You answered 15 questions about physical symptoms—things like headaches, stomach problems, fatigue, and pain—and got a score between 0 and 30. The PHQ-15 measures your "somatic symptom burden": how much physical symptoms are affecting your life. Here's what your score means.
The quick answer
| Score | Severity | What it suggests |
|---|---|---|
| 0-4 | Minimal | Physical symptoms aren't significantly affecting you |
| 5-9 | Low | Some symptom burden; monitoring may be helpful |
| 10-14 | Medium | Moderate symptom burden; evaluation recommended |
| 15-30 | High | Significant symptom burden; comprehensive evaluation needed |
A score of 10 or higher suggests your physical symptoms are substantial enough to warrant further evaluation—both to check for medical causes and to assess whether psychological factors might be contributing.
What the PHQ-15 actually measures
The PHQ-15 doesn't try to diagnose any specific condition. Instead, it measures something simpler: how much 15 common physical symptoms are bothering you.
The 15 symptoms cover several body systems:
1. Stomach pain
2. Back pain
3. Pain in arms, legs, or joints
4. Menstrual problems (women only)
5. Headaches
6. Chest pain
7. Dizziness
8. Fainting spells
9. Heart pounding or racing
10. Shortness of breath
11. Pain during sexual intercourse
12. Constipation, loose bowels, or diarrhea
13. Nausea, gas, or indigestion
14. Feeling tired or low energy
15. Trouble sleeping
For each symptom, you rate how much it's bothered you over the past 4 weeks: not at all (0), a little (1), or a lot (2).
Why physical symptoms matter for mental health
Here's something important: physical symptoms and mental health are deeply connected.
Physical symptoms often accompany depression and anxiety. People with depression commonly report fatigue, sleep problems, and pain. People with anxiety often experience heart pounding, shortness of breath, and dizziness. These aren't "fake" symptoms—they're real physical experiences that occur alongside psychological distress.
Stress shows up in the body. Chronic stress can cause headaches, muscle tension, digestive problems, and fatigue. Your body keeps score of what your mind is experiencing.
Sometimes physical symptoms are the main complaint. Some people experience depression or anxiety primarily through physical symptoms rather than feeling "sad" or "anxious." This is called somatization—and it's common, not unusual.
The PHQ-15 helps identify when physical symptoms are significant, regardless of what's causing them.
What to do based on your score
Score 0-4 (minimal symptoms)
Your physical symptoms aren't causing significant distress. This is a good baseline—you're not heavily burdened by somatic complaints right now.
Score 5-9 (low symptom burden)
You have some physical symptoms, but they're at a manageable level. Consider:
- Monitoring whether symptoms improve, stay stable, or worsen
- Basic self-care: sleep, exercise, stress management
- Mentioning persistent symptoms to your doctor at your next visit
Score 10-14 (medium symptom burden)
Your symptoms are moderate and likely affecting your quality of life. This score suggests:
- A medical evaluation to check for treatable causes
- Mental health screening (depression and anxiety often accompany high PHQ-15 scores)
- Discussion with a healthcare provider about what's driving the symptoms
Score 15-30 (high symptom burden)
Your physical symptoms are substantial. At this level:
- Comprehensive medical evaluation is warranted
- Mental health assessment is strongly recommended
- Integrated care (addressing both physical and psychological factors) often helps most
- Don't assume it's "all in your head"—but don't assume it's purely physical either
What the PHQ-15 doesn't tell you
It doesn't distinguish between "explained" and "unexplained" symptoms. A high score could mean you have a medical condition causing real symptoms, a psychological condition manifesting physically, or both. The PHQ-15 measures burden, not cause.
It doesn't diagnose anything. A high score isn't a diagnosis of somatic symptom disorder, fibromyalgia, or any other condition. It's a signal that symptoms need attention.
It measures "bothered by," not "presence of." Someone might have mild headaches they barely notice (score 0) while another person is greatly distressed by the same symptom (score 2). The PHQ-15 captures impact, not just occurrence.
The mind-body connection
Many people worry that being told their symptoms might have a psychological component means they're being dismissed—that the doctor thinks they're making it up.
This fear is understandable but based on a false premise.
Physical symptoms caused or worsened by stress, anxiety, or depression are real symptoms. When your heart races during a panic attack, it's really racing. When chronic stress gives you headaches, those headaches really hurt. When depression causes fatigue, you're really exhausted.
The goal isn't to prove symptoms are "real" or "fake." The goal is to find what helps. For many people with high PHQ-15 scores, the answer involves addressing both physical and psychological factors.
Common questions
I have a medical condition. Does that explain my score?
Possibly. The PHQ-15 doesn't distinguish between symptoms from diagnosed conditions and unexplained symptoms. If you have chronic pain, IBS, or another medical condition, your score will reflect that. This is still useful information—it quantifies your symptom burden regardless of cause.
My doctor gave me this questionnaire. Does that mean they think it's in my head?
No. The PHQ-15 is part of comprehensive primary care screening. It helps identify patients who might benefit from additional evaluation or integrated care. It's not a test for "imaginary" problems.
I scored high but my medical tests are normal. Now what?
Normal test results don't mean your symptoms aren't real. They mean certain medical causes have been ruled out. The next step is often exploring whether stress, depression, anxiety, or other factors might be contributing—and finding treatments that help regardless of cause.
Can physical symptoms really be caused by stress or emotions?
Yes. The connection between mind and body is well-established. Stress hormones affect every organ system. Depression changes how the brain processes pain signals. Anxiety activates the same nervous system responses as physical danger. This isn't weakness or imagination—it's physiology.
Should I also take depression and anxiety screens?
Often, yes. The PHQ-15 is frequently paired with the PHQ-9 (depression) and GAD-7 (anxiety) because these conditions commonly co-occur with high somatic symptom burden. If one screen is elevated, checking the others provides a fuller picture.
Tracking over time
The PHQ-15 is useful for monitoring symptom burden during treatment:
- Change of 3+ points: Represents meaningful change (not just measurement fluctuation)
- Monthly assessment: Recommended during active treatment
- Tracking patterns: Notice whether certain symptoms improve while others persist
This helps you and your provider see what's working and what needs adjustment.
When symptoms are severe
Some symptoms require immediate medical attention regardless of your score:
- Chest pain with shortness of breath
- Fainting without clear cause
- Severe abdominal pain
- New neurological symptoms
The PHQ-15 is a screening tool, not a substitute for urgent medical evaluation when symptoms warrant it.
The bottom line
Your PHQ-15 score reflects how much physical symptoms are affecting your life. Scores of 0-9 suggest minimal to low burden. Scores of 10 or higher indicate moderate to high symptom burden warranting further evaluation—both medical and psychological. Physical symptoms often have multiple contributing factors, and the most effective treatment addresses all of them. A high score isn't a judgment; it's information that can guide you toward feeling better.
Related assessments
- PHQ-9 — Depression screening (often co-occurs with high somatic symptoms)
- GAD-7 — Anxiety screening
- DASS-21 — Combined depression, anxiety, and stress
- PHQ-4 — Ultra-brief combined depression and anxiety screen