The PHQ-9 is a screening tool that healthcare providers use to assess the likelihood of depression and how severe it might be. The screening has nine questions, hence the “9,” and those questions ask how often you have been bothered by a series of nine problems during the last two weeks.
The questions address sleep, energy, appetite, and other symptoms of depression. The questions also assess the frequency of these symptoms. This is the complete list:
- 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 thoughts of hurting yourself in some way
Why is the PHQ-9 important while TTC and during pregnancy?
The confusion and isolation that can come with trying to conceive can be frustrating, and it can lead to depression in some women. Establishing a mental health baseline before getting pregnant is really important so that healthcare providers can intervene before depression symptoms get significantly worse.
Perinatal depression – depression that occurs during pregnancy or the first twelve months after delivery – affects one in seven women and is one of the most common medical complications during that time. Because untreated depression can impact fertility and pregnancy negatively, it’s important to get screened for depression during this life stage.
When is the PHQ-9 administered?
The American College of Gynecologists and Obstetricians recommends that women be screened for perinatal depression at least once while pregnant or in the twelve months postpartum, and more frequently if they have scores that indicate signs of depression. Studies support screening women twice during pregnancy and once postpartum. In general, depression screening is also recommended as a part of routine wellness care, and may happen during routine annual exams during TTC.
Although a diagnosis of clinical depression requires more than just a high screening result, the PHQ-9 can help providers and their patients understand if there might be a risk. You should speak with your healthcare provider if you have any questions about the PHQ-9 or clinical depression in general.
- Committee on Obstetric Practice. “Committee Opinion: Screening for Perinatal Depression.” American College of Obstetricians and Gynecologists, Committee Opinion No. 630, May 2015. Retrieved July 3 2018. https://www.acog.org/-/media/Committee-Opinions/Committee-on-Obstetric-Practice/co630.pdf?dmc=1&ts=20180503T1424370053.
- “Instruction Manual: Instructions for Patient Health Questionnaire (PHQ) and GAD-7 Measures.” Pfizer. Retrieved July 3 2018. https://phqscreeners.pfizer.edrupalgardens.com/sites/g/files/g10016261/f/201412/instructions.pdf.
- “Reproductive health and mental health.” Office on Women’s Health. U.S. Department of Health and Human Services, May 17 2018. Retrieved July 3 2018. https://www.womenshealth.gov/mental-health/living-mental-health-condition/reproductive-health-and-mental-health.
- “Self-reported home and work stress and trying to conceive.” ASRM Abstracts. 108(3): e298. September 2017. Retrieved July 3 2018. https://www.fertstert.org/article/S0015-0282(17)31402-4/pdf.