Compare the PHQ-9, GAD-7, and PCL-5 mental health assessments. The PHQ-9 measures depression severity (9 items, score 0-27, cutoff ≥10). The GAD-7 measures generalized anxiety (7 items, score 0-21, cutoff ≥10). The PCL-5 measures PTSD symptoms (20 items, score 0-80, cutoff 31-33). Use the PHQ-9 and GAD-7 together in primary care and outpatient settings. Use the PCL-5 for patients with trauma history.
PHQ-9 vs GAD-7 vs PCL-5
When to Use Each
Three of the most widely used validated assessments in mental health, compared side by side. Know which tool to reach for and when.
Side-by-Side Comparison
| Feature | PHQ-9 | GAD-7 | PCL-5 |
|---|---|---|---|
| Measures | Depression severity | Anxiety severity | PTSD symptoms |
| Questions | 9 | 7 | 20 |
| Score Range | 0 – 27 | 0 – 21 | 0 – 80 |
| Clinical Cutoff | ≥ 10 | ≥ 10 | 31–33 |
| Rating Scale | 0 = Not at all, 3 = Nearly every day | 0 = Not at all, 3 = Nearly every day | 0 = Not at all, 4 = Extremely |
| Timeframe | Past 2 weeks | Past 2 weeks | Past month |
| Completion Time | 2–3 min | 2–3 min | 5–10 min |
| DSM-5 Aligned | |||
| Free to use, no permission needed | |||
| Primary Use | Screening + MBC monitoring | Screening + MBC monitoring | Assessment support + trauma monitoring |
| Often Used With | GAD-7, PHQ-2, ASRS | PHQ-9, AUDIT | C-SSRS, LEC-5 |
| HiBoop Assessment | Open | Open | Open |
When to Use Each Assessment
Choosing the right tool for the right patient at the right time is the foundation of effective measurement-based care.
PHQ-9
Use the PHQ-9 when your clinical concern is depression. Ideal for:
- Primary care intake screening
- Routine MBC monitoring for MDD
- Evaluating antidepressant response
- Perinatal / postpartum screening
- Combined with GAD-7 for comorbid screening
Score ≥ 10 = moderate depression, clinical action recommended.
Item 9 ≥ 1 = suicidal ideation, immediate safety evaluation required.GAD-7
Use the GAD-7 when your clinical concern is anxiety. Ideal for:
- Screening for generalized anxiety disorder
- Monitoring anxiety alongside PHQ-9
- Detecting panic disorder and social anxiety
- Integrated primary care workflows
- Population health screening programs
Score ≥ 10 = moderate anxiety, consider treatment.
Score ≥ 15 = severe anxiety, active intervention recommended.PCL-5
Use the PCL-5 when your clinical concern is trauma / PTSD. Ideal for:
- Patients with known trauma history
- Veterans and military populations
- Residential and IOP treatment programs
- Monitoring CPT and PE treatment response
- Combined with C-SSRS for high-risk patients
Score 31–33 = provisional PTSD, clinical interview recommended.
Reliable change = 5–10 point reduction from baseline.
Using the PHQ-9 and GAD-7 Together
The PHQ-9 and GAD-7 are frequently administered together because depression and anxiety are highly comorbid, up to 60% of patients with major depression also meet criteria for an anxiety disorder. Both tools share the same 4-point rating scale and 2-week timeframe, making paired administration natural.
In measurement-based care workflows, running both tools at intake and every 4 weeks provides a detailed picture of the most common outpatient mental health presentations in under 5 minutes of patient time.
Combined Use Cases
- • Primary care integrated behavioural health
- • Collaborative care models (IMPACT, DIAMOND)
- • Outpatient therapy intake batteries
- • University and college counselling centers
Scoring Tip
When both PHQ-9 ≥ 10 and GAD-7 ≥ 10, the clinical picture warrants evaluation of both MDD and GAD. A PHQ-9 elevated alone suggests pure depression; GAD-7 elevated alone suggests pure anxiety.
Scoring Interpretation at a Glance
PHQ-9 Score Guide
0–4Minimal / NoneNo action5–9MildMonitor10–14ModerateTreat15–19Mod. SevereActive Tx20–27ElevatedUrgentGAD-7 Score Guide
0–4MinimalNo action5–9MildMonitor10–14ModerateTreat15–21ElevatedActive TxPCL-5 Score Guide
0–30Below cutoffMonitor31–33ProvisionalInterview34–80Probable PTSDReferReliable change: 5–10 pts
Clinically significant: 10–20 pts
Clinical Decision Framework
Start with the presenting concern. One question usually narrows the field.
Low mood, anhedonia, fatigue?
Patient reports persistent sadness, loss of interest, or sleep and appetite changes.
Reach forPHQ-9Depression severityWorry, nervousness, restlessness?
Patient describes uncontrollable worry, tension, or somatic anxiety symptoms.
Reach forGAD-7Anxiety severityTrauma history, hypervigilance, avoidance?
Patient has known adverse events, re-experiencing symptoms, or is in a trauma-focused program.
Reach forPCL-5PTSD severity
In most outpatient intakes, administer PHQ-9 + GAD-7 together. Add PCL-5 when trauma history is flagged.
Case Study
How CATC runs all three across three inpatient centresCanadian Addiction Treatment Centres saw high completion rates and 75% time savings by running PHQ-9, GAD-7, and PCL-5 digitally through HiBoop.
Measurement-based care
…starts with what we measure, and how long.
Send your first check-in today, with your own assessments and clients. For teams, we set up your assessments and schedules with you. Prefer a guided start? Book a demo on the next page.
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Frequently Asked Questions
What is the difference between the PHQ-9 and GAD-7?
The PHQ-9 measures depression severity across 9 DSM-5 criteria items, scored 0–27. The GAD-7 measures anxiety severity across 7 items, scored 0–21. Both use the same 0–3 rating scale and 2-week timeframe. They are frequently administered together due to the high comorbidity between depression and anxiety.
Can I use the PHQ-9 and GAD-7 at the same time?
Yes, and it is recommended. Administering both together takes under 5 minutes and captures the two most common mental health presentations. This approach is standard in collaborative care models, integrated primary care, and measurement-based care programs.
When should I use the PCL-5 instead of or in addition to the PHQ-9?
Use the PCL-5 when a patient has a known or suspected trauma history, especially if PHQ-9 scores are elevated but do not fully explain the clinical presentation. The PCL-5 is also preferred for monitoring response to trauma-focused treatments like Cognitive Processing Therapy (CPT) or Prolonged Exposure (PE).
What is a good PHQ-9 score?
A PHQ-9 score of 0–4 indicates minimal or no depression. The clinical action cutoff is 10; scores at or above this threshold are well-validated for major depression and should prompt a treatment plan.