PHQ-9 and GAD-7: The Questionnaires Your Doctor Uses

You were handed a short form at your appointment, or you found one online, and now you have a number. Maybe it is 8, or 14, or 21. What does it mean? The PHQ-9 and GAD-7 are the most widely used mental health questionnaires in primary care. This guide explains what they measure, how to read the scores, and what they cannot tell you.

What these questionnaires are

The PHQ-9

The PHQ-9 (Patient Health Questionnaire-9) asks how often, over the past 2 weeks, you have been bothered by 9 problems linked to depression [1]. These include:

• Little interest or pleasure in doing things
• Feeling down, depressed, or hopeless
• Trouble sleeping, or sleeping too much
• Feeling tired or having little energy
• Poor appetite or overeating
• Feeling bad about yourself
• Trouble concentrating
• Moving or speaking slowly, or being restless
• Thoughts that you would be better off dead, or of hurting yourself

Each item is scored from 0 (not at all) to 3 (nearly every day). The total ranges from 0 to 27. A final question asks how hard these problems have made work, home, or relationships.

The PHQ-2

The PHQ-2 uses just the first two questions, about low interest and low mood. Clinicians often use it as a quick first check, then follow up with the full PHQ-9 if the score is 3 or more.

The GAD-7

The GAD-7 (Generalized Anxiety Disorder-7) asks about 7 anxiety symptoms over the past 2 weeks [2]:

• Feeling nervous, anxious, or on edge
• Not being able to stop or control worrying
• Worrying too much about different things
• Trouble relaxing
• Being so restless that it is hard to sit still
• Becoming easily annoyed or irritable
• Feeling afraid as if something awful might happen

Each item is scored 0 to 3, for a total of 0 to 21.

What your doctor looks at

PHQ-9 score ranges

The original study set these severity bands [1]:

• 0 to 4: minimal
• 5 to 9: mild
• 10 to 14: moderate
• 15 to 19: moderately severe
• 20 to 27: severe

In that study, a score of 10 or more correctly identified 88 percent of people with major depression, and correctly ruled out 88 percent of people without it [1]. That is good, but not perfect. Some people with a high score do not have depression, and some with lower scores do.

GAD-7 score ranges

The GAD-7 study set these bands [2]:

• 0 to 4: minimal
• 5 to 9: mild
• 10 to 14: moderate
• 15 to 21: severe

At a cut-off of 10, the GAD-7 identified 89 percent of people with generalized anxiety disorder and correctly ruled out 82 percent of those without it [2]. It also picks up other anxiety conditions, such as panic disorder and social anxiety.

The self-harm question

Clinicians pay close attention to item 9 of the PHQ-9. Any answer other than "not at all" leads to further questions about safety. This does not mean you are in danger, but it opens an important conversation.

Using scores over time

Scores are most useful when repeated. Clinicians often look for:

• Response: a drop of 50 percent or more from the starting score
• Remission: a PHQ-9 score below 5

Screening: Canada and US differ

US guidance

The USPSTF (US Preventive Services Task Force) recommends screening all adults for depression, including during pregnancy and after birth, and older adults [3]. It also recommends screening adults under 65 for anxiety [4]. The USPSTF found too little evidence to recommend for or against screening for suicide risk in adults who do not have symptoms [3].

Canadian guidance

The Canadian Task Force on Preventive Health Care takes a different view. In its 2025 update, it recommends against screening all adults for depression with a questionnaire and a cut-off score [5]. It found little to no evidence that such screening improves health, and it was concerned about false positives and unneeded referrals [5]. This advice does not apply to people with known or suspected mental health conditions. The Canadian Task Force stresses that clinicians should still ask about well-being and watch for signs of depression.

In practice, Canadian clinicians often still use the PHQ-9 and GAD-7 to measure severity and track treatment once a concern is raised.

What a score cannot tell you

• It does not make a diagnosis. Only a clinician can do that after talking with you.
• It does not explain the cause. Grief, stress, thyroid problems, sleep disorders, medications, and substance use can raise scores.
• It may miss things. Some people under-report symptoms, and the forms do not ask about mania or psychosis.

Questions to ask your clinician

• What does my score mean in the context of my life right now?
• Do you think this is depression, anxiety, both, or something else?
• Are there medical causes we should check?
• How often will we repeat the questionnaire?
• What score would show that treatment is working?
• What treatment options fit my score and my preferences?

When to get care quickly

If you have thoughts of suicide or self-harm, get help now. In Canada and the US, call or text 988 to reach a suicide crisis line. Call 911 or go to the nearest emergency department if you are in immediate danger.

Bottom line

The PHQ-9 and GAD-7 are short, well-tested questionnaires that help measure depression and anxiety symptoms. A score of 10 or more often signals the need for a closer look, and repeating them shows whether treatment helps. They support, but never replace, a conversation with your clinician. US and Canadian bodies disagree about routine screening, but both agree that clinicians should ask about mental health.

Primary AI can show you the guideline and study sources behind this topic in plain language, so you can bring better questions to your appointment.