PHQ-9 vs PHQ-2: Depression Screening Comparison
Understand when to use each depression screening tool and how they differ.
Quick Answer
Use PHQ-2 as a quick initial screen. If the score is ≥3, follow up with the full PHQ-9.
Use PHQ-9 when you need severity assessment, treatment planning, or monitoring of depression over time.
The PHQ-2 contains the first two questions of the PHQ-9, making it a natural two-step approach.
What is the PHQ-2?
The PHQ-2 is an ultra-brief depression screening tool containing just two questions about the core symptoms of depression: anhedonia (loss of interest) and depressed mood. It serves as a first-step screen to identify individuals who may need further evaluation.
PHQ-2 Questions:
- 1. Little interest or pleasure in doing things
- 2. Feeling down, depressed, or hopeless
Each item scored 0-3 (Not at all, Several days, More than half the days, Nearly every day)
What is the PHQ-9?
The PHQ-9 is a comprehensive 9-item depression screening and severity measure based on DSM criteria. It assesses all nine symptoms of major depressive disorder and provides a severity score useful for treatment planning and monitoring.
PHQ-9 Questions:
- 1. Little interest or pleasure in doing things
- 2. Feeling down, depressed, or hopeless
- 3. Trouble falling or staying asleep, or sleeping too much
- 4. Feeling tired or having little energy
- 5. Poor appetite or overeating
- 6. Feeling bad about yourself — or that you are a failure
- 7. Trouble concentrating on things
- 8. Moving or speaking slowly, or being fidgety/restless
- 9. Thoughts of being better off dead or hurting yourself
Each item scored 0-3. Total score determines severity: Minimal (0-4), Mild (5-9), Moderate (10-14), Moderately Severe (15-19), Severe (20-27)
Side-by-Side Comparison
| Aspect | PHQ-2 | PHQ-9 |
|---|---|---|
| Number of Questions | 2 questions | 9 questions |
| Time to Complete | < 1 minute | 2-5 minutes |
| Score Range | 0-6 | 0-27 |
| Positive Screen Cutoff | ≥ 3 | ≥ 10 |
| Primary Purpose | Initial screening / triage | Screening + severity assessment |
| Sensitivity | 83% (at cutoff 3) | 88% (at cutoff 10) |
| Specificity | 90% (at cutoff 3) | 88% (at cutoff 10) |
| Assesses Severity | No | Yes (5 levels) |
| Suicide Risk Question | No | Yes (Question 9) |
| Best For | High-volume screening | Comprehensive assessment |
When to Use Each Tool
Use PHQ-2 When:
- ✓Annual wellness visits or routine checkups
- ✓High-volume primary care settings
- ✓Initial triage to determine need for full assessment
- ✓Time is very limited
- ✓Population-level screening programs
Use PHQ-9 When:
- ✓PHQ-2 screen is positive (score ≥3)
- ✓Making treatment decisions
- ✓Monitoring depression over time
- ✓Mental health settings
- ✓Need suicide risk screening (Q9)
Recommended Two-Step Approach
Administer PHQ-2 to all patients
Quick screening identifies those who need further evaluation
If PHQ-2 score ≥3, complete full PHQ-9
Determines severity and guides treatment planning
Use PHQ-9 for ongoing monitoring
Track response to treatment over time
Scoring and Interpretation
PHQ-2 Interpretation
- 0-2: Negative screen - depression unlikely
- 3-6: Positive screen - warrants PHQ-9 follow-up
PHQ-9 Severity Levels
- 0-4: Minimal depression - may not need treatment
- 5-9: Mild depression - watchful waiting, consider counseling
- 10-14: Moderate depression - treatment recommended
- 15-19: Moderately severe - active treatment needed
- 20-27: Severe depression - immediate treatment, consider referral
Try Our Free PHQ-9 Calculator
Use our free PHQ-9 calculator with instant scoring and clinical interpretation.