The 4-item Patient Health Questionnaire-4 (PHQ-4) is an ultra-brief self-report validated questionnaire that consists of a 2-item depression scale (PHQ-2) and a 2-item anxiety scale (GAD-2).
An elevated PHQ–4 score is not diagnostic, but is, instead, an indicator for further inquiry to establish the presence or absence of depression and/or anxiety warranting treatment.
PHQ-4
| Over the last 2 weeks, how often have you been bothered by the following problems? | Not at all | Several days | More than half the days | Nearly every day |
|---|---|---|---|---|
| 1. Feeling nervous, anxious or on edge | 0 | 1 | 2 | 3 |
| 2. Not being able to stop or control worrying | 0 | 1 | 2 | 3 |
| 3. Little interest or pleasure in doing things | 0 | 1 | 2 | 3 |
| 4. Feeling down, depressed, or hopeless | 0 | 1 | 2 | 3 |
Scoring
PHQ-4 total score ranges from 0 to 12, with categories of psychological distress being:
- None  0-2
- Mild  3-5
- Moderate  6-8
- Severe  9-12
Anxiety subscale = sum of items 1 and 2Â Â Â Â Â (score range, 0 to 6)
Depression subscale = sum of items 3 and 4Â Â (score range, 0 to 6)
On each subscale, a score of 3 or greater is considered positive for screening purposes.
Löwe B, Wahl I, Rose M, Spitzer C, Glaesmer H, Wingenfeld K, Schneider A, & Brähler E. (2010). A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of Affective Disorders, 122, 86-95. doi: 10.1016/j.jad.2009.06.019.