{
  "resourceType": "StructureDefinition",
  "id": "logicalmodel-Patienthealthquestionnaire-9_phq-9_-R4",
  "url": "http://linkehr.com/fhir/logicalmodel-patienthealthquestionnaire-9_phq-9_-R4",
  "identifier": [
    {
      "system": "openEHR-CKM",
      "value": "openEHR-EHR-OBSERVATION.phq_9.v0"
    }
  ],
  "version": "0",
  "name": "Patienthealthquestionnaire-9_phq-9_",
  "title": "Patient health questionnaire-9 (PHQ-9)",
  "status": "draft",
  "date": "2024-06-18",
  "publisher": "openEHR",
  "contact": [
    {
      "telecom": [
        {
          "system": "url",
          "value": "http://www.veratech.es"
        }
      ]
    }
  ],
  "description": "Screening questionnaire for mental health that can be used by health professionals or self-reported by individuals.",
  "purpose": "To record the results of the Patient Health Questionnaire-9 (PHQ-9) and its subset assessment PHQ-2.",
  "fhirVersion": "4.0.0",
  "mapping": [
    {
      "identity": "openEHR",
      "uri": "http://openehr.org",
      "name": "openEHR Mapping"
    },
    {
      "identity": "openEHR-natural",
      "uri": "http://openehr.org",
      "name": "openEHR natural path"
    }
  ],
  "kind": "logical",
  "abstract": false,
  "type": "StructureDefinition",
  "baseDefinition": "http://hl7.org/fhir/StructureDefinition/Element",
  "snapshot": {
    "element": [
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9)",
        "path": "Patient_health_questionnaire_9_(PHQ_9)",
        "short": "Patient health questionnaire-9 (PHQ-9)",
        "definition": "Screening questionnaire for mental health that can be used by health professionals or self-reported by individuals.",
        "min": 1,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9)",
          "min": 1,
          "max": "1"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": true,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).protocol",
        "path": "Patient_health_questionnaire_9_(PHQ_9).protocol",
        "short": "Tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).protocol",
          "min": 0,
          "max": "1"
        },
        "type": [
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            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).protocol.Extension",
        "path": "Patient_health_questionnaire_9_(PHQ_9).protocol.Extension",
        "short": "Extension",
        "definition": "Additional information required to capture local content or to align with other reference models/formalisms.",
        "min": 0,
        "max": "*",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).protocol.Extension",
          "min": 0,
          "max": "*"
        },
        "type": [
          {
            "code": "BackboneElement"
          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series",
        "short": "Event Series",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
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          }
        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time",
        "short": "Point in Time",
        "definition": "A specific date and/or time which may be explicitly defined in a template or at run-time.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data",
        "short": "Tree",
        "definition": "@ internal @",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data",
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Interest_pleasure",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Interest_pleasure",
        "short": "Interest/pleasure",
        "definition": "Over the last two weeks, how often have you been bothered by little interest or pleasure in doing things?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Interest_pleasure",
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        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Interest_pleasure.value",
        "short": "Interest/pleasure",
        "definition": "Over the last two weeks, how often have you been bothered by little interest or pleasure in doing things?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Interest_pleasure.value",
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          "max": "1"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_down",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_down",
        "short": "Feeling down",
        "definition": "Over the last two weeks, how often have you been bothered by feeling down, depressed, or hopeless?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_down",
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          "max": "1"
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        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_down.value",
        "short": "Feeling down",
        "definition": "Over the last two weeks, how often have you been bothered by feeling down, depressed, or hopeless?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_down.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Sleep_issues",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Sleep_issues",
        "short": "Sleep issues",
        "definition": "Over the last two weeks, how often have you been bothered by trouble falling or staying asleep, or sleeping too much?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Sleep_issues",
          "min": 0,
          "max": "1"
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Sleep_issues.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Sleep_issues.value",
        "short": "Sleep issues",
        "definition": "Over the last two weeks, how often have you been bothered by trouble falling or staying asleep, or sleeping too much?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Sleep_issues.value",
          "min": 0,
          "max": "1"
        },
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          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Tired_little_energy",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Tired_little_energy",
        "short": "Tired/little energy",
        "definition": "Over the last two weeks, how often have you been bothered by feeling tired or having little energy?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Tired_little_energy",
          "min": 0,
          "max": "1"
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Tired_little_energy.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Tired_little_energy.value",
        "short": "Tired/little energy",
        "definition": "Over the last two weeks, how often have you been bothered by feeling tired or having little energy?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Tired_little_energy.value",
          "min": 0,
          "max": "1"
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        ],
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        "isModifier": false,
        "isSummary": true
      },
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Appetite",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Appetite",
        "short": "Appetite",
        "definition": "Over the last two weeks, how often have you been bothered by poor appetite or overeating?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Appetite",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Appetite.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Appetite.value",
        "short": "Appetite",
        "definition": "Over the last two weeks, how often have you been bothered by poor appetite or overeating?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Appetite.value",
          "min": 0,
          "max": "1"
        },
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_bad_about_yourself",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_bad_about_yourself",
        "short": "Feeling bad about yourself",
        "definition": "Over the last two weeks, how often have you been bothered by feeling bad about yourself — or that you are a failure or have let yourself or your family down?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_bad_about_yourself",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_bad_about_yourself.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_bad_about_yourself.value",
        "short": "Feeling bad about yourself",
        "definition": "Over the last two weeks, how often have you been bothered by feeling bad about yourself — or that you are a failure or have let yourself or your family down?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Feeling_bad_about_yourself.value",
          "min": 0,
          "max": "1"
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        "type": [
          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Trouble_concentrating",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Trouble_concentrating",
        "short": "Trouble concentrating",
        "definition": "Over the last two weeks, how often have you been bothered by trouble concentrating on things, such as reading the newspaper or watching television?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Trouble_concentrating",
          "min": 0,
          "max": "1"
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      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Trouble_concentrating.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Trouble_concentrating.value",
        "short": "Trouble concentrating",
        "definition": "Over the last two weeks, how often have you been bothered by trouble concentrating on things, such as reading the newspaper or watching television?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Trouble_concentrating.value",
          "min": 0,
          "max": "1"
        },
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          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Slow_fidgety",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Slow_fidgety",
        "short": "Slow/fidgety",
        "definition": "Over the last two weeks, how often have you been bothered by 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?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Slow_fidgety",
          "min": 0,
          "max": "1"
        }
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Slow_fidgety.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Slow_fidgety.value",
        "short": "Slow/fidgety",
        "definition": "Over the last two weeks, how often have you been bothered by 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?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Slow_fidgety.value",
          "min": 0,
          "max": "1"
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            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Death_self_harm",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Death_self_harm",
        "short": "Death/self-harm",
        "definition": "Over the last two weeks, how often have you been bothered \r\nby thoughts that you would be better off dead or of hurting yourself in some way?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Death_self_harm",
          "min": 0,
          "max": "1"
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      },
      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Death_self_harm.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Death_self_harm.value",
        "short": "Death/self-harm",
        "definition": "Over the last two weeks, how often have you been bothered \r\nby thoughts that you would be better off dead or of hurting yourself in some way?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Death_self_harm.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "CodeableConcept"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
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      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_2_score",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_2_score",
        "short": "PHQ-2 score",
        "definition": "Total score for the first two questions on 'Interest/Pleasure' and 'Feeling Down'.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_2_score",
          "min": 0,
          "max": "1"
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      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_2_score.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_2_score.value",
        "short": "PHQ-2 score",
        "definition": "Total score for the first two questions on 'Interest/Pleasure' and 'Feeling Down'.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_2_score.value",
          "min": 0,
          "max": "1"
        },
        "type": [
          {
            "code": "Quantity"
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        ],
        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
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      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_9_score",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_9_score",
        "short": "PHQ-9 score",
        "definition": "Total Score for all nine questions.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_9_score",
          "min": 0,
          "max": "1"
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_9_score.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_9_score.value",
        "short": "PHQ-9 score",
        "definition": "Total Score for all nine questions.",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.PHQ_9_score.value",
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          "max": "1"
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        "type": [
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            "code": "Quantity"
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        "mustSupport": false,
        "isModifier": false,
        "isSummary": true
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      {
        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Difficulty_in_life_activities",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Difficulty_in_life_activities",
        "short": "Difficulty in life activities",
        "definition": "If you checked off any problems on this questionnaire, 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?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Difficulty_in_life_activities",
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        "id": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Difficulty_in_life_activities.value",
        "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Difficulty_in_life_activities.value",
        "short": "Difficulty in life activities",
        "definition": "If you checked off any problems on this questionnaire, 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?",
        "min": 0,
        "max": "1",
        "base": {
          "path": "Patient_health_questionnaire_9_(PHQ_9).Event_Series.Point_in_Time.data.Difficulty_in_life_activities.value",
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        },
        "type": [
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            "code": "CodeableConcept"
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        ],
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        "isModifier": false,
        "isSummary": true
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    ]
  }
}