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SCREENING FOR DEPRESSION
Screening for mental health problems is important, especially in primary care settings. Screening tools, self-administered
or practitioner administered, have become useful in diagnosing depression and other mental illnesses and assessing the
severity of depression. The scores provide indicative ranges for depression severity that can be useful for clinical and
research purposes; however, they cannot take the place of a comprehensive clinical interview for confirming a diagnosis of
depression.
The Patient Health Questionnaire-2 (PHQ-2 –
The Patient Health Questionaire-2 (PHQ-2) is used to inquire about the frequency of depressed mood and anhedonia over
the past two weeks. It is a two item test that is very simple to use as a screening method in any area of the clinic, hospital
or home care setting. The purpose is to not establish a final diagnosis or to monitor depression severity, but rather to
screen for depression in a “first step” approach. Patients who screen positive should be further evaluated with the PHQ-9
to determine whether they meet criteria for a depressive disorder. A PHQ-2 score ranges from 0-6. The authors identified
a PHQ-2 cutoff score of 3 as the optimal cut point for screening purposes and stated that a cut point of 2 would enhance
sensitivity, whereas a cut point of 4 would improve specificity.
The Patient Health Questionnaire – 2 (PHQ‐2)
Patient Name___________________________________________ Date of Visit___________________
Over the past two weeks, how often have you been
bothered by any of the following problems?
Not at
All
Several
Days
More
Than
Half the
Days
Nearly
Every
Day
1. Little interest or pleasure in doing things 0 1 2 3
2. Feeling down, depressed or hopeless 0 1 2 3
Kroenke K. The Patient Health Questionnaire‐2 (PHQ‐2): validity of a two‐item depression
screener. Medical Care. 2003;(41):1284‐1294.
The Patient Health Questionnaire – 2 (PHQ‐2)
Patient Name___________________________________________ Date of Visit___________________
Over the past two weeks, how often have you been
bothered by any of th following problems?
Not at
All
Several
Days
More
Than
Half the
Days
Nearly
Every
Day
1. Little interest or pleasure in doing things 0 1 2 3
2. Feeling down, depressed or hopeless 0 1 2 3
Kroenke K. The Patient Health Questionnaire‐2 (PHQ‐2): validity of a two‐item depression
screener. Medical Care. 2003;(41):1284‐1294.
Zung Self-rating Depression Scale –
The Zung Self-Rating Depression Scale is a short, self-administered survey to quantify the depressed status of a patient.
There are 20 items on the scale that rate the affective, psychological and somatic symptoms associated with depression.33
The questions and items are framed in terms of positive and negative statements; each item is scored on a Likert scale
ranging from 1 to 4 (based on these replies: “a little of the time”, “some of the time”, “good part of the time”, “most of the
time”). Scores on the survey range from 20 through 80 and fall into four groupings:
• 20-44 Normal Range
• 45-59 Mildly Depressed
• 60-69 Moderately Depressed
• 70 and above Severely Depressed
The Zung scale is frequently used in research. Physicians and other industry experts have tested its validity extensively and
determined it to be a sensitive measure of clinical severity in depressed patients.