QIDS-SR (Quick Inventory of Depressive Symptomatology)

What is the QIDS-SR?

The Quick Inventory of Depressive Symptomatology: Self-Report (QIDS-SR16) was developed by John Rush, Madhukar Trivedi, and colleagues at the University of Texas Southwestern Medical Center (2003). It was designed to assess the full breadth of major depressive disorder as defined by DSM-IV, covering all nine symptom criteria with greater clinical granularity than shorter screening tools.

The QIDS-SR uses 16 items to assess 9 symptom domains: sleep disturbance (4 items), sad mood, appetite/weight changes (4 items), concentration, self-view, suicidal ideation, interest, energy/fatigue, and psychomotor changes (2 items). Within each domain, the highest item score is used. This domain scoring approach means the total ranges from 0 to 27 rather than a simple sum of all 16 items.

The QIDS-SR is free for clinical and research use with no copyright restrictions. It achieved particular prominence through its use in the STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression), the largest effectiveness trial ever conducted for major depression. It is commonly used alongside the PHQ-9 to provide a fuller picture of depressive severity.

Rate how you have felt over the past week. Answer all 16 items to see your domain score.

Domain 1: Sleep Disturbance (Items 1–4)

Domain 2: Sad Mood (Item 5)

5. Rate your depressed mood over the past week: 0 = did not feel sad; 1 = felt sad less than half the time; 2 = felt sad more than half the time; 3 = felt sad nearly all of the time.

Domain 3: Appetite / Weight Change (Items 6–9)

Answer both the appetite and the weight items that apply to you. Answer the other pair with 0 (no change). Domain 3 uses the highest score among items 6–9.

Domain 4: Concentration (Item 10)

10. Rate your ability to concentrate and make decisions: 0 = no change from usual; 1 = occasionally indecisive or attention wanders; 2 = struggled to focus or make decisions most of the time; 3 = unable to concentrate well enough to read or make minor decisions.

Domain 5: Self-View (Item 11)

11. Rate your view of yourself: 0 = see myself as equally worthwhile as others; 1 = more self-blaming than usual; 2 = largely believe I cause problems for others; 3 = think almost constantly about major and minor defects in myself.

Domain 6: Suicidal Ideation (Item 12)

If you are in crisis, contact the 988 Suicide & Crisis Lifeline by calling or texting 988: free, confidential, 24/7.

12. Rate thoughts of death or suicide: 0 = no thoughts of suicide or dying; 1 = feel that life is empty or wonder if it's worth living; 2 = think of suicide or death several times a week for several minutes; 3 = think of suicide or death several times a day in some detail, or have made a plan or attempt.

Domain 7: General Interest (Item 13)

13. Rate your general interest in people and activities: 0 = no change from usual; 1 = less interested than usual in other people or activities; 2 = interest in only one or two formerly pursued activities; 3 = virtually no interest in formerly pursued activities.

Domain 8: Energy / Fatigue (Item 14)

14. Rate your energy level: 0 = no change from usual; 1 = get tired more easily than usual; 2 = must make a significant effort to start or finish usual daily activities; 3 = unable to carry out most usual daily activities due to lack of energy.

Domain 9: Psychomotor Changes (Items 15–16)

QIDS-SR Score Interpretation

Rush et al. (2003) severity bands. Total score = sum of the 9 domain scores (range 0–27). Domain score = highest item within each domain.

How QIDS-SR Domain Scoring Works

Unlike the PHQ-9 (a simple sum), the QIDS-SR uses domain scoring: within each of the 9 DSM symptom domains, only the highest item score contributes to the total.

Domain 1: Sleep Disturbance

Items 1–4 assess four distinct sleep problems: trouble falling asleep, waking in the night, early morning waking, and sleeping too much. Domain score = max(items 1–4).

Domain 2: Sad Mood

Item 5 alone: the core subjective depressed mood criterion. Rated 0 (not sad) to 3 (sad nearly all the time).

Domain 3: Appetite / Weight

Items 6–9 cover decreased appetite, increased appetite, weight loss, and weight gain. Only one direction is typically elevated. Domain score = max(items 6–9).

Domain 4: Concentration

Item 10 alone: difficulty focusing, making decisions, or remembering. 0 = no difficulty; 3 = cannot concentrate at all.

Domain 5: Self-View

Item 11: negative self-perception ranging from normal self-regard (0) to constant preoccupation with defects (3).

Domain 6: Suicidal Ideation

Item 12: ranges from no thoughts of death (0) to daily suicidal ideation (3). Any score >0 requires clinical follow-up.

Domain 7: General Interest

Item 13: anhedonia / loss of interest in usual activities. 0 = no change; 3 = no interest in anything previously enjoyed.

Domain 8: Energy / Fatigue

Item 14: physical energy depletion. 0 = no change; 3 = unable to carry out most activities due to fatigue.

Domain 9: Psychomotor Changes

Items 15–16 assess slowing and agitation. Take the higher of the two. Domain score = max(item 15, item 16).

QIDS-SR vs PHQ-9

Both tools screen for major depression, but they differ in depth, scoring method, and clinical use case.

Track QIDS-SR Domain Scores Longitudinally in HiBoop

Automated domain scoring, trend visualization, and clinical documentation for every patient: QIDS-SR alongside PHQ-9 and MADRS.

Frequently Asked Questions

What is the QIDS-SR and how does it differ from the PHQ-9?

The QIDS-SR16 (Quick Inventory of Depressive Symptomatology: Self-Report) is a 16-item self-report depression scale developed by Rush, Trivedi, and colleagues (2003) at UT Southwestern. It covers all 9 DSM MDD symptom criteria with greater granularity than the PHQ-9: sleep disturbance is assessed with 4 items (versus 1 in the PHQ-9), and appetite/weight change is captured with 4 separate items for increase and decrease in each direction. The QIDS-SR uses domain scoring (the highest item within each group counts), yielding a 0–27 total. The PHQ-9 uses a simple 9-item sum over the same 0–27 range. The QIDS-SR is primarily used in clinical research and treatment monitoring; the PHQ-9 is the standard for rapid primary care screening.

How is the QIDS-SR scored?

The QIDS-SR16 uses domain scoring. The 16 items map to 9 symptom domains. Within each domain, only the highest-scoring item is counted: Domain 1 (Sleep) = max of items 1–4; Domain 2 (Sad Mood) = item 5; Domain 3 (Appetite/Weight) = max of items 6–9; Domain 4 (Concentration) = item 10; Domain 5 (Self-View) = item 11; Domain 6 (Suicidal Ideation) = item 12; Domain 7 (Interest) = item 13; Domain 8 (Energy) = item 14; Domain 9 (Psychomotor) = max of items 15–16. The total QIDS-SR score is the sum of all 9 domain scores, ranging from 0 to 27.

What does a QIDS-SR score of 11 or above mean?

A QIDS-SR total score of 11–15 indicates moderate depression (Rush et al., 2003). This band represents clinically significant symptom burden that warrants active intervention, typically structured psychotherapy (such as CBT or IPT), pharmacotherapy, or a combination. Scores of 16–20 indicate severe depression and scores of 21–27 indicate very severe depression, both of which require prompt clinical evaluation and more intensive treatment planning. A score of 11 is often used as a clinical decision threshold in research settings for categorizing patients as having meaningful depressive illness.

What are the 9 symptom domains the QIDS-SR assesses?

The QIDS-SR covers all 9 DSM-IV/DSM-5-TR criteria for major depressive disorder through the following domains: (1) Sleep disturbance: insomnia or hypersomnia; (2) Sad mood: depressed mood; (3) Appetite/weight change: decreased or increased appetite and corresponding weight change; (4) Concentration and decision-making; (5) Self-view: worthlessness and excessive guilt; (6) Suicidal ideation: thoughts of death or self-harm; (7) General interest: anhedonia or loss of interest; (8) Energy/fatigue: decreased energy or fatigability; (9) Psychomotor changes: retardation or agitation. This thorough coverage is a key advantage over shorter tools that assess each criterion with only a single item.

What is the QIDS-SR's role in the STAR*D trial?

The STARD trial (Sequenced Treatment Alternatives to Relieve Depression) was the largest effectiveness study of antidepressant treatment ever conducted, enrolling over 4,000 adults with non-psychotic major depression across primary care and psychiatric outpatient settings. The QIDS-SR was the primary self-report outcome measure used throughout STARD, allowing patients to track their own symptom trajectories between clinician visits. STAR*D established benchmarks for depression remission (typically QIDS-SR ≤5) and response (≥50% reduction), and its findings (including the low rate of remission with a single treatment step) shaped contemporary understanding of treatment-resistant depression and the need for systematic measurement-based care.

Does HiBoop support the QIDS-SR?

Yes. HiBoop supports QIDS-SR16 digital administration with automated domain scoring: correctly applying the max-within-domain logic across all 9 criteria. Clinicians see the total score, individual domain scores, and severity band alongside longitudinal trend charts. The QIDS-SR can be tracked alongside the PHQ-9, MADRS, or any other depression measure in HiBoop's measurement-based care platform, supporting systematic treatment monitoring consistent with the STAR*D methodology.

Additional Context

The QIDS-SR16 is a 16-item validated self-report measure covering all 9 DSM depression symptom criteria. Domain scoring (max of related items) yields a 0–27 total. More detailed than the PHQ-9, widely used in treatment-resistant depression research including the STAR*D trial.

The Quick Inventory of Depressive Symptomatology: Self-Report (QIDS-SR16) was developed by John Rush, Madhukar Trivedi, and colleagues at the University of Texas Southwestern Medical Center (2003). It was designed to assess the full breadth of major depressive disorder as defined by DSM-IV, covering all nine symptom criteria with greater clinical granularity than shorter screening tools.

The QIDS-SR uses 16 items to assess 9 symptom domains: sleep disturbance (4 items), sad mood, appetite/weight changes (4 items), concentration, self-view, suicidal ideation, interest, energy/fatigue, and psychomotor changes (2 items). Within each domain, the highest item score is used. This domain scoring approach means the total ranges from 0 to 27 rather than a simple sum of all 16 items.

The QIDS-SR is free for clinical and research use with no copyright restrictions. It achieved particular prominence through its use in the STAR*D trial (Sequenced Treatment Alternatives to Relieve Depression), the largest effectiveness trial ever conducted for major depression. It is commonly used alongside the PHQ-9 to provide a fuller picture of depressive severity.

Rate how you have felt over the past week. Answer all 16 items to see your domain score.

Item 5 (Sad Mood): Rate depressed mood over the past week, from 0 (not sad) to 3 (sad nearly all of the time).

Answer both the appetite and the weight items that apply to you. Answer the other pair with 0 (no change). Domain 3 uses the highest score among items 6–9.

Item 10 (Concentration): Difficulty concentrating or making decisions, from 0 (no change) to 3 (cannot concentrate at all).

Item 11 (Self-View): Negative self-perception, from 0 (normal self-regard) to 3 (constant preoccupation with personal defects).

If you are in crisis, contact the 988 Suicide & Crisis Lifeline by calling or texting 988: free, confidential, 24/7.

12. Rate thoughts of death or suicide: 0 = no thoughts of suicide or dying; 1 = feel that life is empty or wonder if it's worth living; 2 = think of suicide or death several times a week for several minutes; 3 = think of suicide or death several times a day in some detail, or have made a plan or attempt.

Item 13 (General Interest): Anhedonia and loss of interest, from 0 (no change) to 3 (virtually no interest in formerly enjoyed activities).

Item 14 (Energy): Physical fatigue, from 0 (no change) to 3 (unable to carry out usual daily activities).

Domain Scores (9 criteria)

Educational reference only. Cannot diagnose or replace clinical evaluation.

Rush et al. (2003) severity bands. Total score = sum of the 9 domain scores (range 0–27). Domain score = highest item within each domain.

Unlike the PHQ-9 (a simple sum), the QIDS-SR uses domain scoring: within each of the 9 DSM symptom domains, only the highest item score contributes to the total.

Items 1–4 assess four distinct sleep problems: trouble falling asleep, waking in the night, early morning waking, and sleeping too much. Domain score = max(items 1–4).

Item 5 alone: the core subjective depressed mood criterion. Rated 0 (not sad) to 3 (sad nearly all the time).

Items 6–9 cover decreased appetite, increased appetite, weight loss, and weight gain. Only one direction is typically elevated. Domain score = max(items 6–9).

Item 10 alone: difficulty focusing, making decisions, or remembering. 0 = no difficulty; 3 = cannot concentrate at all.

Item 11: negative self-perception ranging from normal self-regard (0) to constant preoccupation with defects (3).

Item 12: ranges from no thoughts of death (0) to daily suicidal ideation (3). Any score >0 requires clinical follow-up.

Item 13: anhedonia / loss of interest in usual activities. 0 = no change; 3 = no interest in anything previously enjoyed.

Item 14: physical energy depletion. 0 = no change; 3 = unable to carry out most activities due to fatigue.

Items 15–16 assess slowing and agitation. Take the higher of the two. Domain score = max(item 15, item 16).

Scoring Formula

Total QIDS-SR = D1 + D2 + D3 + D4 + D5 + D6 + D7 + D8 + D9

Where each Dn is the maximum item score within that domain. The maximum possible score is 3 × 9 = 27. The minimum is 0. This domain approach means that having both insomnia and hypersomnia does not double-count; only the more severe direction counts.

Both tools screen for major depression, but they differ in depth, scoring method, and clinical use case.

Automated domain scoring, trend visualization, and clinical documentation for every patient: QIDS-SR alongside PHQ-9 and MADRS.