Over the last 2 weeks, how often have you been bothered by the following problems?
Report details · optional
Shown on the report and stored with the screening record. Use initials or a code, not full names.
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About this screener — evidence, source, alternatives
Combines the two core depression items of the PHQ-9 (PHQ-2) with the two core anxiety items of the GAD-7 (GAD-2). Each pair scores 0–6; 3 or more on either pair is a positive screen for that condition. The 0–12 total is a general measure of caseness — the higher the score, the more likely an underlying depressive or anxiety disorder.
Evidence · validated
In 2,149 US primary-care patients, factor analysis confirmed separate depression and anxiety factors explaining 84% of variance, and higher PHQ-4 scores were strongly associated with functional impairment, disability days and healthcare use (Kroenke et al., 2009). In a German general-population sample of 5,030, PHQ-2 and GAD-2 scores of 3 corresponded to the 93.4th and 95.2nd percentiles (Löwe et al., J Affect Disord 2010;122:86–95).
Free alternative to
- Hospital Anxiety and Depression Scale (HADS) · GL Assessment
Paid combined anxiety–depression screen; the PHQ-4 covers the same ground for free.
Source & licence
Kroenke K, Spitzer RL, Williams JBW, Löwe B. An ultra-brief screening scale for anxiety and depression: the PHQ-4. Psychosomatics. 2009;50(6):613–621. Developed by Drs Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc.
Licence: Free — PHQ and GAD-7 screeners: no permission required to reproduce, translate, display or distribute
Items are the first two items of the PHQ-9 and of the GAD-7, transcribed from the official English PDFs; the PHQ instruction manual describes deriving the PHQ-4 by selecting these items.
Official source ↗