Important Nuances in Interpreting PHQ-9 and GAD-7 Scores - Summary - MDSpire

Key Considerations for Interpreting Scores from the PHQ-9 and GAD-7 Assessments

  • By

  • Kurt Kroenke

  • July 20, 2026

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Objective:

To investigate the impact of emphasizing the word 'bothered' in the instructions of the PHQ-9 and GAD-7 assessments on scores.

Approach:
  • Study Design: A randomized clinical trial involving 200 adults with depression or anxiety, assessing the influence of instructional emphasis on questionnaire scores.
  • Intervention: Participants completed the PHQ-9 and GAD-7 twice, with the second administration emphasizing 'bothered' for the intervention group.
Key Findings:
  • The intervention group showed a 2.6-point greater reduction in scores compared to the control group, as reported by Young et al.
  • The effect size was large (1.1), indicating potentially clinically meaningful differences, according to the study.
Interpretation:

The study indicates that emphasizing 'bothered' may influence scores on the PHQ-9 and GAD-7 assessments.

Limitations:
  • The emphasis on 'bothered' was only applied during the second administration, which may affect interpretation of results.
  • The study used interviewer administration, which may introduce bias compared to self-completion methods.
Conclusion:

The findings suggest the importance of instructional wording in psychometric assessments.

Sources:

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