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PATIENT HEALTH QUESTIONNAIRE

   < Previous | PHQ-9 English Version | PHQ-9 Spanish Version  
Using the PHQ-9 to Assess Patient Response to Treatment
  • The goal of acute phase treatment is remission of symptoms as indicated by a PHQ-9 Score of < 5 points.
  • Patients who achieve this goal enter into the continuation phase of treatment.
  • Patients who do not achieve this goal remain in the acute phase of treatment and require some alteration in treatment (dose increase, augmentation, combination treatment).
  • Patients who do not achieve remission after two adequate trials of antidepressants and/or psychological counseling or by 20 to 30 weeks would benefit from a formal or informal psychiatric consultation for diagnostic and management suggestions.

Initial Response after Four - Six weeks of an Adequate Dose of an Antidepressant
PHQ-9 Score Treatment Response Treatment Plan
Drop of ≥ 5 points from baseline Adequate No treatment change needed
Follow-up in four weeks.

Drop of 2-4 points from baseline Probably Inadequate Often warrants an increase in antidepressant dose.

Drop of 1 point or no change or increase Inadequate Increase dose: Augmentation; Switch; Informal or formal psychiatric consultation; Add psychological counseling.

Initial Response to Psychological Counseling After Three Sessions
over Four - Six Weeks
PHQ-9 Score Treatment Response Treatment Plan
Drop of ≥ 5 points from baseline Adequate No treatment change needed
Follow-up in four weeks.

Drop of 2-4 points from baseline Probably Inadequate Possibly no treatment change needed.
Share PHQ-9 with psychological counselor.

Drop of 1 point or no change or increase Inadequate If depression-specific psychological counseling (CBT, PST, IPT*) discuss with therapist, consider adding antidepressant.

For patients satisfied in other type of psycholgical counseling, consider starting antidepressant.

For patients dissatisfied in other psychological counseling, review treatment options and preferences.

* CBT - Cognitive-Behavioral Therapy; PST - Problem Solving Treatment; IPT- Interpersonal Therapy


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