PHQ-2 scoring
Use the Patient Health Questionnaire-2 (PHQ-2) to support your clinical assessment. Enter the client’s responses below to calculate a total and check it against the usual cut-off. This tool is for clinicians and supports, rather than replaces, a clinical interview.
Over the last 2 weeks, how often have you been bothered by any of the following problems?
Answered 0 of 2
Running total: 0 / 6
Answer every scored item to see the result and copy it.
Answers stay in this browser. Nothing is saved or sent.
How to score the PHQ-2
- Ask the client to consider the last two weeks and choose one answer for each of the 2 items: little interest or pleasure in doing things, and feeling down, depressed, or hopeless.
- Assign each answer its points: Not at all (0), Several days (1), More than half the days (2), Nearly every day (3).
- Add the two answers for a total from 0 to 6.
- Compare the total with the cut-off of 3. A total of 3 or more calls for the full PHQ-9 and a clinical interview.
PHQ-2 cut-off
| Total score | Result |
|---|---|
| 0 to 2 | below the cut-off of 3 |
| 3 to 6 | at or above the cut-off of 3 |
What the score means and what it does not
The PHQ-2 asks about the two core symptoms of depression: low mood and loss of interest or pleasure. A total of 3 or more is the recommended cut-off when it is used as a screener. In the original validation study, a score of 3 or more had a sensitivity of 83% and a specificity of 92% for major depression. The PHQ instruction manual says a score of 3 or more should prompt the full PHQ-9 and a clinical interview to determine whether a mental disorder is present. A total below 3 does not rule out depression, and the PHQ-2 does not ask about thoughts of self-harm, which PHQ-9 item 9 covers.
Using the PHQ-2 over time
The PHQ-2 is an ultra-brief screener. To measure severity and track change over time, use the PHQ-9, which covers all nine symptoms and has severity bands. Each PHQ-2 response covers the last two weeks.
Frequently asked questions
What is a positive PHQ-2 score?
A total of 3 or more is the usual cut-off for a positive screen. It means the client should complete the full PHQ-9 and a clinical interview. It is not a diagnosis.
What are the PHQ-2 questions?
They are the first two items of the PHQ-9: little interest or pleasure in doing things, and feeling down, depressed, or hopeless, both over the last two weeks.
What should I do after a positive PHQ-2?
Give the full PHQ-9 and follow up with a clinical interview to find out whether a depressive disorder is present.
Can the PHQ-2 replace the PHQ-9?
No. The PHQ-2 is a brief screen. The PHQ-9 measures the severity of all nine symptoms, including thoughts of self-harm, which the PHQ-2 does not ask about.
How accurate is the PHQ-2?
In the original validation study, 580 patients were also interviewed by a mental health professional. A score of 3 or more had a sensitivity of 83% and a specificity of 92% for major depression.
Sources
The PHQ-2 was developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission is required to reproduce, translate, display or distribute it.