Patient Health Questionnaire (PHQ-9)

Little interest or pleasure in doing things: *

Feeling down, depressed, or hopeless: *

Trouble falling or staying asleep, or sleeping too much: *

Feeling tired or having little energy: *

Poor appetite or overeating: *

Feeling bad about yourself — or that you are a failure or have let yourself or your family down: *

Trouble concentrating on things, such as reading the newspaper or watching television: *

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: *

Thoughts that you would be better off dead or of hurting yourself in some way: *

If you checked off any problems, 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? *

Social situations due to a fear of being embarrassed or making a fool of myself *

Certain situations because of a fear of having a panic attack or other distressing symptoms (such as loss of bladder control, vomiting or dizziness) *

Certain situations because of a fear of particular objects or activities (such as animals, heights, seeing blood, being in confined spaces, driving or flying) *