About These Tests
Clinical background, scoring methodology, and important limitations.
About This Site
DepressionTests.org provides free, private access to the PHQ-9 and GAD-7 - two of the most widely-used mental health screening instruments in the world. Our mission is to make clinically-validated mental health screening accessible to anyone, anywhere, at no cost.
We believe that understanding your mental health is the first step toward getting the right support. These tools help people identify potential symptoms, understand severity, and find appropriate resources.
About the PHQ-9
The Patient Health Questionnaire-9 (PHQ-9) is a self-administered depression screening instrument developed by Drs. Robert L. Spitzer, Janet B.W. Williams, and Kurt Kroenke at Columbia University, with an educational grant from Pfizer Inc. It is in the public domain.
The PHQ-9 is the most widely used depression screening tool in primary care worldwide. It has been validated in dozens of peer-reviewed studies and is widely used in the depression screening that the US Preventive Services Task Force (USPSTF) recommends for adults.
PHQ-9 Scoring
Each of the 9 items is scored from 0 (Not at all) to 3 (Nearly every day), for a total possible score of 0-27.
| Score Range | Severity | Suggested Action |
|---|---|---|
| 0-4 | Minimal | None indicated; consider repeating PHQ-9 at follow-up |
| 5-9 | Mild | Watchful waiting; repeat PHQ-9 at follow-up |
| 10-14 | Moderate | Treatment plan, consider counseling, follow-up, and/or pharmacotherapy |
| 15-19 | Moderately Severe | Active treatment with pharmacotherapy and/or psychotherapy |
| 20-27 | Severe | Immediate initiation of pharmacotherapy and, if severe impairment or poor response, expedited referral to a mental health specialist |
Clinical Validity
The PHQ-9 has strong psychometric properties. Using a cutoff score of 10, it has a sensitivity of 88% and specificity of 88% for detecting major depressive disorder (Kroenke et al., 2001). It has been validated across primary care, obstetrics, and psychiatric settings, as well as in diverse cultural and age groups.
About the GAD-7
The Generalized Anxiety Disorder 7-item scale (GAD-7) was also developed by Drs. Robert L. Spitzer, Janet B.W. Williams, and Kurt Kroenke, published in the Archives of Internal Medicine in 2006. Like the PHQ-9, it is in the public domain.
The GAD-7 was initially validated for generalized anxiety disorder, but has since been validated for panic disorder, social anxiety disorder, and post-traumatic stress disorder as well.
GAD-7 Scoring
Each of the 7 items is scored from 0 (Not at all) to 3 (Nearly every day), for a total possible score of 0-21.
| Score Range | Severity | Suggested Action |
|---|---|---|
| 0-4 | Minimal | None indicated; monitor if symptoms persist |
| 5-9 | Mild | Watchful waiting; consider self-help strategies |
| 10-14 | Moderate | Consider further evaluation; treatment may be warranted |
| 15-21 | Severe | Active treatment warranted; consider referral to mental health specialist |
Clinical Validity
Using a cutoff score of 10, the GAD-7 has a sensitivity of 89% and specificity of 82% for detecting GAD. It has been validated in large primary care samples and shown to perform well across demographic groups.
Limitations
Screening vs. Diagnosis
These are screening tools, not diagnostic instruments. A high score does not confirm a diagnosis of depression or anxiety disorder. Diagnosis requires a comprehensive clinical evaluation by a qualified healthcare provider.
A negative result (low score) also does not rule out depression or anxiety - someone could score low while still experiencing significant distress.
Cultural Considerations
While the PHQ-9 and GAD-7 have been validated across many cultural groups, they were developed primarily in Western medical contexts. The expression and perception of mental health symptoms varies across cultures. Results should be interpreted with cultural context in mind.
Self-Report Limitations
These tools rely on self-report, which can be affected by factors such as stigma, insight, memory, and how questions are interpreted. The PHQ-9 and GAD-7 are best used as part of a broader clinical evaluation, not as standalone diagnostic tools.
Medical Disclaimer
The information and tools on DepressionTests.org are provided for educational and informational purposes only. They do not constitute medical advice, diagnosis, or treatment recommendations. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition.
If you are experiencing a mental health emergency or are in crisis, please call or text 988 (Suicide & Crisis Lifeline), call 911, or go to your nearest emergency room.
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This is a screening tool, not a diagnosis. Only a qualified health professional can diagnose depression or anxiety. DepressionTests.org is an independent educational site, not affiliated with any government agency, and does not give medical advice.
If you are in crisis or thinking about harming yourself, call or text 988 (Suicide and Crisis Lifeline, US) or your local emergency number. Outside the US, contact your local emergency services.
The PHQ-9 and GAD-7 were developed by Drs. Kurt Kroenke, Robert L. Spitzer and Janet B.W. Williams.