The patient health questionnaire-2: Validity of a two-item depression screener

Kurt Kroenke, Robert L. Spitzer, Janet B.W. Williams

Research output: Contribution to journalArticle

2034 Citations (Scopus)

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 ≥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.

Original languageEnglish (US)
Pages (from-to)1284-1292
Number of pages9
JournalMedical care
Volume41
Issue number11
DOIs
StatePublished - Nov 1 2003

Fingerprint

Depression
questionnaire
Health
health
gynecology
Sick Leave
obstetrics
Gynecology
health professionals
Obstetrics
Primary Health Care
Mental Health
mental health
Anhedonia
Ambulatory Care
construct validity
Health Surveys
mood
Surveys and Questionnaires
recipient

Keywords

  • Depression
  • Diagnosis
  • Functional status
  • Mental disorders
  • Screening

ASJC Scopus subject areas

  • Nursing(all)
  • Public Health, Environmental and Occupational Health
  • Health(social science)
  • Health Professions(all)

Cite this

The patient health questionnaire-2 : Validity of a two-item depression screener. / Kroenke, Kurt; Spitzer, Robert L.; Williams, Janet B W.

In: Medical Care, Vol. 41, No. 11, 11.2003, p. 1284-1292.

Research output: Contribution to journalArticle

Kroenke, Kurt ; Spitzer, Robert L. ; Williams, Janet B.W. / The patient health questionnaire-2 : Validity of a two-item depression screener. In: Medical care. 2003 ; Vol. 41, No. 11. pp. 1284-1292.
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