Outcome MeasureDepression

PHQ-9

Patient Health Questionnaire-9

19 Papers in Blossom

About This Instrument

The Patient Health Questionnaire-9 (PHQ-9) is a 9-item self-report instrument derived from the full PHQ designed to screen for, diagnose, and monitor the severity of major depressive disorder. Each item corresponds to one of the nine DSM-IV/DSM-5 criteria for major depression and is rated on a 0–3 scale (0 = not at all, 3 = nearly every day) over the past two weeks. Total scores range from 0 to 27. The PHQ-9 is the most widely used depression screener in clinical practice globally and is increasingly adopted as a secondary endpoint in psychedelic clinical trials due to its brevity, strong psychometric properties (sensitivity 88%, specificity 88% at cutoff ≥10), and free availability in the public domain. It correlates well with clinician-rated scales and is sensitive to treatment-related change.

Clinical Thresholds

027
Minimal
Score 0–4
Mild
Score 5–9
Moderate
Score 10–14
Mod. severe
Score 15–19
Severe
Score 20–27

Outcome Data Across Studies

Reported results for PHQ-9 across 11 studies with quantitative data.

Outcome data across 43 study arm–timepoint observations
SD
High-dose ketamine infusion for the treatment of posttraumatic stress disorder in combat veterans.
2019Secondary
Ketamine infusion(experimental)03018.96.2—
High-dose ketamine infusion for the treatment of posttraumatic stress disorder in combat veterans.
2019Secondary
Ketamine infusion(experimental)21309.57.3—
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder
2021Secondary
Immediate Treatment(experimental)01316.53.1—
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder
2021Secondary
Delayed Treatment(experimental)01117.93.3—
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder
2021Secondary
Immediate Treatment(experimental)56134.82.90.001
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder
2021Secondary
Delayed Treatment(experimental)561118.84.30.001
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder
2021Secondary
Pooled psilocybin-treated sample(experimental)02417.13.2—
Effects of Psilocybin-Assisted Therapy on Major Depressive Disorder
2021Secondary
Pooled psilocybin-treated sample(experimental)28245.25.0—
Evaluation of Individual Items of the Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) in Adults with Treatment-Resistant Depression Treated with Esketamine Nasal Spray Combined with a New Oral Antidepressant
2022Secondary
Esketamine + oral antidepressant(experimental)011420.23.6—
Evaluation of Individual Items of the Patient Health Questionnaire (PHQ-9) and Montgomery-Asberg Depression Rating Scale (MADRS) in Adults with Treatment-Resistant Depression Treated with Esketamine Nasal Spray Combined with a New Oral Antidepressant
2022Secondary
Placebo + oral antidepressant(active_comparator)010920.43.7—

Papers Using PHQ-9

Paywallindividual

Intranasal Ketamine for Existential Distress in Advanced Cancer

This secondary analysis of the INKeD-PC trial (n=15) found that three doses of intranasal racemic ketamine in patients with advanced cancer receiving palliative care led to clinically meaningful improvements in existential distress, anxiety, symptom burden, and quality of life, with psychological symptoms improving more than physical ones.

Published
Journal
Journal of Pain and Symptom Management
Authors
Aguiar, S., Makarious, M., Lipsitz, O., deVries, F. E., Doyle, Z., McIntyre, R. S., Rodin, G., Zimmermann, C., Mak, E., Hannon, B., Schulz-Quach, C., Al Kindy, A., Patel, Z., Rosenblat, J. D., Li, M.
Open Accessindividual

Long-term treatment with esketamine nasal spray in patients with treatment resistant depression: Results from the ESCAPE-LTE study

This Phase IV single-arm long-term extension trial (n=183) found that the vast majority of patients with treatment-resistant depression who achieved remission with esketamine nasal spray (plus an antidepressant) did not relapse over 136 weeks of treatment, with side effects largely resolving the same day and no new safety concerns identified.

Published
Journal
European Neuropsychopharmacology
Authors
Reif, A., Anıl, Y. A., Bitter, I., Buyze, J., Frey, R., Godinov, Y., Haggström, L., Kambarov, Y., Nielsen, R., Oliveira-Maia, A., von Holt, C., Cubała, W., Young, A. H., DJ, Fu.
Open Accessindividual

Esketamine Monotherapy in Adults With Treatment-Resistant Depression: A Randomized Clinical Trial

In a phase 4, multicentre, double-blind randomised trial in adults with treatment‑resistant depression, intranasal esketamine monotherapy (56 mg and 84 mg) produced significant reductions in MADRS score versus placebo at day 28 (LS mean differences −5.1 and −6.8; effect sizes 0.48 and 0.63) and demonstrated rapid benefit at 24 hours. The tolerability profile was consistent with prior reports, most commonly nausea, dissociation, dizziness and headache.

Published
Journal
JAMA Psychiatry
Authors
Janik, A., Qiu, X., Lane, R., Popova, V., Drevets, W. C., Canuso, C. M., Macaluso, M., Mattingly, G. W., Shelton, R. C., Zajecka, J. M., Fu, D. J.
Open Accessindividual

Safety and Efficacy with Esketamine in Treatment-Resistant Depression: Long-Term Extension Study

In the phase 3 SUSTAIN-3 long-term extension (1,148 patients, 3,777 patient‑years), intermittent intranasal esketamine plus an oral antidepressant showed no new safety signals and an adverse event profile consistent with earlier studies. Depression severity improved during induction and was generally maintained during optimisation/maintenance, with remission in 35.6% at induction and about 48–50% at week 112/maintenance endpoint.

Published
Journal
International Journal of Neuropsychopharmacology
Authors
Zaki, N., Chen, N. )., Lane, R., Doherty, T., Drevets, W. C., Morrison, R. L., Sanacora, G., Wilkinson, S. T., Young, A. H., Chb, M. B., Lacerda, A. L. T., Paik, J. W., Popova, V., Fu, D. J.
Open Accessindividual

Negative Affect Circuit Subtypes and Neural, Behavioral, and Affective Responses to MDMA: A Randomized Clinical Trial

In a double‑blind, placebo‑controlled within‑participant randomised trial of 16 adults stratified by baseline nonconscious‑threat–evoked amygdala activity, 120 mg MDMA acutely reduced amygdala and subgenual ACC activity, increased sgACC–amygdala connectivity, and raised likability of threat expressions in the high‑reactivity subgroup (NTNA+) versus the low‑reactivity subgroup. These results indicate that baseline neuroimaging of negative affect circuitry can identify biomarkers to personalise MDMA‑based therapies.

Published
Journal
JAMA Network Open
Authors
Zhang, X., Hack, L. M., Bertrand, C., Hilton, R., Gray, N. J., Boyar, L., Laudie, J., Heifets, B. D., Suppes, T., Van Roessel, P. J., Rodriguez, C. I., Deisseroth, K., Knutson, B., Williams, L. M.
Paywallindividual

Rapid and sustained antidepressant effects of vaporized N,N-dimethyltryptamine: a phase 2a clinical trial in treatment-resistant depression

This open-label fixed-order dose-escalation trial (n=14) evaluated inhaled DMT (15mg & 60mg) for treatment-resistant depression (TRD) for the first time. Results showed rapid and sustained antidepressant effects with a 21-point reduction on the Montgomery-Asberg Depression Rating Scale by day 7 (p<0.001), an 86% response rate, and a 57% remission rate lasting up to 3 months, with significant decreases in suicidal ideation (SI).

Published
Journal
Neuropsychopharmacology
Authors
Falchi-Carvalho, M., Palhano-Fontes, F., Wießner, I., Barros, H., Bolcont, R., Laborde, S., Silva, S. R. B., Montanini, D., Barbosa, D. C., Teixeira, E., Florence-Vilela, R., Almeida, R., Macedo, R. K. A., Arichelle, F., Pantrigo, E. J., Costa-Macedo, J. V., da Cruz Nunes, J. A., Araújo, D. B., de Araujo Costa Neto, L. A., Nunes Ferreira, L. F., Dantas Correa, L., da Costa Bezerra, R. B., Arcoverde, E., Galvão-Coelho, N. L.

Quick Facts

Full Name
Patient Health Questionnaire-9
Domain
Depression
Papers Indexed
19
Score Range
0–27
Interpretation
Lower = better
Unit
points
Reference
Visit
All Measures