Two screening questions can rule out depression

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Two screening questions can rule out depression

A recent Alberta Tools for Practice1 notes that two questions can be used to rule out depression when the answer is no to both questions (this is similar to a negative brain natriuretic peptide (BNP) to rule out congestive heart failure).

If the patient scores positive on either question a more detailed assessment to confirm or refute depression needs to be made (e.g. using the PHQ-9). 

The two questions are:
During the past month have you often been bothered by:

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

Whether screening alters outcomes is debatable, but the 2-question screen may be reasonable for case-finding or screening higher risk patients.


  1. Alberta Tools for Practice #203. Got Depression? I can answer that in two questions! Click here 

Gems are chosen by the Goodfellow director Dr. Bruce Arroll to be either practice changing or practice maintaining. The information is educational and not clinical advice.

As published in NZ Doctor 14/02/2018