[{"data":1,"prerenderedAt":1006},["ShallowReactive",2],{"assessment-phq-2":3,"all-assessments-nav":187,"related-assessments-query":852},{"id":4,"title":5,"body":6,"category":173,"categoryTitle":174,"clinicalCitations":173,"copyright":173,"description":175,"disclaimer":173,"downloadLink":173,"extension":176,"faqs":173,"i18nReady":177,"icon":173,"lastReviewed":173,"meta":178,"navigation":179,"path":180,"permissionsNote":173,"recommendedFrequency":173,"relatedConditions":173,"reviewedBy":173,"seo":181,"slug":182,"stem":183,"summary":184,"takeaways":173,"type":185,"usedToDiagnose":173,"__hash__":186},"assessments\u002Fhelp\u002Fassessment-library\u002Fphq-2.md","PHQ-2 Depression Screener (Patient Health Questionnaire-2)",{"type":7,"value":8,"toc":155},"minimark",[9,13,18,21,24,27,32,35,39,42,46,49,52,56,59,63,79,82,86,90,93,107,110,113,127,132,135,139,142,145,148,151],[10,11,12],"p",{},"The PHQ-2 is a 2-item depression screener derived from the PHQ-9. With a score range of 0–6 and a ≥3 positive threshold, it identifies patients who need the full PHQ-9 in under 1 minute.",[14,15,17],"h2",{"id":16},"what-is-the-phq-2","What is the PHQ-2?",[10,19,20],{},"The PHQ-2 (Patient Health Questionnaire-2) consists of the first two questions of the PHQ-9, assessing the two core symptoms of major depressive disorder: anhedonia (loss of interest or pleasure) and depressed mood. Developed from the PRIME-MD diagnostic tool and validated by Kroenke et al. (2003), it is the recommended first-step depression screen in primary care, behavioral health integration, and population health programs.",[10,22,23],{},"Each item is rated 0–3 based on symptom frequency over the past 2 weeks (Not at all \u002F Several days \u002F More than half the days \u002F Nearly every day), yielding a total score of 0–6. A score of 3 or higher is a positive screen and indicates the need for full PHQ-9 administration and clinical evaluation.",[10,25,26],{},"The PHQ-2 is part of the PHQ family of tools (PHQ-9, PHQ-A, PHQ-SADS) developed by Drs. Spitzer, Kroenke, and Williams. It is freely available in the public domain and widely endorsed by USPSTF, APA, and primary care guidelines internationally.",[28,29,31],"h3",{"id":30},"phq-2-is-a-gateway-screen-not-a-standalone-diagnostic","PHQ-2 is a Gateway Screen, Not a Standalone Diagnostic",[10,33,34],{},"A positive PHQ-2 (≥3) requires follow-up with the full PHQ-9 and clinical evaluation. The PHQ-2 alone is not sufficient to diagnose depression or determine severity. It is designed as an efficient first step to identify who needs further assessment.",[28,36,38],{"id":37},"public-domain","Public Domain",[10,40,41],{},"The PHQ-2 is in the public domain. No permissions, licensing fees, or royalties are required for clinical, educational, or research use.",[14,43,45],{"id":44},"the-two-phq-2-questions","The Two PHQ-2 Questions",[10,47,48],{},"Both questions ask about the past 2 weeks. Each is rated on a 4-point scale: 0 (Not at all), 1 (Several days), 2 (More than half the days), 3 (Nearly every day).",[10,50,51],{},"Over the past 2 weeks, how often have you been bothered by little interest or pleasure in doing things?",[28,53,55],{"id":54},"depressed-mood","Depressed Mood",[10,57,58],{},"Over the past 2 weeks, how often have you been bothered by feeling down, depressed, or hopeless?",[28,60,62],{"id":61},"administration-best-practices","Administration Best Practices",[64,65,66,70,73,76],"ul",{},[67,68,69],"li",{},"Administer at intake and as a periodic check at follow-up visits",[67,71,72],{},"Proceed to PHQ-9 promptly when score ≥3, do not defer to a later visit",[67,74,75],{},"Can be patient self-administered (paper, tablet, or digital), saving clinician time",[67,77,78],{},"Always ask about suicidal ideation when PHQ-2 is positive, regardless of PHQ-9 results",[10,80,81],{},"Answer both questions based on how often you have been bothered over the past 2 weeks.",[14,83,85],{"id":84},"phq-2-scoring-interpretation","PHQ-2 Scoring & Interpretation",[28,87,89],{"id":88},"sensitivity-specificity","Sensitivity & Specificity",[10,91,92],{},"At the ≥3 threshold (Kroenke et al., 2003):",[64,94,95,98,101,104],{},[67,96,97],{},"Sensitivity: 76–83% for major depressive disorder (pooled ~76%, Levis et al. 2020 JAMA meta-analysis; original 2003 study: 83%)",[67,99,100],{},"Specificity: 78–92% (varies by population)",[67,102,103],{},"PPV: 54% in primary care populations",[67,105,106],{},"NPV: 97%, excellent for ruling out depression",[10,108,109],{},"When PHQ-2 is Positive (≥3)",[10,111,112],{},"Required follow-up steps:",[64,114,115,118,121,124],{},[67,116,117],{},"Administer full PHQ-9 (9 items) for severity scoring",[67,119,120],{},"Ask directly about suicidal ideation (PHQ-9 item 9)",[67,122,123],{},"Conduct clinical interview to assess duration, impairment, and triggers",[67,125,126],{},"Consider GAD-7 for comorbid anxiety (very common)",[128,129,131],"h4",{"id":130},"negative-phq-2-doesnt-rule-out-all-depression","Negative PHQ-2 Doesn't Rule Out All Depression",[10,133,134],{},"The PHQ-2's NPV of 97% is excellent but not perfect. If clinical suspicion is high (e.g., patient reports sadness, sleep changes, or weight loss), administer the full PHQ-9 regardless of PHQ-2 score. Clinical judgment always supersedes a screening score.",[14,136,138],{"id":137},"phq-2-vs-phq-9-when-to-use-each","PHQ-2 vs PHQ-9: When to Use Each",[10,140,141],{},"The PHQ-2 and PHQ-9 are designed to work together as a two-stage screening and assessment protocol.",[10,143,144],{},"Clinical Guidance: The PHQ-2 functions as a triage gate. In high-volume settings (primary care, urgent care, employee health), administer PHQ-2 to all patients. Those who screen positive (≥3) proceed directly to PHQ-9. This two-stage approach reduces patient burden for the ~80% who screen negative while ensuring the PHQ-9's full diagnostic power is applied where it matters. For measurement-based care programs focused on depression treatment monitoring, use PHQ-9 directly at every visit rather than starting with PHQ-2.",[10,146,147],{},"Documenting PHQ-2 scores in clinical notes?",[10,149,150],{},"PHQ-2 scores belong in the Objective section of your note. See our\nSOAP notes guide\nand Intake Notes guide\nfor templates and examples.",[14,152,154],{"id":153},"phq-2-frequently-asked-questions","PHQ-2 Frequently Asked Questions",{"title":156,"searchDepth":157,"depth":157,"links":158},"",2,[159,164,168,171,172],{"id":16,"depth":157,"text":17,"children":160},[161,163],{"id":30,"depth":162,"text":31},3,{"id":37,"depth":162,"text":38},{"id":44,"depth":157,"text":45,"children":165},[166,167],{"id":54,"depth":162,"text":55},{"id":61,"depth":162,"text":62},{"id":84,"depth":157,"text":85,"children":169},[170],{"id":88,"depth":162,"text":89},{"id":137,"depth":157,"text":138},{"id":153,"depth":157,"text":154},null,"Depression","PHQ-2 is a 2-item ultra-brief depression screener derived from the PHQ-9. 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