PRIME-MD / PHQ Clinical Screening Framework
Also known as: PRIME-MD · PHQ Framework
Clinical screening framework derived from the Primary Care Evaluation of Mental Disorders (PRIME-MD). Operationalizes DSM-IV diagnostic criteria into brief self-report screeners for depression (PHQ-9/PHQ-2), anxiety (GAD-7), somatization (PHQ-15), and other conditions. Not a diagnostic system — designed to identify probable cases for clinical follow-up.
- Source:
- Spitzer, R. L., Kroenke, K., & Williams, J. B. W. (1999). Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. JAMA, 282(18), 1737-1744.
Constructs
Depression Severity
As operationalized in the PHQ-9 and PHQ-2 (Kroenke, Spitzer & Williams, 2001), depression severity is assessed by the frequency of the nine cardinal symptoms of Major Depressive Disorder specified in DSM-IV: anhedonia, depressed mood, sleep disturbance, fatigue, appetite change, guilt/worthlessness, concentration difficulty, psychomotor change, and suicidal ideation. Scores index symptom burden rather than categorical diagnosis.
Generalized Anxiety Severity
As operationalized in the GAD-7 (Spitzer, Kroenke, Williams & Löwe, 2006), anxiety severity is assessed by the frequency of seven core symptoms of Generalized Anxiety Disorder specified in DSM-IV: nervousness, uncontrollable worry, excessive worry, restlessness, difficulty relaxing, irritability, and fearfulness.
Somatic Symptom Severity
As operationalized in the PHQ-15 (Kroenke, Spitzer & Williams, 2002), somatic symptom severity is assessed by the frequency and bothersomeness of 15 common physical symptoms (headaches, pain, gastrointestinal, cardiovascular, etc.) that account for more than half of all outpatient visits and are often associated with functional impairment.
Instruments
- Patient Health Questionnaire — 9 item(PHQ-9)Kroenke, K., Spitzer, R. L., & Williams, J. B. W.2001
- Patient Health Questionnaire — 2 item(PHQ-2)Kroenke, K., Spitzer, R. L., & Williams, J. B. W.2003
- Patient Health Questionnaire — 15 item (Somatic Symptom Severity)(PHQ-15)Kroenke, K., Spitzer, R. L., & Williams, J. B. W.2002
- Generalized Anxiety Disorder 7-item scale(GAD-7)Spitzer, R. L., Kroenke, K., Williams, J. B. W., & Löwe, B.2006
Tests built on this theory
PHQ-9: Patient Health Questionnaire (Depression)
9-item depression severity screener based on DSM criteria.
Learn more →PHQ-2: Ultra-Brief Depression Screener
Ultra-brief 2-item depression screening for depressed mood and anhedonia.
Learn more →PHQ-15: Somatic Symptom Severity Scale
15-item somatic symptom severity screening for physical complaints linked to distress.
Learn more →GAD-7: Generalized Anxiety Disorder Scale
7-item anxiety severity screener for generalized anxiety disorder.
Learn more →