PHQ9 PHQ9 Your Name Date of Birth Gender ---FemaleMale Surgery Dr Date PLEASE ENSURE YOU ANSWER ALL THE QUESTIONS BELOW A. Over the last 2 weeks, how often have you been bothered by any of the following problems? 1. Little interest or pleasure in doing things ---0 Not at all1 Several days2 More than half the days3 Nearly every day 2. Feeling down, depressed, or hopeless ---0 Not at all1 Several days2 More than half the days3 Nearly every day 3.Trouble falling/staying asleep, sleeping too much ---0 Not at all1 Several days2 More than half the days3 Nearly every day 4. Feeling tired or having little energy ---0 Not at all1 Several days2 More than half the days3 Nearly every day 5. Poor appetite or overeating ---0 Not at all1 Several days2 More than half the days3 Nearly every day 6. Feeling bad about yourself – or that you are a failure or have let yourself or your family down. ---0 Not at all1 Several days2 More than half the days3 Nearly every day 7.Trouble concentrating on things, such as reading the newspaper or watching television. ---0 Not at all1 Several days2 More than half the days3 Nearly every day 8. Moving 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 usual. ---0 Not at all1 Several days2 More than half the days3 Nearly every day 9.Thoughts that you would be better off dead or of hurting yourself in some way ---0 Not at all1 Several days2 More than half the days3 Nearly every day B. If you have been bothered by any of the 9 problems listed above, please answer the following: How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? ---Not difficult at allSomewhat difficultVery difficultExtremely difficult THANK YOU FOR COMPLETING THIS QUESTIONNAIRE. STAFF USE ONLY Participants NHS Number: Researchers Name: NHS Site Number: NHS Site Name: Postcode:
