> ## Documentation Index
> Fetch the complete documentation index at: https://docs.getrivet.ca/llms.txt
> Use this file to discover all available pages before exploring further.
# QIDS-SR-16 — scoring and severity ranges
> How to score the Quick Inventory of Depressive Symptomatology, including the highest-item rule for the sleep, weight and psychomotor domains, and what each severity range means.
The QIDS-SR-16 is a 16-item self-report depression severity scale designed
to map directly onto DSM-IV-TR criteria for major depressive disorder.
Where the PHQ-9 collapses each DSM domain into a single item, QIDS gives
sleep, appetite/weight, and psychomotor symptoms multiple items each — so
the practitioner has tighter coverage of which symptoms are driving
severity.
## What it measures
Depression severity over the last 7 days, broken across nine DSM-IV-TR
symptom domains:
* **Sleep** — four items (initial, middle, late insomnia, hypersomnia)
* **Sad mood** — one item
* **Appetite / weight** — four items (decreased appetite, increased
appetite, weight loss, weight gain)
* **Concentration** — one item
* **Self-view** — one item
* **Suicidality** — one item
* **Interest** — one item
* **Energy** — one item
* **Psychomotor** — two items (slowing, agitation)
## When to use it
* **Outcome tracking in research-informed practice.** QIDS is widely used
in NIMH-funded studies (STAR\*D, CO-MED) and many outcome-tracking
practices prefer it for that lineage.
* **When PHQ-9's single-item-per-domain isn't enough detail.** If you
want to see which insomnia pattern is in play (initial vs middle vs
late), or whether appetite is increased or decreased, QIDS shows you
that explicitly.
* **Intake, regular monitoring, discharge.** Same cadence as PHQ-9 —
baseline, every 2–4 weeks, pre/post intervention, end of treatment.
## How clients fill it
About three to five minutes, depending on how the client thinks about
their week. The instrument asks them to pick the one statement in each
group that best describes them over the past 7 days.
## Scoring and severity cutoffs
The canonical QIDS-SR-16 total is **not** a simple sum of all 16 items.
It is the sum of the highest item rating within each of the nine DSM
symptom domains:
* Sleep: max of items 1–4
* Sad mood: item 5
* Appetite/weight: max of items 6–9
* Concentration: item 10
* Self-view: item 11
* Suicidality: item 12
* Interest: item 13
* Energy: item 14
* Psychomotor: max of items 15–16
The canonical total range is 0–27 with severity bands:
| Total | Severity |
| ----- | ----------- |
| 0–5 | None |
| 6–10 | Mild |
| 11–15 | Moderate |
| 16–20 | Severe |
| 21–27 | Very severe |
**Rivet's in-session scoring pill shows a raw all-item sum as a proxy,
not the canonical domain-max total.** The published source of truth for
the canonical QIDS-SR total is the IDS-QIDS.org scoring sheet — consult
it when you need the canonical number to put in the chart.
Item 12 (suicidality) is still flagged separately regardless of which
total you're reading.
The raw-sum proxy is useful as a live "is this moving" signal during the
fill, but the number you put in the chart should be the canonical
domain-max sum.
## Item 12 — suicidality
**Any answer above "I do not think of suicide or death" on Item 12
warrants clinical follow-up regardless of the total score.** Rivet
surfaces a flag in the scoring pill when Item 12 crosses the cutoff.
This rule is the same shape as PHQ-9's Item 9 rule — the item matters
on its own, not just as part of the total.
## When NOT to use it
* **Clients under 18.** The QIDS family was validated in adults; the
age-appropriate version for adolescents is QIDS-A17.
* **When the practitioner needs the canonical number live during the
session.** Until the domain-max calculation is computed by Rivet's
engine, the in-session pill shows a raw-sum proxy only. If you need the
canonical number in real time, the PHQ-9 is the simpler fit.
* **As a sole diagnostic instrument.** Screening, not diagnosis.
## QIDS-SR-16 vs PHQ-9
Both measure depression severity over the same two weeks, and both are
free. The difference is resolution. The QIDS gives sleep four items and
appetite and weight four more, so the profile it produces maps onto the
DSM symptom domains item by item — which is why it's the depression
measure used in a lot of treatment-outcome research. The PHQ-9 covers the
same ground in nine items and is the one an insurer, an EFAP referral or
another clinician will recognise on sight.
Reach for the QIDS when you want the domain detail and are willing to work
the domain-max calculation from the published scoring sheet. Reach for the
[PHQ-9](/clinical-templates/screening/phq-9) when you want the number
live in session and a total nobody has to interpret for you.
## Is it free to use?
**Yes — it is public domain.** Distributed at IDS-QIDS.org with explicit free clinical and research use.
## Citation
Rush, A. J., Trivedi, M. H., Ibrahim, H. M., Carmody, T. J., Arnow, B.,
Klein, D. N., Markowitz, J. C., Ninan, P. T., Kornstein, S., Manber, R.,
Thase, M. E., Kocsis, J. H., & Keller, M. B. (2003). "The 16-item Quick
Inventory of Depressive Symptomatology (QIDS), clinician rating
(QIDS-C), and self-report (QIDS-SR): a psychometric evaluation in
patients with chronic major depression." *Biological Psychiatry*, 54(5):
573–583.
Public-domain instrument distributed at IDS-QIDS.org with explicit free
clinical and research use. Rivet preserves canonical item wording verbatim.
## Related articles
The simpler depression measure if the QIDS detail isn't what you
need.
The other DSM-symptom-group-aligned depression scale in the library.
Picking between overlapping depression measures.