Instrument template · DepressionUpdated September 28, 2026

PHQ-9 eCRF template, ready for participant phones

The Patient Health Questionnaire-9 is the most widely used self-report measure of depression severity. This template has all nine items with their exact response scale, coded 0 to 3, plus a safety follow-up on item 9.

  • Free to reproduce
  • Runs on any phone, no app
  • Item 9 query for clinician follow-up

Free sandbox · No credit card · 21 CFR Part 11 aligned

PHQ-9 · Week 4

Over the last 2 weeks, how often have you been bothered by:

1. Little interest or pleasure in doing things

Not at all (0)Several days (1)More than half the days (2)Nearly every day (3)

2. Feeling down, depressed, or hopeless

Not at all (0)Several days (1)More than half the days (2)Nearly every day (3)
Answers save as they go

PHQ-9 at a glance

  • Nine items, one for each DSM criterion for major depressive disorder, each scored 0 (not at all) to 3 (nearly every day), with a two-week recall period.
  • Total score 0 to 27. Bands: 0 to 4 minimal, 5 to 9 mild, 10 to 14 moderate, 15 to 19 moderately severe, 20 to 27 severe. A score of 10 or more is the most commonly used cut-off for clinically significant depression.
  • Item 9 asks about thoughts of death or self-harm. Any answer above 0 needs a clinician follow-up defined in your protocol, typically a structured assessment such as the C-SSRS.
  • The PHQ-9 was developed with an educational grant from Pfizer, and no permission is required to reproduce, translate, display or distribute it.
  • In Capture it runs as an ePRO on the participant's own phone, or as a site-completed form at the visit, with the same coded values either way.

The instrument

What the PHQ-9 measures and why trials use it

The PHQ-9 is the depression module of the Patient Health Questionnaire, published by Kroenke, Spitzer and Williams in 2001. Each of its nine items maps to one of the nine DSM criteria for a major depressive episode, which is why it can be used both to screen for depression and to grade how severe it is. It takes most participants two to three minutes.

Clinical trials use the PHQ-9 in three ways: as an eligibility screen (to include or exclude participants with depression), as a safety measure in studies of treatments with central nervous system effects, and as an efficacy endpoint in depression and behavioural health studies. It is short enough to repeat at every visit, and its two-week recall period fits neatly into typical visit intervals.

Scoring

Each item is scored 0 to 3 and the nine scores are summed for a total of 0 to 27. In Capture every answer is stored as its coded value with the label alongside, so the total is a straightforward sum in your analysis program, and the data dictionary in every export documents the coding. A tenth question asks how difficult the problems have made work, home life or relationships. It is not part of the score, but it is worth keeping because it describes functional impact.

Response and remission

In treatment studies, response is often defined as a reduction of at least 50% from baseline and remission as a score below 5. A change of about five points is frequently cited as clinically meaningful. Define whichever definitions you use in the statistical analysis plan before unblinding, along with how you will handle missing items.

PHQ-9, PHQ-8 and PHQ-2

The PHQ-8 drops item 9 and is scored 0 to 24 with the same cut-offs. It is used in settings where nobody can follow up a positive answer on self-harm, such as anonymous surveys. The PHQ-2 is the first two items only, used as a quick pre-screen. If your trial has clinicians who can act on item 9, use the full PHQ-9.

PHQ-9 total · Subject 001-0042

Week 4 total

14 / 27

Moderate
0-4 Minimal5-9 Mild10-14 Moderate15-19 Mod. severe20-27 Severe
Baseline19
Week 217
Week 414

All nine items

PHQ-9 items and the DSM criterion each one covers

Every item uses the same four-point scale: not at all (0), several days (1), more than half the days (2), nearly every day (3). Recall period: the last two weeks.

#ItemCriterion
1Little interest or pleasure in doing thingsAnhedonia
2Feeling down, depressed, or hopelessDepressed mood
3Trouble falling or staying asleep, or sleeping too muchSleep disturbance
4Feeling tired or having little energyFatigue
5Poor appetite or overeatingAppetite change
6Feeling bad about yourself, or that you are a failure or have let yourself or your family downWorthlessness or guilt
7Trouble concentrating on things, such as reading the newspaper or watching televisionConcentration
8Moving or speaking so slowly that other people could have noticed, or the opposite, being so fidgety or restless that you have been moving around a lot more than usualPsychomotor change
9Thoughts that you would be better off dead, or of hurting yourself in some waySuicidal ideation

The PHQ-9 was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission is required to reproduce, translate, display or distribute it. Use an officially translated version for non-English speaking participants.

Safety follow-up

Item 9 answered above zero? The site hears about it.

A positive answer on item 9 should never sit unread until the next monitoring visit. Add a custom-value edit check to item 9: any answer other than "Not at all" raises an auto-query in the site's action list, so the investigator can carry out the follow-up assessment your protocol defines and record it.

  • Custom-value edit check on item 9 with a high priority.
  • The query and its resolution are part of the audit trail.
  • Link the follow-up to a C-SSRS form or your protocol's own risk assessment.
  • Record any resulting event on the adverse event form where the protocol requires it.
Vital signs · Systolic blood pressure

Edit checks / auto-queries

2
Auto-query

Type

Range High

Operator

Greater than

Value

180

Priority: High

Auto-query

Type

Range Low

Operator

Less than

Value

80

Priority: Normal

Query raised automatically

Value 192 violates limit (180). Please verify.

Run it as ePRO

Participants complete it on their own phone

The PHQ-9 is a self-report questionnaire, so it belongs in the participant's hands. Capture sends a secure link by email or SMS that opens the questionnaire in the phone's browser, already tied to the participant's record. There is no app to install and no password to forget.

  • Scheduled at specific visits or as a recurring questionnaire every two weeks.
  • Completion windows and reminders when due, the next day and before the window closes.
  • Compliance and at-risk participants visible on the study dashboard.
  • The same form can be completed by site staff on a clinic tablet if the protocol prefers in-clinic administration.
BYOD ePRO with no app download

From: Capture.Study · Sleep and Recovery Study

Your questionnaire is ready

Hi Anna, your evening diary is open until midnight. Tap the button to start. The link signs you in, no password needed.

Open my tasks

Questions? Reply to reach your study site.

My tasks

Evening diary

Due tonight

Week 4 questionnaire

Opens Monday

+ Report an episode

Where it fits

A typical PHQ-9 schedule in a 12-week study

The two-week recall period sets the natural rhythm: administer it at screening for eligibility, at baseline, then every two to four weeks. Place it on the schedule once and every site follows the same timing.

Schedule of assessments · PHQ-9 and GAD-7
AssessmentScrBLW2W4W6W8W12
PHQ-9
GAD-7
C-SSRS
Vital signs
AE review
Same timing at every site

Open the PHQ-9 on your own phone

Copy the template into a sandbox study and send yourself the participant link.

Use the PHQ-9 template free

Data quality

Getting clean PHQ-9 data in a trial

The PHQ-9 is simple, which makes the few ways it goes wrong easy to overlook. Most problems come from mixing administration modes, changing wording, or not planning for missing answers.

Keep the mode consistent

Self-completed and interviewer-administered PHQ-9 scores are close but not identical. Decide whether participants complete it themselves or a coordinator reads it aloud, and keep that the same for every participant and every visit.

Do not reword items

The validation rests on the exact wording. Use official translations rather than translating locally, and do not shorten items to fit a screen: Capture's phone layout wraps long items instead.

Make every item required

A missing item changes the total. Set all nine items as required so participants cannot submit a partial questionnaire by accident, and define in the analysis plan what happens if a whole questionnaire is missed.

Watch the window, not just the date

Because the recall period is two weeks, a questionnaire completed ten days late covers a different period than planned. Visit windows with reminders keep completion inside the interval the endpoint assumes.

FAQ

Questions about this template

Something not covered here? Ask us directly.

Is the PHQ-9 free to use in a clinical trial?

Yes. The PHQ-9 was developed with an educational grant from Pfizer and no permission is required to reproduce, translate, display or distribute it.

How is the PHQ-9 scored?

Each of the nine items is scored 0 to 3 and the scores are summed, giving a total of 0 to 27. Bands are 0 to 4 minimal, 5 to 9 mild, 10 to 14 moderate, 15 to 19 moderately severe and 20 to 27 severe.

Does Capture calculate the PHQ-9 total automatically?

Answers are stored as coded values (0 to 3) with labels, and the export includes a data dictionary, so the total is a simple sum in your analysis program. Capture's built-in calculated fields cover clinical derivations such as BMI and eGFR.

What should happen when item 9 is positive?

Your protocol should define a follow-up, usually a clinician risk assessment. In Capture a custom-value edit check on item 9 raises an auto-query to the site so the follow-up is not missed.

Can participants complete the PHQ-9 at home?

Yes. It runs in the phone's browser from a secure link sent by email or SMS, with no app to install.

What is the difference between the PHQ-9 and PHQ-8?

The PHQ-8 leaves out item 9 on thoughts of death or self-harm and is scored 0 to 24. It is used where a positive answer could not be followed up.

Which recall period does the PHQ-9 use?

The last two weeks. Schedule it at intervals of about two weeks or longer so recall periods do not overlap.

Is the template free?

Yes, in the free sandbox with the rest of the template library. You pay only when a study goes live.

Run the PHQ-9 the same way at every site

Copy the template, schedule it and test it on your own phone. Free sandbox, no credit card.

Use the PHQ-9 template free