Victoria Oceanside Health

Patient Health Questionnaire (PHQ)

Answer the questions below based on the last 2 weeks. On how many days have you been bothered by any of the following problems?

1. Little interest or pleasure in doing things?

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

2. Feeling down, depressed, or hopeless?

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

3. Trouble falling or staying asleep, or sleeping too much?

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

4. 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

6. Feeling bad about yourself — or that you are a failure or have let yourself or your family down?

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

7. 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

8. Moving or speaking so slowly that other people could have noticed? Or so fidgety or restless that you have been moving a lot more than usual?

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

9. Thoughts that you would be better off dead, or thoughts of hurting yourself in some way?

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

Answer the questions below based on the last 2 weeks. On how many days have you been bothered by any of the following problems?

1. Feeling nervous, anxious, or on edge?

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

2. Not being able to stop or control worrying?

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

3. Worrying too much about different things?

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

4. Trouble relaxing?

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

5. Being so restless it is hard to sit still?

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

6. Becoming easily annoyed or irritable?

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

7. Feeling afraid as if something aweful might happen?

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