1           2           3

                                                                                            Not            Somewh      Very        Extremely
How difficult have these problems made it for you to do your work, take care of                            at          difficult   difficult
                                                                                            difficult at
   things at home, or get along with other people?                                          all            difficult


                                                                                            0              1           2           3


                           Patient Health Questionnaire (PHQ) Copyright© 1999 Pfizer Inc. All rights reserved.

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Combined PHQ9 and GAD7 (17 items)

  • 1. PATIENT HEALTH QUESTIONNAIRE & GENERALIZED ANXIETY DISORDER (PHQ‐9 & GAD‐7) Over the last 2 weeks, how often have you been bothered by any of the following problems? (use √ to indicate your answer) More Several Nearly Not at all than half days every day the days Low Mood 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/staying asleep, 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 ‐ 0 1 2 3 or that you are a failure or have let yourself or your family down 7. Trouble concentrating on things, such as reading the newspaper or watching 0 1 2 3 television 8. Moving or speaking so slowly that other people could have noticed. Or the opposite 0 1 2 3 being so fidgety /restless that you have been moving around a lot more than usual 9. Thoughts that you would be better off dead, or of hurting yourself in some way. 0 1 2 3 Anxiety 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 is 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 happen 0 1 2 3 Not Somewh Very Extremely How difficult have these problems made it for you to do your work, take care of at difficult difficult difficult at things at home, or get along with other people? all difficult 0 1 2 3 Patient Health Questionnaire (PHQ) Copyright© 1999 Pfizer Inc. All rights reserved.