The Patient Health Questionnaire-2
2003/10/21 by Kurt Kroenke, Robert L. Spitzer, Janet B. W. Williams · 6,405 citations
Medicine · Psychology · #Anhedonia #Anxiety #Cardiac Health and Mental Health #Clinical psychology #Construct validity #Criterion validity #Depression (economics) #Depressive symptoms #Medicine #Mental Health Treatment and Access #Mood #Patient Health Questionnaire #Psychiatry #Psychometrics #Treatment of Major Depression
paper · doi:10.1097/01.mlr.0000093487.78664.3c
published in Medical Care 41(11), 1284-1292 (Lippincott Williams & Wilkins)
openalex publication_date 2003/10/21 · openalex created_date 2016/06/24 · openalex updated_date 2026/08/06
Abstract
BACKGROUND: A number of self-administered questionnaires are available for assessing depression severity, including the 9-item Patient Health Questionnaire depression module (PHQ-9). Because even briefer measures might be desirable for use in busy clinical settings or as part of comprehensive health questionnaires, we evaluated a 2-item version of the PHQ depression module, the PHQ-2. METHODS: The PHQ-2 inquires about the frequency of depressed mood and anhedonia over the past 2 weeks, scoring each as 0 ("not at all") to 3 ("nearly every day"). The PHQ-2 was completed by 6000 patients in 8 primary care clinics and 7 obstetrics-gynecology clinics. Construct validity was assessed using the 20-item Short-Form General Health Survey, self-reported sick days and clinic visits, and symptom-related difficulty. Criterion validity was assessed against an independent structured mental health professional (MHP) interview in a sample of 580 patients. RESULTS: As PHQ-2 depression severity increased from 0 to 6, there was a substantial decrease in functional status on all 6 SF-20 subscales. Also, symptom-related difficulty, sick days, and healthcare utilization increased. Using the MHP reinterview as the criterion standard, a PHQ-2 score > or =3 had a sensitivity of 83% and a specificity of 92% for major depression. Likelihood ratio and receiver operator characteristic analysis identified a PHQ-2 score of 3 as the optimal cutpoint for screening purposes. Results were similar in the primary care and obstetrics-gynecology samples. CONCLUSION: The construct and criterion validity of the PHQ-2 make it an attractive measure for depression screening.
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