An 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:
- Feeling down, depressed or hopeless?
- 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.