PHQ-2 Patient Health Questionnaire for Depression Screening

Screens for depression severity based on the presence or absence of depressed mood and anhedonia.

Refer to the text below the questionnaire for more information about the PHQ-2 and its psychometric properties.

The PHQ-2 is the condensed version of the Patient Health Questionnaire (PHQ-9) and was validated in the study by Kroenke et al. on 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics.

The PHQ-2 enquires about the frequency of depressed mood and anhedonia over the last two weeks.

PHQ-2 scores range from 0 to 6 with a cut-off set at 3 points. For scores of 3 or higher please administer the full PHQ-9 or conduct a clinical interview to assess for major depressive disorder.

PHQ-2 score Probability of major depressive disorder (%) Probability of any depressive disorder score (%)
1 15.4 36.9
2 21.1 48.3
3 38.4 75.0
4 45.4 81.2
5 56.4 84.6
6 78.6 92.9
Over the last 2 weeks, how often have you been bothered by the following problems?
1

Little interest or pleasure in doing things

2

Feeling down, depressed or hopeless

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Patient Health Questionnaire (PHQ-2) Explained

The PHQ-2 enquires about the frequency of depressed mood and anhedonia over the last two weeks, based on the following items:

  1. Little interest or pleasure in doing things
  2. Feeling down, depressed or hopeless

Each of the items (which incorporate DSM-IV depression criteria) may be rated on the following scale:

  • Not at all (0)
  • Several days (1)
  • More than half the days (2)
  • Nearly every day (3)

Therefore, scores range from 0 to 6 with a cut-off set at 3 points. For scores of 3 or higher please administer the full PHQ-9 or conduct a clinical interview to assess for major depressive disorder.

The PHQ-2 was developed by Kurt Kroenke, Robert L. Spitzer, Janet B.W. Williams, and colleagues, with an educational grant from Pfizer, Inc.

The PHQ-2 is the condensed version of the Patient Health Questionnaire (PHQ-9) and was validated in the study by Kroenke et al. on 6,000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics.

The tables below summarize the psychometric properties of the PHQ-2 in relation to major depressive disorder:

PHQ-2 score Sensitivity Specificity Positive Predictive Value
1 97.6 59.2 15.4
2 92.7 73.7 21.1
3 82.9 90.0 38.4
4 73.2 93.3 45.4
5 53.7 96.8 56.4
6 26.8 99.4 78.6

and for any depressive disorder:

PHQ-2 score Sensitivity Specificity Positive Predictive Value
1 90.6 65.4 36.9
2 82.1 80.4 48.3
3 62.3 95.4 75.0
4 50.9 97.4 81.2
5 31.1 98.7 84.6
6 12.3 99.8 92.9

The PHQ-2 was further validated in other studies which showed wide variability in sensitivity. Please note that this is only a screening instrument, not a diagnosis or symptoms severity monitoring tool. Scores of 3 or greater can be positive for disorders such as but not limited to bipolar I or II, cyclothymia, dysthymia, or personality disorders.

 

References

Original reference

Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: validity of a two-item depression screener. Med Care. 2003; 41(11):1284-1292.

Other references

Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001; 16(9):606-613.

Gilbody S, Richards D, Brealey S, Hewitt C. Screening for depression in medical settings with the Patient Health Questionnaire (PHQ): a diagnostic meta-analysis. J Gen Intern Med. 2007; 22(11):1596-602.

Arroll B, Goodyear-Smith F, Crengle S, Gunn J, Kerse N, Fishman T, Falloon K, Hatcher S. Validation of PHQ-2 and PHQ-9 to screen for major depression in the primary care population. Ann Fam Med. 2010; 8(4):348-53.

Levis B, Sun Y, He C, et al. Accuracy of the PHQ-2 Alone and in Combination With the PHQ-9 for Screening to Detect Major Depression: Systematic Review and Meta-analysis. JAMA. 2020; 323(22):2290-2300.

Specialty: Psychiatry

System: Screening

Objective: Questionnaire

Year Of Study: 2003

Abbreviation: PHQ-2

Article By: Denise Nedea

Published On: August 13, 2020 · 12:00 AM

Last Checked: August 13, 2020

Next Review: August 13, 2025