Just want to know how you are doing lately? The PHQ-4 is the shortest validated screener — 4 items covering the core symptoms of anxiety (GAD-2) and depression (PHQ-2), with results in 30 seconds. When your score reaches the screening threshold, it guides you straight to the full GAD-7 or PHQ-9 assessment.

30 seconds to know where you stand

If you have been feeling off lately — poor sleep, low energy, restlessness, overthinking — but cannot quite say what is wrong, the PHQ-4 is for you.

The PHQ-4 is the shortest validated screening tool, developed by Kroenke, Spitzer, Williams, and Löwe in 2009. Just 4 items, yet it covers the two core symptom clusters of both anxiety and depression:

  • First 2 items (GAD-2): core anxiety symptoms — feeling nervous, uncontrollable worry
  • Last 2 items (PHQ-2): core depressive symptoms — low mood, loss of interest
In a validation study of 2,149 primary-care patients, the PHQ-4 separated anxiety and depression into two distinct factors (explaining 84% of the variance), and higher scores were strongly associated with functional impairment and healthcare use.

What the scores mean

  • 0-2: Normal — little to no distress
  • 3-5: Mild distress (a total of 3 or more already meets the threshold for further assessment)
  • 6-8: Moderate distress — a full assessment is recommended
  • 9-12: Severe distress — professional help is recommended as soon as possible

After screening: your next step

The PHQ-4's job is triage, not a final answer. It captures only the core signals; the full screeners provide severity grading:

  • Anxiety subscale (first 2 items) of 3 or more → take the GAD-7 (7 items, about 3 minutes)
  • Depression subscale (last 2 items) of 3 or more → take the PHQ-9 (9 items, about 3 minutes)
This follows a validated clinical workflow: 30 seconds to find the direction, then a full screener to confirm the degree. After the GAD-7 or PHQ-9 you will get a precise severity rating and tailored advice.

Psychometric notes

  • Construct validity: two-factor model fit well (RMSEA 0.027, Löwe 2010)
  • Subscale cutoffs: GAD-2 ≥3 corresponds to the 95th percentile of the general population; PHQ-2 ≥3 to the 93rd
  • Score range: 0-12
  • Completion time: about 30 seconds
This is a screening tool, not a diagnosis. If your score worries you or meets the assessment threshold, complete the corresponding full screener and, if needed, consult a healthcare professional.

Scoring Guide

Total 0-12. 0-2=Normal, 3-5=Mild, 6-8=Moderate, 9-12=Severe (Löwe 2010 bands). First 2 items (GAD-2 anxiety subscale) ≥3 suggests anxiety; last 2 items (PHQ-2 depression subscale) ≥3 suggests depression (Kroenke 2009). Total ≥3 warrants further assessment. No reverse-scored items.

Result Interpretation

After completing the 4 questions, you'll receive an immediate, detailed report with:

  • Your score — calculated automatically based on your responses
  • Score interpretation — what your score means in practical terms
  • Context — how your results compare to general population norms where available

All results are displayed on screen. No account or login needed.