Instructional Emphasis and PHQ-9 and GAD-7 Scores Among Participants With Anxiety or Depression

Does emphasizing instructional wording influence Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) symptom scores?In this randomized clinical trial of 200 adults with depression or anxiety, emphasizing the word in questionnaire instructions produced significant reductions in PHQ-9 and GAD-7 scores compared with standard administration.The findings of this study suggest that small, naturalistic differences in instruction delivery may affect mental health screening results, highlighting the importance of standardized administration across clinical and digital settings.

Corresponding Author: Sean D. Young, PhD, Department of Emergency Medicine, School of Medicine, University of California, Irvine, 6091 Bren Hall, Irvine, CA 92617 (syoung5@hs.uci.edu).

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