Patient Health Questionnaire-2 (PHQ-2)
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The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past two weeks. The PHQ-2 includes the first two items of the PHQ-9.
- The purpose of the PHQ-2 is to screen for depression in a “first-step” approach.
- Patients who screen positive should be further evaluated with the PHQ-9 to determine whether they meet criteria for a depressive disorder.
Over the last 2 weeks, how often have you been bothered by the following problems?
Not at all
Several days
More than half the days
Nearly every day
1. Little interest or pleasure in doing things
2. Feeling down, depressed or hopeless
PHQ-2 score obtained by adding score for each question (total points)
Interpretation:
- A PHQ-2 score ranges from 0-6. The authors identified a score of 3 as the optimal cutpoint when using the PHQ-2 to screen for depression.
- If the score is 3 or greater, major depressive disorder is likely.
- Patients who screen positive should be further evaluated with the PHQ-9, other diagnostic instruments, or direct interview to determine whether they meet criteria for a depressive disorder.
Operating Characteristics of PHQ-2 as a Screener for Depressive Disorders in 580 Patients Who Had an Independent Mental Health Professional Interview
| PHQ-2 Score | Sensitivity | Specificity | Positive Predictive Value (PPV*) |
|---|---|---|---|
| 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 |
| PHQ-2 Score | Sensitivity | Specificity | Positive Predictive Value (PPV*) |
|---|---|---|---|
| 1 | 90.6 | 65.4 | 36.9 |
| 2 | 82.1 | 80.4 | 48.3 |
| 3 | 62.3 | 95.4 | 75.0 |
| 4 | 50.9 | 97.9 | 81.2 |
| 5 | 31.1 | 98.7 | 84.6 |
| 6 | 12.3 | 99.8 | 92.9 |
Notes:
- *Because the PPV varies with the prevalence of depression, the PPV will be higher in settings with a higher prevalence of depression and lower in settings with a lower prevalence.
Sources
Kroenke K, Spitzer RL, Williams JB. The Patient Health Questionnaire-2: Validity of a Two-Item Depression Screener. Medical Care. 2003;41:1284-92.
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