PHQ-A · Depression in teens
Is my teen depressed? Free PHQ-A test for adolescents
Teen Depression Self-Test
The PHQ adapted for adolescents - a depression screener for teens.
Reviewed by Komel Kaur, Psychotherapist
Last reviewed 9 July 2026
9
Questions
~3
Minutes
Free
Always
What the PHQ-A measures
The PHQ-A (Patient Health Questionnaire for Adolescents) is the version of the PHQ-9 adapted for young people aged 11-17. It measures the same nine DSM depression symptoms - low interest, low mood, sleep changes, appetite changes, fatigue, feeling like a failure, poor concentration, restlessness or slowing, and thoughts of self-harm - with wording adjusted for adolescents (for example, referring to school work and family rather than adult work contexts).
Each item is scored 0-3, giving a total between 0 and 27. Higher scores indicate more severe depressive symptoms over the past two weeks.
Item 9 asks directly about thoughts of being better off dead or hurting yourself. A positive answer on item 9 is treated as a safety flag regardless of the total score.
Where the PHQ-A came from
The PHQ-A was developed and validated in 2002 by Jeffrey Johnson, Erin Harris, Robert Spitzer, and Janet Williams and published in the Journal of Adolescent Health. It adapted the PHQ-9 for adolescents through pilot work in adolescent primary care and mental-health clinics, with wording changes and validation against structured psychiatric interviews. It is now widely used in paediatric primary care, school counselling, and adolescent mental-health services and is endorsed by professional bodies including the American Academy of Pediatrics for depression screening in adolescents.
How the PHQ-A is scored
The PHQ-A uses the same five severity bands as the PHQ-9. Item 9 is treated as a safety indicator: any non-zero answer prompts follow-up regardless of the total score.
| Score | Severity | What it usually means |
|---|---|---|
| 0-4 | Minimal or none | Symptoms within the normal range for adolescents. |
| 5-9 | Mild | Mild depression. Talking with a parent, school counsellor, or trusted adult is a good first step. |
| 10-14 | Moderate | Moderate depression. Structured support from a therapist or paediatrician is typically recommended. |
| 15-19 | Moderately severe | Moderately severe depression. Prompt professional evaluation strongly recommended. |
| 20-27 | Severe | Severe depression. Immediate professional support is important. |
How the PHQ-A is used in clinical practice
The PHQ-A is used at adolescent well-child visits, in school-based mental-health programs, and at intake in adolescent therapy. It is often paired with the SCARED for anxiety.
As with the adult PHQ-9, a drop of 5 or more points between administrations is considered a clinically meaningful improvement, and repeat administrations are used to track response to therapy or medication.
Item 9 is treated as a safety screen: any endorsement (even 'several days') triggers a structured suicide-risk conversation with the adolescent and involvement of parents or carers as appropriate.
Limitations to keep in mind
- ·The PHQ-A is a screen, not a diagnosis. Adolescent depression should be assessed by a qualified clinician who can consider development, family context, school function, and other contributors.
- ·Adolescents may under-report or over-report depending on how safe they feel with the person receiving their answers. Where possible, the PHQ-A is given privately and confidentially.
- ·Irritability rather than sadness can be the dominant mood in adolescent depression. The scale captures this partially through the second item ('down, depressed, irritable, or hopeless') but a clinician's judgement adds important nuance.
- ·Cultural context matters. In many families, adolescents present distress somatically (headaches, stomach pain) rather than as sadness, and this may not be captured fully by the PHQ-A alone.
Before you start
- · Find a quiet few minutes - answer honestly, not how you wish you felt.
- · There are no right or wrong answers. Pick what feels closest.
- · This is a screening tool, not a diagnosis.
- · If anything brings up something heavy, support is at the end.
Common questions about the PHQ-A
What is the PHQ-A?
The PHQ-A is the adolescent version of the PHQ-9 depression screener, adapted for young people aged 11-17. It measures the same nine DSM depression symptoms with age-appropriate wording.
What is a normal PHQ-A score for a teenager?
Scores of 0-4 are within the normal range. Scores of 5-9 are mild, 10-14 moderate, 15-19 moderately severe, and 20-27 severe.
Does a positive PHQ-A mean my teen has depression?
No. The PHQ-A is a screen. A positive result means further evaluation is worthwhile - it does not confirm depression. Adolescent depression is diagnosed by a clinician who considers full context and rules out other causes.
What if my teen answered 'yes' to item 9 (thoughts of self-harm)?
Any non-zero answer on item 9 should be taken seriously and followed up promptly with a mental-health professional. If your teen is in immediate danger, contact local emergency services or a crisis line right away.
Can teens take the PHQ-A on their own?
Yes. The PHQ-A is designed to be self-administered by adolescents aged 11-17. Parents can review results together with their teen and discuss next steps.
Is the PHQ-A free?
Yes. The PHQ-A is in the public domain and free to use for screening, research, and clinical purposes.
Reviewed by Komel Kaur, Psychotherapist
Last reviewed 9 July 2026
Johnson JG, Harris ES, Spitzer RL, Williams JBW. The PHQ-A for adolescents: validity of a brief measure. J Adolesc Health. 2002;30:196-204.