Patient Health Questionnaire (PHQ-9)

Patient Health Questionnaire (PHQ-9)

1. Over the last 2 weeks, how often have you been bothered
by any of the following problems?

[select name="Q1" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- a. Little interest or pleasure in doing things

[select name="Q2" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- b. Feeling down, depressed, or hopeless

[select name="Q3" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- c. Trouble falling/staying asleep, sleeping too much

[select name="Q4" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- d. Feeling tired or having little energy

[select name="Q5" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- e. Poor appetite or overeating

[select name="Q6" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- f. Feeling bad about yourself or that you are a failure or have let yourself or your family down

[select name="Q7" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- g. Trouble concentrating on things, such as reading the newspaper or watching television

[select name="Q8" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- h. 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.

[select name="Q9" value="Not at all=0|Several days=1|More than half the days=2|Nearly everyday=3"] <-- i. Thoughts that you would be better off dead or of hurting yourself in some way. 

[select name="Q10" value="Not difficult at all=0|Somewhat difficult=1|Very difficult=2|Extremely difficult=3"] <-- 2. If you checked off any problem on this questionnaire so far, 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?

Score --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)" memo="score"] out of 27 points.  Interpretation --> [calc value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9);
score>20?'Severe':score>14?'Moderately Severe':score>9?'Mild':score>4?'Minimal Symptoms':'Asymptomatic'" memo="interpretation"]

[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).isNot('')"]
reference:  [link url="http://www.ncbi.nlm.nih.gov/pubmed/11556941" memo="#1"] Kroenke (2001) J Gen Intern Med 16:606-13.[/conditional]
Patient Health Questionnaire (PHQ-9)

1. Over the last 2 weeks, how often have you been bothered
by any of the following problems?

<-- a. Little interest or pleasure in doing things

<-- b. Feeling down, depressed, or hopeless

<-- c. Trouble falling/staying asleep, sleeping too much

<-- d. Feeling tired or having little energy

<-- e. Poor appetite or overeating

<-- f. Feeling bad about yourself or that you are a failure or have let yourself or your family down

<-- g. Trouble concentrating on things, such as reading the newspaper or watching television

<-- h. 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.

<-- i. Thoughts that you would be better off dead or of hurting yourself in some way.

<-- 2. If you checked off any problem on this questionnaire so far, 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?

Score --> scorescore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9) out of 27 points. Interpretation --> interpretationscore=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9);
score>20?'Severe':score>14?'Moderately Severe':score>9?'Mild':score>4?'Minimal Symptoms':'Asymptomatic'


display/hide references

Result - Copy and paste this output:

Sandbox Metrics: Structured Data Index 1, 15 form elements, 198 boilerplate words, 1 checkboxes, 10 drop downs, 1 links, 2 calculations, 1 conditionals, 11 total clicks
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