This form structure is an organized set of data definitions for a copyrighted form

 General Details

Title:
Patient Health Questionnaire - 9 (PHQ-9)
Short Name:
PHQ9
Description:
PHQ-9 provides a reliable and valid measure of depression severity and also yields a DSM-IV criteria based diagnosis of a depressive disorder. This 9 item measure asks subjects whether and how often they have been bothered by depression related symptoms over the last two weeks, ranging from not at all (0) to nearly every day (3). Based on total score, depression severity ranges from minimal symptoms (5-9) to greater than 20 indicating severe major depression. Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003; 41(11): 1284-92. Recommended by CDISC TAUG TBI for TBI. References: http://www.phqscreeners.com/
Disease:
Epilepsy , Headache , General (For all diseases) , Traumatic Brain Injury
Organization:
NINDS
Required Program Form:
No
Standardization:
Standard NINDS CDE
Labels:
Form Type:
Clinical Assessment
Publication Date:
2014-12-17
Version:
1.2
Date Created:
2014-09-16
Owner:
Number of Data Elements:
19
eForms:
Y

 Documentation


 Groups & Attached Data Elements

Logically grouped data elements with defined frequency at which they repeat.

# Title Short Description Variable Name Required? Type
1 GUID   Global Unique ID which uniquely identifies a subject GUID Required CDE
2 Subject identifier number   An identification number assigned to the participant/subject within a given protocol or a study. SubjectIDNum Optional CDE
3 Age in years   Value for participant's subject age recorded in years. AgeYrs Recommended CDE
4 Visit date   Actual interview or visit date VisitDate Recommended CDE
5 Site name   The name of the site for the study SiteName Recommended CDE
6 Days since baseline   The number of days since baseline DaysSinceBaseline Optional CDE
7 Case control indicator   Indicator of whether subject is in the case or control arm of the study CaseContrlInd Optional CDE
8 General notes text   General notes GeneralNotesTxt Optional CDE

Additional Element Groups

Listed below are your additional element groups.

Patient Health Questionnaire (PHQ-9) (Repeat Infinitely)

# Title Short Description Variable Name Required? Type
1 Patient Health Questionnaire (PHQ9) - Little interest score  Score of how much the subject has been bothered by having little interest or pleasure in doing things in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9IntrstPleasrActScore Recommended CDE
2 Patient Health Questionnaire (PHQ9) - Depressed score  Score of how much the subject has been feeling down and depressed in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9DwnDeprssnHopelssScore Recommended CDE
3 Patient Health Questionnaire (PHQ9) - Sleep impairment score  Score of how much the subject has been bothered with troubling falling/staying asleep or sleeping too much in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9SleepImpairScore Recommended CDE
4 Patient Health Questionnaire (PHQ9) - Tired little energy score  Score of how much the subject has been feeling tired in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9TirdLittleEnrgyScore Recommended CDE
5 Patient Health Questionnaire (PHQ9) - Abnormal diet score  Score of how much the subject has been bothered by abnormal diet/appetite in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9AbnrmlDietScore Recommended CDE
6 Patient Health Questionnaire (PHQ9) - Feeling failure score  Score of how much the subject has been feeling bad for himself/herself in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9FlngFailrScore Recommended CDE
7 Patient Health Questionnaire (PHQ9) - Concentration impairment score  Score of how much the subject has been bothered with troubling concentrating in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9ConcntrtnImprmntScore Recommended CDE
8 Patient Health Questionnaire (PHQ9) - Movement speech impairment score  Score of how much the subject has been suffering with moving or speaking too slowly in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9MovmntSpchImprmntScore Recommended CDE
9 Patient Health Questionnaire (PHQ9) - Better dead thought score  Score of how much the subject has been suffering with the thoughts of that he/she would be better off dead to hurt in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9BttrDdThghtScore Recommended CDE
10 Patient Health Questionnaire (PHQ9) - Questionnaire total score  Total score of the questionnaire, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9TotalScore Recommended CDE
11 Patient Health Questionnaire (PHQ9) - Difficulty performing scale  Scale of how difficult it is to do work, take care of things at home, or get along with other people for the subject in the past two weeks, as the part of Patient Health Questionnaire Depression (PHQ). PHQ9DiffcltyPerfActScre Recommended CDE

 Change History

 Administrative Change History