English

BRIEF PATIENT HEALTH QUESTIONNAIRE (Brief PHQ)

1 forms  
General information
Description

General information

Alias
UMLS CUI-1
C1508263
Name
Description

Name

Data type

text

Alias
UMLS CUI [1]
C0027365
Age
Description

Age

Data type

integer

Alias
UMLS CUI [1]
C0001779
Sex
Description

Sex

Data type

text

Alias
UMLS CUI [1]
C0079399
Today's Date
Description

Date

Data type

date

Alias
UMLS CUI [1]
C0011008
1. Over the last 2 weeks, how often have you been bothered by any of the following problems?
Description

1. Over the last 2 weeks, how often have you been bothered by any of the following problems?

Alias
UMLS CUI-1
C0436350
UMLS CUI-2
C1442457
a. Little interest or pleasure in doing things
Description

Reduced interest in usual activities

Data type

integer

Alias
UMLS CUI [1]
C0860654
b. Feeling down, depressed, or hopeless
Description

Depression

Data type

integer

Alias
UMLS CUI [1]
C0011581
c. Trouble falling or staying asleep, or sleeping too much
Description

Sleep disturbance

Data type

integer

Alias
UMLS CUI [1]
C0037317
d. Feeling tired or having little energy
Description

Fatigue frequency

Data type

integer

Alias
UMLS CUI [1]
C0015672
e. Poor appetite or overeating
Description

Appetite Disorder

Data type

integer

Alias
UMLS CUI [1]
C0003621
6. Feeling bad about yourself, or that you are a failure, or have let yourself or your family down
Description

Inferiority complex

Data type

integer

Alias
UMLS CUI [1]
C0854366
g. Trouble concentrating on things, such as reading the newspaper or watching television
Description

Concentration difficulty

Data type

integer

Alias
UMLS CUI [1]
C0235198
h. Moving or speaking so slowly that other people could have noticed. Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual
Description

Slowed down or restless

Data type

integer

Alias
UMLS CUI [1,1]
C0424114
UMLS CUI [1,2]
C0237280
i. Thoughts that you would be better off dead, or of hurting yourself in some way
Description

Suicidal

Data type

integer

Alias
UMLS CUI [1]
C0438696
2. Questions about anxiety.
Description

2. Questions about anxiety.

Alias
UMLS CUI-1
C0003467
a. In the last 4 weeks, have you had an anxiety attack – suddenly feeling fear or panic?
Description

If you checked “NO”, go to question 3.

Data type

boolean

Alias
UMLS CUI [1]
C0700031
b. Has this ever happened before?
Description

Anxiety attack before

Data type

boolean

Alias
UMLS CUI [1,1]
C0700031
UMLS CUI [1,2]
C0332152
c. Do some of these attacks come suddenly out of the blue – that is, in situations where you don’t expect to be nervous or uncomfortable?
Description

Unexpected panic attack

Data type

boolean

Alias
UMLS CUI [1]
C0395002
d. Do these attacks bother you a lot or are you worried about having another attack?
Description

Anxiety attack, severe

Data type

boolean

Alias
UMLS CUI [1,1]
C0700031
UMLS CUI [1,2]
C0205082
e. During your last bad anxiety attack, did you have symptoms like shortness of breath, sweating, your heart racing or pounding, dizziness or faintness, tingling or numbness, or nausea or upset stomach?
Description

Somatic symptoms during anxiety attack

Data type

boolean

Alias
UMLS CUI [1,1]
C3839861
UMLS CUI [1,2]
C0700031
Problems with activities of daily living
Description

Problems with activities of daily living

Alias
UMLS CUI-1
C0001288
UMLS CUI-2
C0033213
If you checked off any problems on this questionnaire so far, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
Description

Problems with activities of daily living

Data type

integer

Alias
UMLS CUI [1,1]
C0001288
UMLS CUI [1,2]
C0033213
4. In the last 4 weeks, how much have you been bothered by any of the following problems?
Description

4. In the last 4 weeks, how much have you been bothered by any of the following problems?

a. Worrying about your health
Description

Worries about health

Data type

integer

Alias
UMLS CUI [1,1]
C0233481
UMLS CUI [1,2]
C0018759
b. Your weight or how you look
Description

Worries about weight or appearance

Data type

integer

Alias
UMLS CUI [1,1]
C0233481
UMLS CUI [1,2]
C0005910
UMLS CUI [2,1]
C0233481
UMLS CUI [2,2]
C0423989
c. Little or no sexual desire or pleasure during sex
Description

Difficulties with sexual life

Data type

integer

Alias
UMLS CUI [1,1]
C1299586
UMLS CUI [1,2]
C0011124
d. Difficulties with husband/wife, partner/lover, or boyfriend/girlfriend
Description

Difficulties with partner

Data type

integer

Alias
UMLS CUI [1]
C0236858
e. The stress of taking care of children, parents, or other family members
Description

Taking care of others as stressor

Data type

integer

Alias
UMLS CUI [1,1]
C2184152
UMLS CUI [1,2]
C0038435
f. Stress at work outside of the home or at school
Description

Stress at work or school

Data type

integer

Alias
UMLS CUI [1]
C0558919
UMLS CUI [2,1]
C0038435
UMLS CUI [2,2]
C0580094
g. Financial problems or worries
Description

Financial problems or worries

Data type

integer

Alias
UMLS CUI [1]
C0549106
h. Having no one to turn to when you have a problem
Description

No one to turn to in case of problems

Data type

integer

Alias
UMLS CUI [1,1]
C0033964
UMLS CUI [1,2]
C2111017
i. Something bad that happened recently
Description

Recent negative life event

Data type

integer

Alias
UMLS CUI [1,1]
C1822593
UMLS CUI [1,2]
C0332185
j. Thinking or dreaming about something terrible that happened to you in the past—like your house being destroyed, a severe accident, being hit or assaulted, or being forced to commit a sexual act
Description

Stress due to traumatic experience

Data type

integer

Alias
UMLS CUI [1,1]
C0231288
UMLS CUI [1,2]
C0038443
Past and current stress
Description

Past and current stress

5. In the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone, or has anyone forced you to have an unwanted sexual act?
Description

Experience of physical violence in last year

Data type

boolean

Alias
UMLS CUI [1]
C2711168
6. What is the most stressful thing in your life right now?
Description

Most stressful thing in life currently

Data type

text

Alias
UMLS CUI [1,1]
C0038444
UMLS CUI [1,2]
C0521116
7. Are you taking any medication for anxiety, depression, or stress?
Description

Medication for anxiety, depression, or stress

Data type

boolean

Alias
UMLS CUI [1]
C0003289
UMLS CUI [2]
C0597318
8. FOR WOMEN ONLY: Questions about menstruation, pregnancy, and childbirth.
Description

8. FOR WOMEN ONLY: Questions about menstruation, pregnancy, and childbirth.

a. Which best describes your menstrual periods?
Description

Description of menstrual periods

Data type

integer

Alias
UMLS CUI [1,1]
C0025344
UMLS CUI [1,2]
C0678257
b. During the week before your period starts, do you have a serious problem with your mood—like depression, anxiety, irritability, anger, or mood swings?
Description

No=No or does not apply

Data type

boolean

Alias
UMLS CUI [1]
C0857183
c. If YES, do these problems go away by the end of your period?
Description

No=No or does not apply

Data type

boolean

Alias
UMLS CUI [1]
C0857183
d. Have you given birth within the last 6 months?
Description

No=No or does not apply

Data type

boolean

Alias
UMLS CUI [1,1]
C0086839
UMLS CUI [1,2]
C3828652
e. Have you had a miscarriage within the last 6 months?
Description

No=No or does not apply

Data type

boolean

Alias
UMLS CUI [1,1]
C3828652
UMLS CUI [1,2]
C0438080
f. Are you having difficulty getting pregnant?
Description

No=No or does not apply

Data type

boolean

Alias
UMLS CUI [1]
C0021359
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Similar models

BRIEF PATIENT HEALTH QUESTIONNAIRE (Brief PHQ)

1 forms
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
General information
C1508263 (UMLS CUI-1)
Name
Item
Name
text
C0027365 (UMLS CUI [1])
Age
Item
Age
integer
C0001779 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Sex
Code List
Sex
CL Item
Female (Female)
CL Item
Male (Male)
Date
Item
Today's Date
date
C0011008 (UMLS CUI [1])
Item Group
1. Over the last 2 weeks, how often have you been bothered by any of the following problems?
C0436350 (UMLS CUI-1)
C1442457 (UMLS CUI-2)
Item
a. Little interest or pleasure in doing things
integer
C0860654 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
a. Little interest or pleasure in doing things
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
b. Feeling down, depressed, or hopeless
integer
C0011581 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
b. Feeling down, depressed, or hopeless
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
c. Trouble falling or staying asleep, or sleeping too much
integer
C0037317 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
c. Trouble falling or staying asleep, or sleeping too much
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
d. Feeling tired or having little energy
integer
C0015672 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
d. Feeling tired or having little energy
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
e. Poor appetite or overeating
integer
C0003621 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
e. Poor appetite or overeating
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
6. Feeling bad about yourself, or that you are a failure, or have let yourself or your family down
integer
C0854366 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
6. Feeling bad about yourself, or that you are a failure, or have let yourself or your family down
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
g. Trouble concentrating on things, such as reading the newspaper or watching television
integer
C0235198 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
g. Trouble concentrating on things, such as reading the newspaper or watching television
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
h. Moving or speaking so slowly that other people could have noticed. Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual
integer
C0424114 (UMLS CUI [1,1])
C0237280 (UMLS CUI [1,2])
Nervousness, anxiety, or tension
Code List
h. Moving or speaking so slowly that other people could have noticed. Or the opposite — being so fidgety or restless that you have been moving around a lot more than usual
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item
i. Thoughts that you would be better off dead, or of hurting yourself in some way
integer
C0438696 (UMLS CUI [1])
Nervousness, anxiety, or tension
Code List
i. Thoughts that you would be better off dead, or of hurting yourself in some way
CL Item
Not at all (0)
C2984077 (UMLS CUI-1)
CL Item
Several days (1)
C3844034 (UMLS CUI-1)
CL Item
More than half the days (2)
C3828960 (UMLS CUI-1)
CL Item
Nearly every day (3)
C3845713 (UMLS CUI-1)
Item Group
2. Questions about anxiety.
C0003467 (UMLS CUI-1)
Anxiety attack
Item
a. In the last 4 weeks, have you had an anxiety attack – suddenly feeling fear or panic?
boolean
C0700031 (UMLS CUI [1])
Anxiety attack before
Item
b. Has this ever happened before?
boolean
C0700031 (UMLS CUI [1,1])
C0332152 (UMLS CUI [1,2])
Unexpected panic attack
Item
c. Do some of these attacks come suddenly out of the blue – that is, in situations where you don’t expect to be nervous or uncomfortable?
boolean
C0395002 (UMLS CUI [1])
Anxiety attack, severe
Item
d. Do these attacks bother you a lot or are you worried about having another attack?
boolean
C0700031 (UMLS CUI [1,1])
C0205082 (UMLS CUI [1,2])
Somatic symptoms during anxiety attack
Item
e. During your last bad anxiety attack, did you have symptoms like shortness of breath, sweating, your heart racing or pounding, dizziness or faintness, tingling or numbness, or nausea or upset stomach?
boolean
C3839861 (UMLS CUI [1,1])
C0700031 (UMLS CUI [1,2])
Item Group
Problems with activities of daily living
C0001288 (UMLS CUI-1)
C0033213 (UMLS CUI-2)
Item
If you checked off any problems on this questionnaire so far, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
integer
C0001288 (UMLS CUI [1,1])
C0033213 (UMLS CUI [1,2])
Problems with activities of daily living
Code List
If you checked off any problems on this questionnaire so far, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
CL Item
Not difficult at all (0)
C3845941 (UMLS CUI-1)
CL Item
Somewhat difficult (1)
C3829283 (UMLS CUI-1)
CL Item
Very difficult (2)
C3845317 (UMLS CUI-1)
CL Item
Extremely difficult (3)
C3845947 (UMLS CUI-1)
Item Group
4. In the last 4 weeks, how much have you been bothered by any of the following problems?
Item
a. Worrying about your health
integer
C0233481 (UMLS CUI [1,1])
C0018759 (UMLS CUI [1,2])
Worries about health
Code List
a. Worrying about your health
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
b. Your weight or how you look
integer
C0233481 (UMLS CUI [1,1])
C0005910 (UMLS CUI [1,2])
C0233481 (UMLS CUI [2,1])
C0423989 (UMLS CUI [2,2])
Worries about health
Code List
b. Your weight or how you look
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
c. Little or no sexual desire or pleasure during sex
integer
C1299586 (UMLS CUI [1,1])
C0011124 (UMLS CUI [1,2])
Worries about health
Code List
c. Little or no sexual desire or pleasure during sex
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
d. Difficulties with husband/wife, partner/lover, or boyfriend/girlfriend
integer
C0236858 (UMLS CUI [1])
Worries about health
Code List
d. Difficulties with husband/wife, partner/lover, or boyfriend/girlfriend
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
e. The stress of taking care of children, parents, or other family members
integer
C2184152 (UMLS CUI [1,1])
C0038435 (UMLS CUI [1,2])
Worries about health
Code List
e. The stress of taking care of children, parents, or other family members
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
f. Stress at work outside of the home or at school
integer
C0558919 (UMLS CUI [1])
C0038435 (UMLS CUI [2,1])
C0580094 (UMLS CUI [2,2])
Worries about health
Code List
f. Stress at work outside of the home or at school
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
g. Financial problems or worries
integer
C0549106 (UMLS CUI [1])
Worries about health
Code List
g. Financial problems or worries
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
h. Having no one to turn to when you have a problem
integer
C0033964 (UMLS CUI [1,1])
C2111017 (UMLS CUI [1,2])
Worries about health
Code List
h. Having no one to turn to when you have a problem
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
i. Something bad that happened recently
integer
C1822593 (UMLS CUI [1,1])
C0332185 (UMLS CUI [1,2])
Worries about health
Code List
i. Something bad that happened recently
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item
j. Thinking or dreaming about something terrible that happened to you in the past—like your house being destroyed, a severe accident, being hit or assaulted, or being forced to commit a sexual act
integer
C0231288 (UMLS CUI [1,1])
C0038443 (UMLS CUI [1,2])
Worries about health
Code List
j. Thinking or dreaming about something terrible that happened to you in the past—like your house being destroyed, a severe accident, being hit or assaulted, or being forced to commit a sexual act
CL Item
Not bothered (0)
C3845941 (UMLS CUI-1)
CL Item
Bothered a little (1)
C3829283 (UMLS CUI-1)
CL Item
Bothered a lot (2)
C3829282 (UMLS CUI-1)
Item Group
Past and current stress
Experience of physical violence in last year
Item
5. In the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone, or has anyone forced you to have an unwanted sexual act?
boolean
C2711168 (UMLS CUI [1])
Most stressful thing in life currently
Item
6. What is the most stressful thing in your life right now?
text
C0038444 (UMLS CUI [1,1])
C0521116 (UMLS CUI [1,2])
Medication for anxiety, depression, or stress
Item
7. Are you taking any medication for anxiety, depression, or stress?
boolean
C0003289 (UMLS CUI [1])
C0597318 (UMLS CUI [2])
Item Group
8. FOR WOMEN ONLY: Questions about menstruation, pregnancy, and childbirth.
Item
a. Which best describes your menstrual periods?
integer
C0025344 (UMLS CUI [1,1])
C0678257 (UMLS CUI [1,2])
Description of menstrual periods
Code List
a. Which best describes your menstrual periods?
CL Item
Periods are unchanged (1)
CL Item
No periods because pregnant or recently gave birth (2)
CL Item
Periods have become irregular or changed in frequency, duration, or amount (3)
CL Item
No periods for at least a year (4)
CL Item
Having periods because taking hormone replacement (estrogen) therapy or oral contraceptives (5)
Pre-menstrual mood symptoms
Item
b. During the week before your period starts, do you have a serious problem with your mood—like depression, anxiety, irritability, anger, or mood swings?
boolean
C0857183 (UMLS CUI [1])
Disappearance of mood symptoms by end of period
Item
c. If YES, do these problems go away by the end of your period?
boolean
C0857183 (UMLS CUI [1])
Birth within the last 6 months
Item
d. Have you given birth within the last 6 months?
boolean
C0086839 (UMLS CUI [1,1])
C3828652 (UMLS CUI [1,2])
Miscarriage within the last 6 months
Item
e. Have you had a miscarriage within the last 6 months?
boolean
C3828652 (UMLS CUI [1,1])
C0438080 (UMLS CUI [1,2])
Difficulty getting pregnant
Item
f. Are you having difficulty getting pregnant?
boolean
C0021359 (UMLS CUI [1])
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