The two-question Patient Health Questionnaire (PHQ-2) asks how often, over the last two weeks, the person has had little interest or pleasure in doing things, and has felt down, depressed or hopeless. Each is scored 0 to 3. A total of 3 or more warrants the full PHQ-9 or a clinical assessment.
It takes under a minute and has been used in many languages, including Hindi. It is useful in any long-term illness where depression is common and easy to miss, such as tuberculosis, diabetes, chronic pain or cancer. A positive screen is a prompt for a conversation, not a diagnosis, and any thoughts of self-harm need asking about directly.
- Ask the two PHQ-2 questions at review in long-term illnesses where depression is common.
- Follow a score of 3 or more with the PHQ-9 or a clinical interview.
- Ask directly about thoughts of self-harm when the screen is positive.
- Record the result so it can be compared at the next visit.
Why it matters
Depression in chronic illness often goes unnoticed because nobody asks.
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