PHQ-9(2)
The PHQ-9 (Patient Health Questionnaire - 9 Items) is used to record and assess depressive symptoms. It consists of nine questions, the answers to which are scored from 0 to 3. The answer options are “not at all” (0 points), “some days” (1 point), “more than half of the days” (2 points) and “almost every day” (3 points). The total score is calculated by adding up the points from all nine questions and is therefore between 0 and 27. The evaluation is based on the scores assigned to the answers to the 9 items.
FHIR Instances for the GPDS
Exemplatory instances of the PHQ-9 were created by the GPDS that have correct values within one instance for easy implementation in German University Hospitals:
German Version of the PHQ-9
| Questionnaire |
| id : PHQ-9-de-DE |
| meta |
| profile : http://charite.de/fhir/psycho/StructureDefinition/psych-befund-questionnaire |
| language : de-DE |
| url : http://charite.de/fhir/psycho/Questionnaire/PHQ-9-de-DE |
| title : Patient Health Questionnaire - 9-Item Short-form |
| status : draft |
| subjectType : Patient |
| code |
| system : http://loinc.org |
| code : 44249-1 |
| display : PHQ-9 quick depression assessment panel [Reported.PHQ] |
| item |
| linkId : q1-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44250-9 |
| display : Little interest or pleasure in doing things |
| text : Wenig Interesse oder Freude an Ihren Tätigkeiten |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q2-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44255-8 |
| display : Feeling down, depressed, or hopeless |
| text : Niedergeschlagenheit, Schwermut oder Hoffnungslosigkeit |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q3-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44259-0 |
| display : Trouble falling or staying asleep, or sleeping too much |
| text : Schwierigkeiten ein- oder durchzuschlafen oder vermehrter Schlaf |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q4-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44254-1 |
| display : Feeling tired or having little energy |
| text : Müdigkeit oder Gefühl, keine Energie zu haben |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q5-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44251-7 |
| display : Poor appetite or overeating |
| text : Verminderter Appetit oder übermäßiges Bedürfnis zu essen |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q6-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44258-2 |
| display : Feeling bad about yourself-or that you are a failure or have let yourself or your family down |
| text : Schlechte Meinung von sich selbst; Gefühl, ein Versager zu sein oder die Familie enttäuscht zu haben |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q7-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44252-5 |
| display : Trouble concentrating on things, such as reading the newspaper or watching television |
| text : Schwierigkeiten, sich auf etwas zu konzentrieren, z.B. beim Zeitunglesen oder Fernsehen |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q8-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44253-3 |
| display : 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 |
| text : Waren Ihre Bewegungen oder Ihre Sprache so verlangsamt, dass es auch anderen auffallen würde? Oder waren Sie im Gegenteil „zappelig“ oder ruhelos und hatten dadurch einen stärkeren Bewegungsdrang als sonst? |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q9-PHQ-9-de |
| code |
| system : http://loinc.org |
| code : 44260-8 |
| display : Thoughts that you would be better off dead, or of hurting yourself in some way |
| text : Gedanken, dass Sie lieber tot wären oder sich Leid zufügen möchten |
| type : choice |
| required : False |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| extension |
| url : http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression |
| value |
| description : Gesamtpunktzahl des Fragebogens wird aufsummiert |
| name : score |
| language : text/fhirpath |
| expression : %resource.answers().value.ordinal().sum() |
| linkId : PHQ-9-de-score |
| code |
| system : http://loinc.org |
| code : 44261-6 |
| display : Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] |
| text : PHQ-9-de-Score |
| type : quantity |
| required : True |
| readOnly : True |
English Version of the PHQ-9
| Questionnaire |
| id : PHQ-9-en-US |
| meta |
| profile : http://charite.de/fhir/psycho/StructureDefinition/psych-befund-questionnaire |
| language : en-US |
| url : http://charite.de/fhir/psycho/Questionnaire/PHQ-9-en-US |
| title : Patient Health Questionnaire - 9-Items |
| status : draft |
| subjectType : Patient |
| code |
| system : http://loinc.org |
| code : 44249-1 |
| display : PHQ-9 quick depression assessment panel [Reported.PHQ] |
| item |
| linkId : q1-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44250-9 |
| display : Little interest or pleasure in doing things |
| text : Little interest or pleasure in doing things |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q2-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44255-8 |
| display : Feeling down, depressed, or hopeless |
| text : Feeling down, depressed, or hopeless |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q3-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44259-0 |
| display : Trouble falling or staying asleep, or sleeping too much |
| text : Trouble falling or staying asleep, or sleeping too much |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q4-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44254-1 |
| display : Feeling tired or having little energy |
| text : Feeling tired or having little energy |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q5-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44251-7 |
| display : Poor appetite or overeating |
| text : Poor appetite or overeating |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q6-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44258-2 |
| display : Feeling bad about yourself-or that you are a failure or have let yourself or your family down |
| text : Feeling bad about yourself-or that you are a failure or have let yourself or your family down |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q7-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44252-5 |
| display : Trouble concentrating on things, such as reading the newspaper or watching television |
| text : Trouble concentrating on things, such as reading the newspaper or watching television |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q8-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44253-3 |
| display : 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 |
| text : 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 |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q9-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 44260-8 |
| display : Thoughts that you would be better off dead, or of hurting yourself in some way |
| text : Thoughts that you would be better off dead, or of hurting yourself in some way |
| type : choice |
| required : False |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| linkId : q10-PHQ-9 |
| code |
| system : http://loinc.org |
| code : 69722-7 |
| display : 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? |
| text : 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? |
| type : choice |
| required : False |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Not at all |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - Several days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - More than half the days |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Nearly every day |
| item |
| extension |
| url : http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression |
| value |
| description : The score is being calculated |
| name : score |
| language : text/fhirpath |
| expression : %resource.answers().value.ordinal().sum() |
| linkId : PHQ-9-score |
| code |
| system : http://loinc.org |
| code : 44261-6 |
| display : Patient Health Questionnaire 9 item (PHQ-9) total score [Reported] |
| text : PHQ-9 Score |
| type : quantity |
| required : True |
| readOnly : True |
German Version of the PHQ-2
Additionally, an instance for the a PHQ with 2 items was created - the PHQ-2 - needed for quick assessments.
| Questionnaire |
| id : PHQ-2-de-DE |
| meta |
| profile : http://charite.de/fhir/psycho/StructureDefinition/psych-befund-questionnaire |
| language : de-DE |
| url : http://charite.de/fhir/psycho/Questionnaire/PHQ-2-de-DE |
| title : Patient Health Questionnaire - 2-Item Short-form |
| status : draft |
| subjectType : Patient |
| code |
| system : http://loinc.org |
| code : 55757-9 |
| display : Patient Health Questionnaire 2 item (PHQ-2) [Reported] |
| item |
| linkId : q1-PHQ-2-de |
| code |
| system : http://loinc.org |
| code : 44250-9 |
| display : Little interest or pleasure in doing things |
| text : Wenig Interesse oder Freude an Ihren Tätigkeiten |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| linkId : q2-PHQ-2-de |
| code |
| system : http://loinc.org |
| code : 44255-8 |
| display : Feeling down, depressed, or hopeless |
| text : Niedergeschlagenheit, Schwermut oder Hoffnungslosigkeit |
| type : choice |
| required : True |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 0 |
| value |
| system : http://loinc.org |
| code : LA6568-5 |
| display : 0 - Überhaupt nicht |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 1 |
| value |
| system : http://loinc.org |
| code : LA6569-3 |
| display : 1 - An einzelnen Tagen |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 2 |
| value |
| system : http://loinc.org |
| code : LA6570-1 |
| display : 2 - An mehr als der Hälfte der Tage |
| answerOption |
| extension |
| url : http://hl7.org/fhir/StructureDefinition/ordinalValue |
| value : 3 |
| value |
| system : http://loinc.org |
| code : LA6571-9 |
| display : 3 - Beinahe jeden Tag |
| item |
| extension |
| url : http://hl7.org/fhir/uv/sdc/StructureDefinition/sdc-questionnaire-calculatedExpression |
| value |
| description : Gesamtpunktzahl des Fragebogens wird aufsummiert |
| name : score |
| language : text/fhirpath |
| expression : %resource.answers().value.ordinal().sum() |
| linkId : PHQ-2-de-score |
| code |
| system : http://loinc.org |
| code : 55758-7 |
| display : Patient Health Questionnaire 2 item (PHQ-2) total score [Reported] |
| text : PHQ-2-de-Score |
| type : quantity |
| required : True |
| readOnly : True |
Scoring
The total score is interpreted as follows:
Fig. Evaluation of PHQ-9 German Modification (Source: Kassenärztliche Bundesvereinigung)
Values between 0 and 4 indicate no or minimal depressive symptoms. A score of 5 to 9 indicates mild, 10 to 14 moderate, 15 to 19 moderately severe and 20 to 27 severe depressive symptoms.
SDC-PHQ9
It is one of the few psychiatric instruments which are already part of exemplatory FHIR profiles. There is an example for the representation of the PHQ-9 in the Structured Data Capture implementation guide developed by HL7 International as part of the FHIR standard.
The following profile shows a Questionnaire example of how the PHQ-9 Questionnaire could be rendered as a FHIR Questionnaire Resource.
| LinkId | Text | Cardinality | Type | Description & Constraints |
|---|---|---|---|---|
  SDCPHQ9 | This is a Questionnaire example of how the PHQ-9 Questionnaire could be rendered as a FHIR Questionnaire Resource according to the Structured Data Capture SDC Base Questionnaire Profile. This example also portrays how FHIRpaths can be used to perform total score calculations using answer values. | Questionnaire | http://hl7.org/fhir/uv/sdc/Questionnaire/questionnaire-sdc-profile-example-PHQ9#3.0.0 | |
  H1/T1 | Over the last two weeks, how often have you been bothered by any of the following problems? | 0..1 | group | |
   H1/T1/Q1 | Little interest or pleasure in doing things? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q2 | Feeling down, depressed, or hopeless? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q3 | Trouble falling or staying asleep, or sleeping too much? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q4 | Feeling tired or having little energy? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q5 | Poor appetite or overeating? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q6 | Feeling bad about yourself - or that you are a failure or have let yourself or your family down? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q7 | Trouble concentrating on things, such as reading the newspaper or watching television? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q8 | Moving or speaking so slowly that other people could gave noticed? Or so fidgety or restless that you have been moving a lot more than usual? | 0..1 | choice | Value Set: VSPHQ9 |
| H1/T1/Q9 | Thoughts that you would be better off dead, or thoughts of hurting yourself in some way? | 0..1 | choice | Value Set: VSPHQ9 |
 H1/TS | Patient health questionnaire 9 item total score | 0..1 | quantity | Expressions:
|
| Documentation for this format | ||||
As a Value Set for answers it uses the VSPHQ9-Value Set with item weights form 0 to 4 but as the answers options actually each have the item weight options from 0 to 3 the value set cannot be used for implementations with standardized content.
Fig. Evaluation of PHQ-9 (Source: HL7)