UPDOX - PATIENT PORTAL

Available Forms

PHQ- 9: Modified for Teens

Instructions: How often have you been bothered by each of the following symptoms during the past 2 WEEKS? For each symptom select the answer that best describes the how you have been feeling.

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

2. Little interest or pleasure in doing things *

3. Trouble fallins asleep, staying asleep, or sleeping too much? *

4. Poor appetite, weight loss, or overeating? *

5. Feeling tires or having little energy? *

6. Feeling bad about yourself or feeling that you are a failure or that you have let yourself and/ or 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 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? *

In the past YEAR have you felt depressed or sad most days, even if you felt okay sometimes? *

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 car othings at home, or get along with other people?

Has there been a time in the pat MONTH when you have had serious thoughts about ending your life? *

Have you EVER, in your WHOLE LIFE, tried to kill yourself of made a suicide attempt? *

* Required field