PHQ-15: four-week physical symptom score

Overview

The PHQ-15 records how much 15 physical symptoms bothered an adult during the past four weeks. A complete form totals 0 to 30 and uses cut points at 5, 10, and 15. Survey Doctor lets everyone skip the source's women-only item, lowering the possible maximum to 28. The total cannot identify a cause or diagnosis.

Cause stays open.

Introduction

Kurt Kroenke, Robert Spitzer, and Janet Williams introduced the PHQ-15 in 2002 as part of the Patient Health Questionnaire family. The source form asks how bothered a person was by common physical symptoms.

Physical symptoms are real regardless of cause. The questionnaire should not label them as psychological or medically unexplained.

Who should take this assessment?

The PHQ-15 may help when you:

• Want a structured record of recent physical symptom burden
• Were asked by a qualified provider to use this exact form
• Are tracking the same questionnaire as part of an agreed care plan
• Need to discuss physical symptoms and their effect on daily life

Score interpretation

Each of the 15 items is rated on a 3-point scale: 0 (Not bothered at all), 1 (Bothered a little), 2 (Bothered a lot). Complete totals range from 0 to 30.

These labels summarize symptom burden. They do not rule out illness at a low score or prescribe medical or mental health care at a high score.

Use the symptoms and medical context.

Symptom categories by body system

The optional item changes the maximum

The source form labels item 4 “WOMEN ONLY.” Survey Doctor displays that label, but it does not infer eligibility from profile data. The item appears to everyone and is optional.

That changes the range.

The maxima differ.

If item 4 is skipped, Survey Doctor adds the other 14 answers without proration. The maximum is then 28. Answering all 15 items raises the maximum to 30. Survey Doctor does not convert one denominator to the other.

Totals with different item-4 status therefore need that context. Manual total entry is disabled until a source-backed missing-item and denominator policy is selected.

Administration

Answer for the past four weeks. If repeating the questionnaire is useful, choose the interval with the provider reviewing the results. The PHQ-15 itself does not prescribe monthly, per-visit, or indefinite administration.

The PHQ-15 measures how much physical symptoms are bothering you. It is not a diagnostic test and does not identify their cause. Real physical illness and stress-related symptoms both raise the score.

For a plain-language walkthrough of what each band means and what to do next, see what your PHQ-15 score means.

The seven-day DSM-5-TR version

The DSM-5-TR Level 2 Somatic Symptom Adult measure adapts the PHQ-15 to a seven-day recall period. A person usually answers it before a clinical visit. A knowledgeable informant may answer when the person cannot complete it.

The weekly form keeps 15 ratings, the 0-to-2 response scale, and the 0-to-30 total. It also keeps the minimal, low, medium, and high labels shown above.

Same range. Different window.

Its missing-answer rule is different. With one to three unanswered items, multiply the answered-item sum by 15 and divide by the number answered. Round the result to the nearest whole number. Do not calculate a total when four or more items are unanswered.

Leave the total blank.

Survey Doctor administers the original four-week form and does not prorate missing responses. A weekly DSM-5-TR total and a four-week PHQ-15 total describe different time windows. Record the version before comparing results.

Do not mix them.

Intervals matter.

What the questions measure

The questions cover pain, gastrointestinal symptoms, dizziness and fainting, cardiopulmonary sensations, sexual and menstrual symptoms, fatigue, and sleep. These topic groups are not separate scored subscales.

They are topics only.

The PHQ-15 does not distinguish medically explained from unexplained symptoms. A high total does not show why symptoms occurred, and a low total does not make an individual symptom unimportant.

Using the result

Review the symptoms themselves, not just the sum. Which answers changed? Which symptoms interfere with daily life? Are any new, severe, or otherwise concerning?

Start there.

A qualified healthcare professional can consider medical history, examination, other symptoms, medicines, and mental health alongside the questionnaire. The PHQ-15 total does not decide which evaluation or treatment is appropriate.

The sum is secondary.

Low mood and anxiety require their own questions. The PHQ-9 and GAD-7 produce separate symptom totals, not PHQ-15 subscales.

When to seek help

Do not wait for a PHQ-15 category when a symptom is new, severe, rapidly worsening, or otherwise concerning. Seek care according to the symptom and your health circumstances. The total cannot determine urgency.

Urgency is separate.

Evidence and limitations

Survey Doctor implements the original four-week adult PHQ-15, not the separate seven-day DSM-5 Level 2 somatic symptom adaptation. Those forms use different instructions and missing-item rules and must not be merged.

The 2002 validation paper studied 6,000 adult patients from eight primary-care or family-practice clinics and seven obstetrics-gynecology clinics. It supports the 5, 10, and 15 symptom-severity cut points for a complete PHQ-15.

That study does not establish Survey Doctor's optional-item denominator. It also does not turn the cut points into automatic medical workup, treatment, utilization, or case-management rules.

Important considerations

The PHQ-15 records how bothered someone was, not simply whether a symptom occurred. It omits many possible symptoms and does not measure functional impairment directly. Fatigue and sleep items can overlap with other questionnaires, but overlap does not reveal a cause.

Interpret the result with the four-week timeframe, item-4 completion status, medical context, and reason for assessment. Do not compare a 14-item raw sum with a 15-item raw sum as though their attainable ranges were identical.