Somatic symptoms, anxiety, and depression commonly occur together and can significantly affect overall functioning and well being. The Patient Health Questionnaire Somatic, Anxiety, & Depressive Symptoms (PHQ-SADS) is a combined screening tool that assesses physical symptoms, generalized anxiety symptoms, panic symptoms, and depressive symptoms within a single structured form. It is frequently used in primary care and mental health settings to help clinicians understand the full range of symptoms that may be contributing to a patient’s distress.
This resource page explains how the PHQ-SADS works, what each section measures, and how clinicians can use the combined scores to guide assessment. The questionnaire includes the PHQ-15 for somatic symptoms, the GAD-7 for generalized anxiety, a brief screening section for panic symptoms, and the PHQ-9 for depressive symptoms. A downloadable version of the Patient Health Questionnaire Somatic, Anxiety, & Depressive Symptoms is available for clinicians using the download resource button above.
Understanding How the PHQ-SADS Works
The PHQ-SADS combines four validated components into a single assessment. The first section, the PHQ-15, asks patients to rate how much they have been bothered by a list of fifteen physical symptoms over the past four weeks. Items shown on page 1 of the PDF include common somatic concerns such as stomach pain, back pain, headaches, dizziness, sleep difficulties, gastrointestinal problems, menstrual symptoms, shortness of breath, and fatigue.
The second section, the GAD-7, assesses generalized anxiety symptoms experienced over the past two weeks. As shown in the PDF, this includes items such as nervousness, excessive worry, trouble relaxing, restlessness, irritability, and fears that something awful might happen. The third section screens for panic symptoms by asking whether the patient has experienced sudden anxiety attacks in the past four weeks, followed by additional questions if panic symptoms are endorsed.
The final component is the PHQ-9, which evaluates depressive symptoms over the past two weeks. Items include low interest, depressed mood, sleep changes, low energy, appetite changes, feelings of worthlessness, concentration problems, psychomotor changes, and thoughts of self harm. The PDF shows that each section includes a brief scoring area, allowing clinicians to calculate individual scores alongside a global understanding of distress severity.
“Integrated mental health screening tools help clinicians recognize when symptoms occur together and support more comprehensive care planning.”
— National Institute of Mental Health
By combining multiple symptom domains into one form, the PHQ-SADS provides a broader view of patient well being and can help clinicians identify when physical symptoms, anxiety, and mood concerns may be interacting. The functional difficulty question at the end of the PHQ-SADS gives additional context about how symptoms affect work, home responsibilities, and social functioning.
Frequently Asked Questions
Physical symptoms may include headaches, stomach discomfort, muscle tension, dizziness, shortness of breath, or fatigue. These symptoms can occur even when no medical condition is present. Understanding the relationship between physical and emotional symptoms helps clinicians plan appropriate care.
Anxiety may lead to worry, restlessness, difficulty concentrating, and irritability. These symptoms can interfere with work performance, social relationships, and overall quality of life. Early recognition supports effective management.
Stress, trauma, medical illness, hormonal influences, family history, and environmental factors may all play a role. These symptom clusters can influence one another and may require a comprehensive approach to treatment.
Clinicians evaluate the pattern, duration, and impact of symptoms while also considering medical history, physical examination findings, and patient reports. Screening tools help clarify whether symptoms may relate to anxiety, mood, or both.
Treatment may include psychotherapy, lifestyle adjustments, supportive strategies, and medication classes such as antidepressants or anxiolytics when appropriate. Addressing multiple symptom domains often leads to improved overall functioning.
Conclusion
The Patient Health Questionnaire Somatic, Anxiety, & Depressive Symptoms is a practical tool that brings together assessments of physical symptoms, anxiety, panic, and depression into a single form. By organizing these components in one place, the PHQ-SADS provides a clearer understanding of how symptoms interact and influence daily functioning.
Using the PHQ-SADS during clinical assessment helps clinicians identify symptom patterns, prioritize concerns, and determine when additional evaluation or treatment adjustments may be needed. The downloadable resource includes complete instructions and scoring guidance using the download resource button above. The Patient Health Questionnaire Somatic, Anxiety, & Depressive Symptoms supports comprehensive, integrated care for individuals experiencing multiple areas of distress.
The PHQ-SADS helps clinicians understand symptom clusters, guide treatment decisions, and support whole-person care.