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What is a PHQ-9 and GAD-7?
The Patient Health Questionnaire – 9 (PHQ-9) and Generalized Anxiety Disorder – 7 (GAD-7) are short screening measures used in medical and community settings to assess depression and anxiety severity. Although the GAD-7 was designed to detect generalized anxiety disorder, it is fairly accurate for panic, social anxiety, and posttraumatic stress disorders. The GAD-7 is a 7-item self-report scale developed to assess the defining symptoms of GAD. Items are rated on a 4-point Likert-type scale (0 = not at all to 3 = nearly every day). A PHQ-9 score total of 0-4 points equals “normal” or minimal depression. Scoring between 5-9 points indicates mild depression, 10-14 points indicates moderate depression, 15-19 points indicates moderately severe depression, and 20 or more points indicates severe depression. Score 0-4: Minimal Anxiety. Score 5-9: Mild Anxiety. Score 10-14: Moderate Anxiety. Score greater than 15: Severe Anxiety. The GAD-7 score is calculated by assigning scores of 0, 1, 2, and 3, to the response categories of “not at all,” “several days,” “more than half the days,” and “nearly every day,” respectively, and then adding together the scores for the seven questions. GAD-7 total score for the seven items ranges from 0 to 21.
What is the cut-off for GAD-7 and PHQ-9?
The clinical cut-off scores for the PHQ-9 BSL is eight and for the GAD-7 BSL it is six. PHQ-9 Depression Severity. Scores of 5, 10, 15, and 20 represent cutpoints for mild, moderate, moderately severe and severe depression, respectively. The GAD-7 represents an anxiety measure based on seven items which are scored from zero to three. The whole scale score can range from 0 to 21 and cut-off scores for mild, moderate and severe anxiety symptoms are 5, 10 and 15 respectively [13]. At the cut-off score of 10 both sensitivity as well as specificity exceed . Scores range from 0–27, and are classified ‘mild’ (5–9), ‘moderate’ (10–14), ‘moderately severe’ (15–19) and ‘severe’ (20–27). The clinical range is declared ≥ 10. ‘mild’ (5–9), ‘moderate’ (10–14) and ‘severe’ (15–21). The clinical range is declared ≥ 8.
What is a PHQ-9 test?
The Patient Health Questionnaire (PHQ) is a self-administered version of the PRIME-MD diagnostic instrument for common mental disorders. The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as “0” (not at all) to “3” (nearly every day). ShareThe PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression. A diagnostic tool for mental health disorders used by health care professionals, covering mood (PHQ-9), anxiety, alcohol, eating, and somatoform modules as those covered in the original PRIME-MD. The PHQ-9 should be administered at least quarterly after initial positive screen (defined as a score of 10 or greater). b. For enrollee/members scoring 5-9 on the PHQ-9, a repeat PHQ-9 should be completed as clinically indicated or at a minimum of at least annually. A PHQ-9 score of 5 was ideal for screening (sensitivity, 87.1%; specificity, 79.7%). In addition to good content validity, PHQ-9 had good 1-month test-retest reliability (r = . 875) and internal consistency (Cronbach’s a = . 835). Scores are rated as normal (0-2), mild (3-5), moderate (6-8), and severe (9-12). Total score ≥3 for first 2 questions suggests anxiety. Total score ≥3 for last 2 questions suggests depression. Reprinted with permission from Kroenke K, Spitzer RL, Williams JB, Löwe B.
Why is PHQ-9 important?
Its purpose is not to establish final diagnosis or to monitor depression severity, but rather to screen for depression. Patients who screen positive should be further evaluated with the PHQ-9 to determine whether they meet criteria for a depressive disorder. The PHQ-9 is a multipurpose instrument for screening, diagnosing, monitoring and measuring the severity of depression: n The PHQ-9 incorporates DSM-IV depression diagnostic criteria with other leading major depressive symptoms into a brief self-report tool. In conclusion, the PHQ-9 is a widely used tool in primary care for diagnosing depression and determining depression severity. For practitioners, it can provide an appealing numerical and “objective” diagnosis (Tavabie & Tavabie, 2009). The 9-question Patient Health Questionnaire (PHQ-9) is a diagnostic tool introduced in 2001 to screen adult patients in a primary care setting for the presence and severity of depression. The Patient Health Questionnaire—9 (PHQ-9) and the Generalized Anxiety Disorder Questionnaire– 7 (GAD-7) are short screening instruments used for detection of depression and anxiety symptoms in various settings, including general and mental health care as well as the general population. The PHQ-ADS is the sum of the PHQ-9 and GAD-7 scores and thus can range from 0 to 48, with higher scores indicating higher levels of depression and anxiety symptomatology.
What do PHQ and GAD scores mean?
Scores represent: 0-5 = mild 6-10 = moderate 11-15 = moderately severe. 16-20 = severe depression. GAD-7 Anxiety Severity. Using the threshold score of 10, the GAD-7 has sensitivity of 89% and specificity of 82% for generalized anxiety disorder. GAD-7 has been used to detect symptoms of anxiety disorders in various settings and across diverse populations, beyond its original application in primary-care settings. Therefore, evaluating the psychometric properties of the scale is necessary. Limitations: the GAD-7 scale focuses on only 1 anxiety disorder, although there are many patients with other anxiety disorders, such as social phobia and posttraumatic stress disorder, who need clinical attention. the GAD-7 provides only probable diagnoses that should be confirmed by further evaluation. Scores are calculated based on how frequently a person experiences these feelings. Each “not at all” response is scored as 0; each “several days” response is 1; each “more than half the days” response is 2; and each “nearly every day” response is 3. The sum value of these responses gives you your total score.