PHQ-4

The questionnaire PHQ-4

In psychiatry, PHQ-4 is the ultra-short form of the health questionnaire for patients ( PHQ-D ). It comprises the first two questions of the depression module of the PHQ-D ( PHQ-2 ) and the first two questions of the module on the assessment of generalized anxiety ( GAD-2 ).

Structure of the PHQ-4

The PHQ-2 consists of the two core diagnostic criteria for depressive disorders according to DSM-IV. The GAD-2 consists of two core criteria for Generalized Anxiety Disorder according to DSM-IV, which have also proven to be an effective screening tool for the disorders of social phobia , panic disorder and post-traumatic stress disorder . Therefore, both instruments with 2 questions each have been combined to form a new instrument, the PHQ-4. According to the original scales of the health questionnaire for patients ( PHQ-D ), the PHQ-4 asks how often you feel in the course of the last two weeks through a loss of interest and joy (question 1) and depression, sadness or hopelessness (question 2) as well as through Feels nervous, anxious or worried (question 3) and feelings of restlessness (question 4) impaired. Possible answers are

"not at all",
"at some days",
“On more than half the days” and
"almost every day",

to which the numerical values 0 to 3 are assigned accordingly. When evaluating the PHQ-4, the values on the four items are added so that the total value can assume values from 0 to 12.

Test diagnostic quality criteria of the PHQ-4

'Reliability: The internal consistency according to Cronbach is α = 0.85.

Factorial validity: Exploratory and confirmatory factor analyzes confirmed the arrangement of both items on two factors with the items of GAD-2 on the first factor and the items of PHQ-2 on the second factor.
Comparative values: The mean characteristic value in a sample with 2149 patients is 2.5 (SD = 2.8)

Notes on usage authorization

The PHQ-D and its subscales are freely available and free of charge and can be used for non-commercial purposes without charge. When using the PHQ-D or a short form, the German version of the instrument must be quoted correctly when the data generated is published.

Web links

http://www.uke.de/kliniken/psychosomatik/

Individual evidence

↑ ^a ^b ^c K. Kroenke, RL Spitzer, JB Williams, PO Monahan, B. Löwe: Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. In: Ann Intern Med . 146, 2007, pp. 317-325.
^ B. Löwe, I. Wahl, M. Rose, C. Spitzer, H. Glaesmer, K. Wingenfeld, A. Schneider, E. Brähler: A 4-item measure of depression and anxiety: Validation and standardization of the patient health Questionnaire-4 (PHQ-4) in the general population. In: Journal of Affective Disorders. 122, 2010, pp. 86-95.

[KRO-1] K. Kroenke, RL Spitzer, JB Williams, PO Monahan, B. Löwe: Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. In: Ann Intern Med . 146, 2007, pp. 317-325.

[2] B. Löwe, I. Wahl, M. Rose, C. Spitzer, H. Glaesmer, K. Wingenfeld, A. Schneider, E. Brähler: A 4-item measure of depression and anxiety: Validation and standardization of the patient health Questionnaire-4 (PHQ-4) in the general population. In: Journal of Affective Disorders. 122, 2010, pp. 86-95.