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The PHQ-9 is a widely used self-report screening measure for depression that corresponds to the nine diagnostic symptoms of a major depressive episode. Items are scored on a 4-point scale (0 = not at all, 3 = nearly every day; total scores range from 0 to 27). A cut score ≥10 suggests the presence of clinically significant depression with favorable specificity and sensitivity. As such, PHQ-9 total score is both treated as a continuous variable and dichotomized into clinical symptoms of depres-sion (≥10) and no depression (<10).