The Two-Question Screen

To aid with identification of depression, you may use the two-question screen. Consider this tool anytime you suspect that a patient is suffering from depression, specifically if the patient presents with any red-flag complaints suggestive of depression, including the following:

• A history of depression
• Multiple unexplained somatic symptoms
• A recent major stress or loss
• Frequent use of the emergency room or frequent office visits
• Chronic pain
• Chronic illness(es)
• Sleep disturbance, fatigue, appetite or weight change as the chief complaint

Whenever you suspect depression, a quick way to screen patients is to ask these two questions during the patient interview. The two questions, which take less than a minute to ask, have been shown to be effective for identifying patients who may be depressed.

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If patient responds “yes” to either of these questions, consider asking more detailed questions or use the Patient Health Questionnaire (PHQ-9) to assist with diagnosis.

If the patient responds “no” to both questions, the screen is negative, and it is unlikely the patient is depressed.

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These guidelines are not intended to be exhaustive, nor are they intended to be prescriptive or replace your own independent medical judgment.