PHQ-15 (Patient Health Questionnaire-15)

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The Patient Health Questionnaire–15 (PHQ-15) is a brief, self-report tool used to screen for somatic symptom severity—physical symptoms that may or may not have an identifiable medical cause. It helps clinicians identify clients experiencing significant bodily distress and determine whether these symptoms may be associated with somatic symptom disorder, depression, anxiety, or stress-related conditions.

Developed as part of the PHQ suite, the PHQ-15 has strong validation for primary care, mental health, and integrated behavioural medicine settings, especially where unexplained medical symptoms are common.

Recommended Frequency: Every 4–8 weeks for symptom monitoring or when somatic concerns persist

About the PHQ-15

The PHQ-15 consists of 15 common physical symptoms, including:

  • Fatigue
  • Sleep problems
  • Pain (back, limbs, stomach, chest, head)
  • Digestive issues
  • Dizziness
  • Shortness of breath
  • Sexual and menstrual problems

Clients rate how much each symptom bothered them over the past 4 weeks, using a 3-point scale:

  • 0 = Not bothered at all
  • 1 = Bothered a little
  • 2 = Bothered a lot

The scale does not differentiate between medically explained and unexplained symptoms—making it ideal for exploring subjective symptom burden and its impact on functioning.

Who is the PHQ-15 For?

The PHQ-15 is best suited for clients experiencing multiple physical symptoms, particularly when:

  • Medical workups do not fully explain the client’s level of distress
  • There’s a suspected link between physical symptoms and emotional health
  • Clients are describing exhaustion, pain, or bodily dysfunction without clear physical etiology
  • There’s potential for somatic symptom disorder, functional syndromes, or high levels of health-related anxiety

It is also commonly used alongside PHQ-9 and GAD-7 to understand mind-body interactions.

The Scale

Clients respond to 15 physical symptoms, indicating how much each has bothered them in the past month.

Example items:

  • “Stomach pain”
  • “Feeling tired or having low energy”
  • “Pain in arms, legs, or joints”
  • “Trouble sleeping”

HiBoop displays the total score and flags functional impairment based on severity thresholds.

Scoring the PHQ-15

Scores range from 0 to 30. Each item is scored 0–2 and summed.

Score Range

0–4: Minimal - Likely not clinically significant

5–9: Low - Mild somatic symptom burden

10–14: Medium - Moderate symptom severity; monitor or evaluate

15–30: High - Severe symptom burden; further assessment needed

A score of 10 or more is often used as a cutoff for somatization and warrants further inquiry into emotional distress, medical rule-outs, and functional impact.

HiBoop can surface patterns over time, track somatic burden alongside mood scales, and alert clinicians when symptom clusters worsen despite other improvement.

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TIP FOR PRACTICE

Don’t dismiss physical symptoms as “just psychological.” Instead, explore how clients interpret and experience their symptoms. Validation, psychoeducation, and mind-body integration are key for trust and therapeutic progress.

The PHQ-15 in Practice

This tool is helpful for:

  • Integrating behavioral health into medical settings
  • Working with clients who emphasize physical over emotional symptoms
  • Tracking symptom clusters over time during stressful life events or trauma processing
  • Supporting diagnosis and treatment planning for Somatic Symptom Disorder, Health Anxiety, or Functional Neurological Symptom Disorder

In HiBoop, PHQ-15 results can be cross-referenced with mood scales (PHQ-9, GAD-7) or used to prompt physical health or psychophysiology-focused interventions.

Copyright

The PHQ-15 is part of the PHQ family of assessments, developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke, and colleagues. It is free to use for clinical and research purposes.

References

  • Kroenke, K., Spitzer, R. L., & Williams, J. B. W. (2002). The PHQ-15: Validity of a new measure for evaluating the severity of somatic symptoms. Psychosomatic Medicine, 64(2), 258–266.
  • American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.)

Disclaimer

The PHQ-15 is a validated symptom burden scale. It does not diagnose medical or mental health conditions, and it should always be interpreted in the context of clinical interviews, medical history, and functional impact.

Permissions

The PHQ-15 (Somatic Symptom Assessment) was released for public use by Pfizer. HiBoop may include digital delivery and scoring functionality without a licensing agreement, with attribution to Pfizer and Spitzer et al.

Frequently Asked Questions

  • Can the PHQ-15 be used for treatment monitoring?

    Yes. Repeating the PHQ-15 every few weeks can help track how symptom severity changes with stress, treatment, or life events.

  • What should I do if the PHQ-15 is high but mood scales are low?

    Explore health anxiety, trauma, somatization, or undiagnosed medical issues. Ask about stress, beliefs about illness, and symptom meaning.

  • Can I use the PHQ-15 for teens?

    It is validated for adults, though use in adolescents may be considered with clinical judgment.

  • How is it different from the PHQ-9?

    PHQ-9 screens for depressive symptoms; PHQ-15 focuses on physical symptoms regardless of mood. They complement each other.

  • What does a high score mean if the client has a known medical condition?

    Even medically explained symptoms can cause distress. The PHQ-15 is still useful to track impact and severity, especially in integrated care.

  • Does the PHQ-15 diagnose somatic symptom disorder?

    No. It screens for symptom burden, not diagnosis. Clinical assessment is needed to determine whether symptoms are disproportionate or medically unexplained.