Depression Primary care physicians hospitals whatever
Depression in Primary Care
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Recognition Tools

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
The Screening Questions

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.


During the past two weeks, have you ever been bothered by:

1. Little interest or pleasure in doing things?   
2. Feeling down, depressed or hopeless?   


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Scoring

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.

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