01732 808 626 info@thinkcbt.com

01732 808 626 info@thinkcbt.com

01732 808 626 info@thinkcbt.com

PHQ9-A Severity Measure for Depression Child Age 11–17
You can respond anonymously, and no data will be retained from this assessment. If you choose to include your initials and an email address, your results will be automatically sent to the email address provided. Please check that the email address has been entered correctly before submitting this form. All client information is managed on a strictly confidential basis. Please Note: Whilst every effort is made to ensure that our system is securely encrypted, email is not a completely secure means of communication. Think CBT does not accept liability for loss or theft of personal data where any individual chooses to transmit or receive information via email.
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Instructions

How often have you been bothered by each of the following symptoms during the past 7 days?

For each symptom select the answer that best describes how you have been feeling.


1. Feeling down, depressed, irritable, or hopeless?




2. Little interest or pleasure in doing things?




3. Trouble falling asleep, staying asleep, or sleeping too much?




4. Poor appetite, weight loss, or overeating?




5. Feeling tired, or having little energy?




6. Feeling bad about yourself—or feeling that you are a failure, or that you have let yourself or your family down?




7. Trouble concentrating on things like school work, reading, or watching TV?




8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you were moving around a lot more than usual?




9. Thoughts that you would be better off dead, or of hurting yourself in some way?