Your PHQ-2 score ranges from 0 to 6 and reflects the frequency of the two core symptoms of depression: depressed mood and anhedonia (loss of interest or pleasure). A score of 0-2 is considered a negative screen, suggesting that clinically significant depression is unlikely at this time. A score of 3 or higher is a positive screen, indicating that further evaluation with the full PHQ-9 or a clinical interview is warranted.

A positive PHQ-2 does not mean you have depression. It means these two cardinal symptoms are present frequently enough to merit a more thorough assessment. Conversely, a negative screen does not absolutely exclude depression, as some patients with depression may not endorse these specific core symptoms prominently. The PHQ-2 has a sensitivity of 83% and specificity of 92% for major depressive disorder at the cutoff of 3.

The PHQ-2 is ideal for rapid, first-pass depression screening in settings where time is limited or where screening large numbers of patients is necessary. Common use cases include primary care intake forms, emergency department triage, annual wellness visits, and pre-surgical assessments. It is also appropriate for community-based screening programs and population health initiatives.

Because of its brevity (two questions), it can be administered verbally in under 30 seconds or included on a written intake questionnaire without significantly adding to patient burden. When paired with the GAD-2, these four questions provide a quick screen for both depression and anxiety, the two most common mental health conditions in primary care.

The PHQ-2 captures only two of the nine DSM criteria for major depressive disorder and therefore lacks the depth to characterize symptom severity, track treatment response, or detect the full range of depressive symptoms. It should always be followed by the full PHQ-9 or a clinical interview when the screen is positive.

The PHQ-2 may miss depression in patients whose primary symptoms are somatic (fatigue, insomnia, appetite changes) rather than mood-based. It may also miss patients with persistent depressive disorder (dysthymia) who have adapted to a low-grade depressed mood and do not recognize it as abnormal. Cultural differences in how sadness and pleasure are expressed and reported can also affect accuracy.

As with all self-report tools, the PHQ-2 is subject to response bias. Patients may underreport symptoms due to stigma, desire to appear well, or lack of insight into their emotional state.