Skip to main content

Transforming the understanding
and treatment of mental illnesses.

Celebrating 75 Years! Learn More >>

PHQ-9 modified for Adolescents (PHQ-A)

Instructions: How often have you been bothered by each of the following symptoms during the past two weeks? For each symptom put an “X” in the box beneath 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?
  10. In the past year have you felt depressed or sad most days, even if you felt okay sometimes?
  11. If you are experiencing any of the problems on this form, 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?
  12. Office use only:
  13. Johnson JG, Harris ES, Spitzer RL, Williams JB. The patient health questionnaire for adolescents: validation of an instrument for the assessment of mental disorders among adolescent primary care patients. J Adolesc Health. 2002;30(3):196-204. doi:10.1016/s1054-139x(01)00333-0

Ask Suicide-Screening Questions (ASQ)

Ask the patient:

  1. In the past few weeks, have you wished you were dead?
  2. In the past few weeks, have you felt that you or your family would be better off if you were dead?
  3. In the past week, have you been having thoughts about killing yourself?
  4. Have you ever tried to kill yourself?

    If the patient answers yes to any of the above, ask the following question:
  5. Are you having thoughts of killing yourself right now?
  • Horowitz LM, Bridge JA, Teach SJ, et al. Ask Suicide-Screening Questions (ASQ): a brief instrument for the pediatric emergency department. Arch Pediatr Adolesc Med. 2012;166(12):1170-1176. doi:10.1001/archpediatrics.2012.1276

Provide resources to all patients:

  • 24/7 National Suicide Prevention Lifeline 1-800-273-TALK (8255) En Español: 1-888-628-9454
  • 24/7 Crisis Text Line: Text “HOME” to 741-741