PHQ-A

Patient Health Questionnaire for Adolescents

De-identify everything. Never enter client names, dates of birth, record numbers, or other identifying information anywhere on Meridian.

Content note: For adolescents ages 11–17. If you are 18 or older, use the PHQ-9 instead. This tool includes a question about thoughts of self-harm.

Your privacy: Screening results are stored only on this device and are never sent to our servers. You can share results with your provider using a secure link.

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Little interest or pleasure in doing things
Feeling down, depressed, hopeless, or irritable
Trouble falling asleep, staying asleep, or sleeping too much
Feeling tired or having little energy
Poor appetite, weight loss, or overeating
Feeling bad about yourself — or feeling that you are a failure, or that you have let yourself or your family down
Trouble concentrating on things like school work, reading, or watching TV
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
Thoughts that you would be better off dead, or of hurting yourself in some way

Meridian Mental Health

Clinical screening form

For clinical use — retain with the record

PHQ-A — Patient Health Questionnaire for Adolescents

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Client name

Date of birth

Date administered

Clinician

Meridian does not collect client-identifying information on screen — complete this section by hand.

#	Item	Not at all	Several days	More than half the days	Nearly every day
1	Little interest or pleasure in doing things	(0)	(1)	(2)	(3)
2	Feeling down, depressed, hopeless, or irritable	(0)	(1)	(2)	(3)
3	Trouble falling asleep, staying asleep, or sleeping too much	(0)	(1)	(2)	(3)
4	Feeling tired or having little energy	(0)	(1)	(2)	(3)
5	Poor appetite, weight loss, or overeating	(0)	(1)	(2)	(3)
6	Feeling bad about yourself — or feeling that you are a failure, or that you have let yourself or your family down	(0)	(1)	(2)	(3)
7	Trouble concentrating on things like school work, reading, or watching TV	(0)	(1)	(2)	(3)
8	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	(0)	(1)	(2)	(3)
9	Thoughts that you would be better off dead, or of hurting yourself in some way *	(0)	(1)	(2)	(3)

* Safety-flagged item — see note below.

Functional impact

If you checked off any problems, how difficult have these made it to do your school work, take care of things at home, or get along with other people?

Not difficult at allSomewhat difficultVery difficultExtremely difficult

* Safety-flagged item

A response above 0 on the marked item warrants a direct safety assessment (ideation, plan, intent, access to means) regardless of the total score. If risk is imminent, call or text 988, or call 911.

Total score / 27

Severity

(0/9 answered on screen — score by hand)

Severity key
Score	Severity	Guidance
0–4	Minimal	Minimal or no depressive symptoms. Monitor; no treatment typically indicated.
5–9	Mild	Mild symptoms. Watchful waiting; consider repeat screening, supportive counseling, and follow-up in 2–4 weeks.
10–14	Moderate	Moderate symptoms. Consider a treatment plan: psychotherapy, further evaluation, and involving a parent/guardian and the adolescent's care team.
15–19	Moderately severe	Moderately severe. Active treatment with psychotherapy and/or pharmacotherapy is warranted; coordinate with the adolescent's medical provider.
20–27	Severe	Severe symptoms. Prompt initiation of treatment and expedited specialty referral; assess safety and supports carefully.

Johnson JG, Harris ES, Spitzer RL, Williams JBW. The Patient Health Questionnaire for Adolescents (PHQ-A): validation of an instrument for the assessment of mental disorders among adolescent primary care patients. J Adolesc Health. 2002. Adapted from the PHQ-9 (Kroenke, Spitzer & Williams, 2001). Public domain.

This form is a scoring aid, not a diagnosis. A score alone never establishes or rules out a clinical diagnosis — interpret alongside clinical judgment. Printed Aug 20, 2026 from Meridian Mental Health.

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