c) PHQ-8 (Patient Health Questionnaire-8 item)
The PHQ-9 [19] is a brief, self-administered measure of depressive symptoms, with 9 items that fit the diagnostic criteria for Major Depressive Disorder. It is free, available in all major world languages and recommended by international guidelines [15,20]. It has extensive reliability (Cronbach’s alpha=0.86–0.89) and validity [21]. PHQ-8 was used because sessions were remote and asking about suicidal ideation was not appropriate. The recall period is two weeks, using a 4-point frequency scale. Severity of depressive symptoms was categorized as “no symptom s” (0-4), “mild symptoms”(5-9), “moderate symptoms ” (10-14) and “severe symptoms ” (≥15) range [22]. The Italian version was used (http://www.phqscreeners.com/).