How to Administer, Score, and Graph the PHQ-9 Online

The web application Better Outcomes Now (BON) just made life easier for those behavioral health professionals working in primary care, or for those who want to add a specific measure for clients struggling with depression. BON now includes the functionality to administer, score, and graph the Patient Health Questionnaire-9 (PHQ-9) online.

Why the PHQ-9?

The PHQ-9 has become an important component of primary care, given that depression is the most prevalent behavioral health condition and the majority of adults diagnosed with depression ultimately receive treatment in primary care.

Routine depression screening via the PHQ-9 has been recommended by the U.S. Preventive Services Task Force, and the U.S. Department of Health and Human Services now requires depression screening for patients seen in Federally Qualified Health Centers.

What Exactly Is the PHQ-9?

The PHQ-9 is a nine-item screening tool for depression, in which each item is rated on a 0–3 scale, yielding a total depression severity score between 0 and 27. A cutoff score of 10 or above has been recommended to screen for major depression, and a difference of 6 or more points between assessments is indicative of reliable change. The PHQ-9 has demonstrated high sensitivity and specificity for detecting major depression.

PHQ-9 vs. ORS

Thanks to Project Leader, Brian DeSantis, we conducted a study (DeSantis, Jackson, Duncan, & Reese, 2016) comparing the Outcome Rating Scale (ORS) and the PHQ-9 as screening tools. Although useful, the PHQ-9 is symptom based and diagnosis specific, and therefore can potentially limit the identification of broader social or relational distress in patients that affect medical outcomes.

In our study of adult primary care patients, we compared the ORS and the PHQ-9. We found the expected high correlations but more importantly, the ORS identified significantly more patients who might benefit from psychotherapy. We concluded that the ORS may cast a wider net in identifying patients with significant distress in primary care.

The Good News

However, the good news is that whether the PHQ-9 is a requirement in your setting, or you want to target its use with clients presenting with depressive symptoms, you can now use the BON web application to administer, score, and graph the PHQ-9 online.

Coming soon: The Generalized Anxiety Disorder-7 (GAD-7).