A guide to the PHQ-2 assessment

About the PHQ-2 Assessment

Recommended Frequency: Every 2 weeks

The Patient Health Questionnaire (PHQ) is a self-report assessment designed to screen for signs of clinical depression. The PHQ-2 is one version of the questionnaire and consists of the first two questions of the PHQ-9, which assess the frequency of depressed mood and anhedonia, two key symptoms of depressive disorders.

Since it draws its items from another, longer assessment, the PHQ-2 is not designed to be a robust diagnostic tool. Instead, its purpose is to serve as a “first step” approach to screening for depression. In other words, the PHQ-2 can be used as a first step when identifying patients who may need a full evaluation for depressive disorders.

Patients who screen positive on the PHQ-2 should be further evaluated using the PHQ-9 to more accurately determine whether they meet diagnostic criteria for depression.

PHQ-2 Confidence Intervals

A recent meta-analysis of 44 studies involving the PHQ-2 found that the instrument’s sensitivity and specificity varied based on the cutoff score used. Researchers also noted that these values differed depending on whether semistructured interviews were used in conjunction with the PHQ-2.

The analysis found that in studies that used semi-structured interviews, PHQ-2 sensitivity and specificity (95% CI) were (Levis et al., 2020):

• For cutoff scores of 2 or greater: 0.91 (0.88-0.94) and 0.67 (0.64-0.71)
• For cutoff scores of 3 or greater: 0.72 (0.67-0.77) and 0.85 (0.83-0.87)

It also noted that the PHQ-2 could help clinicians reduce the number of lengthy evaluations given to patients. Using the PHQ-2 was estimated to reduce the number of patients who needed to complete the full PHQ-9 by 57%.

Who is the PHQ-2 for?

Any patient who may be at risk for depressive disorders may benefit from routine screenings like the PHQ-2. The same goes for patients who have been diagnosed with a depressive or related mental health disorder and are undergoing treatment.

The PHQ-2 is quick and easy, which makes it accessible to patients of all kinds. Reducing depression evaluation to just two screening items makes it easier for providers to regularly inquire about some of the most prevalent (but treatable) mental health disorders.

Breaking Down the PHQ-2 Scale

Like its longer counterpart, the PHQ-2 assessment asks respondents to consider whether they’ve experienced symptoms over the past two weeks. Below is an example of the PHQ-2 questionnaire and its two items, which are pulled from the PHQ-9.

Once patients answer each question, their score from each item can be summed together to get a total score.

Interpreting PHQ-2 Scoring

Since it’s so short, scoring the PHQ-2 is fairly simple. Its scores range from 0-6, with a score of 3 being the optimal cutoff point for measuring depression.

A score of 3 or greater indicates that major depressive disorder is likely. Meanwhile, a score of 2 or below indicates that a depressive disorder is unlikely and that further evaluation is likely not necessary.

Patients who receive a score of 3 or higher should then be evaluated using other diagnostic instruments, direct interviews, or the PHQ-9. A combination of these tactics can help providers more thoroughly understand a patient’s symptoms and determine whether they meet the diagnostic criteria for major depressive disorder.

Save Time with Digital PHQ-2 & More Clinical Assessments

Routine clinical assessments like the PHQ-2 are an important part of the care process. However, even simple questionnaires can take a surprising amount of time to facilitate. Locating, printing, distributing, collecting, and manually uploading information from physical assessments can be a hassle.

The time and energy spent on managing all that paperwork could be better spent assisting and supporting patients. With a tool like Linear Health at your side, your team can leverage digital clinical assessments, including the PHQ-2, to save time (and trees).

Plus, using digital assessments allows you to automate the screening process. Patients can receive routine assessments without any intervention on your end – set up a schedule, customize assessments as needed, and watch as patient health information is transferred directly to your health records system.

Linear Health is here to simplify and streamline the everyday tasks your team manages so that you can focus on what matters most: delivering top-quality care to your patients. Book a demo with us today to learn more.