PHQ-9

GAD-7

PHQ-4

1) Depressed mood

1) Anxious

1) Depressed mood

2) Loss of interest

2) Uncontrollable worry

2) Loss of interest

3) Under- or over-sleeping

3) Worry about everything

3) Anxious

4) Lack of energy

4) Trouble relaxing

4) Uncontrollable worry

5) Under- or over-eating

5) Restless

6) Low self-esteem

6) Irritable

7) Trouble concentrating

7) Afraid

8) Under- or over-active

9) Suicidal thoughts

Answer scale: “Over the last 2 weeks, how often have you been bothered by the following problems?”

Not at all

Several days

More than half the days

Nearly every day

0

1

2

4

Devalidating problems:

1) Only the first two items in the PHQ-9 and the GAD-7 are essential symptoms. The others are not unique to the disorder according to the DSM-5. Total scores on the PHQ-9 and the GAD-7 are therefore meaningless.

2) Functional impairment, required by the DSM-5, is not measured. “Bothered by” is not sufficient evidence of dysfunction.

3) The answer scale for all three measures records frequency instead of severity. The symptoms could be prevalent but subthreshold and mild.

4) The PHQ-4 is scored wrongly. The correct scoring is affirmative answers to Q1 or Q2 for depression, and to Q3 and Q4 for anxiety.