PHQ-9 — MRCPsych Paper B MCQ

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Which of the following is a nine-item, patient-completed questionnaire used to assess the presence and severity of depressive symptoms over the preceding 2 weeks, with each item scored 0–3 giving a total score of 0–27?

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Correct answer: E — PHQ-9

The correct answer is E, the PHQ-9 (Patient Health Questionnaire-9). It is a self-completed measure covering the nine DSM depression criteria over the preceding 2 weeks, each rated 0 ('not at all') to 3 ('nearly every day'), giving a total of 0–27. Cut-points of 5, 10, 15 and 20 indicate mild, moderate, moderately severe and severe depression, and a score ≥10 has ~88% sensitivity and specificity for major depression (Kroenke et al., 2001). It is widely used in UK primary care and NHS Talking Therapies to quantify severity and monitor treatment response, but should support rather than replace full clinical assessment including risk. The distractors fail because none measures depression: the MMSE and MoCA are brief clinician-administered cognitive screens, the CAM is a delirium detection tool, and the AUDIT is a 10-item screen for hazardous and harmful alcohol use.

Reference: Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16(9):606-13. https://pubmed.ncbi.nlm.nih.gov/11556941/