Phq-4: the four-item patient health questionnaire for anxiety ... 2026

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The document outlines the PHQ-4, a validated screening tool for assessing anxiety and depression over the past two weeks. It includes four questions with a scoring system ranging from 0 to 3 for each item, leading to a total score between 0 and 12. The scores categorize psychological distress into none, mild, moderate, and severe levels. Additionally, it provides subscales for anxiety and depression, where a score of 3 or higher on either subscale indicates a positive screening result.

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Begin with the first question regarding feelings of nervousness or anxiety. Select your response based on how often you've experienced this over the last two weeks, choosing from 'Not at all' to 'Nearly every day'.
Proceed to the second question about controlling worrying. Again, select your answer reflecting your experience in the past two weeks.
Move on to the third question concerning interest or pleasure in activities. Choose an option that best describes your feelings recently.
Finally, answer the fourth question about feeling down or hopeless. Select your response accordingly.
Once all questions are answered, review your selections and ensure accuracy before submitting.

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What is the difference between PHQ-4 and PHQ 8?

The PHQ-2 and PHQ-8 are self-report measures used to assess depression symptoms. The PHQ-4 is also a self-report measure for depression, but it assesses both depression and anxiety.

What is a positive score on the PHQ-4?

Source. The PHQ-4 is available from .phqscreeners.com free of charge, and permission for use is not required.

What is the 4 item anxiety scale?

Total score is determined by adding together the scores of each of the 4 items. Scores are rated as normal (0-2), mild (3-5), moderate (6-8), and severe (9-12). Total score 3 for first 2 questions suggests anxiety. Total score 3 for last 2 questions suggests depression.

What is the PHQ-4?

The Patient Health Questionnaire-4 (PHQ-4) was developed and validated by Kroenke, Spitzer, Williams, Lwe, (2009) in order to address the fact that anxiety and depression are two of the most prevalent illnesses among the general population.