Last updated: March 16, 2026
The PHQ-4, an ultra-brief 4-question screening that simultaneously checks for both anxiety and depression.
Anyone who wants the quickest possible validated check for both anxiety and depression symptoms.
The PHQ-4 takes under a minute — a positive result on either subscale suggests taking the full GAD-7 or PHQ-9. This tool is for informational purposes only. Not a substitute for professional mental health treatment.
What Is the PHQ-4 Anxiety and Depression Screen?
How Is the PHQ-4 Scored?
What Do My PHQ-4 Results Mean?
PHQ-4: Ultra-Brief Anxiety & Depression Screen
The PHQ-4 is a validated 4-question screening tool that checks for both anxiety and depression in under 60 seconds. It combines the first 2 questions of the GAD-7 (anxiety) with the first 2 questions of the PHQ-9 (depression). Used in primary care, research, and population health settings worldwide.
Over the last 2 weeks, how often have you been bothered by the following?
Feeling nervous, anxious, or on edge
Not being able to stop or control worrying
Little interest or pleasure in doing things
Feeling down, depressed, or hopeless
PHQ-4 Score Interpretation
| Total Score | Level | Suggested Action |
|---|---|---|
| 0–2 | Minimal | No action needed; monitor if concerned |
| 3–5 | Mild | Consider full PHQ-9 or GAD-7 assessment |
| 6–8 | Moderate | Consider speaking with a healthcare provider |
| 9–12 | Severe | Professional evaluation recommended |
Subscale: Anxiety score ≥3 or Depression score ≥3 suggests possible disorder in that domain. Source: Kroenke K, Spitzer RL, Williams JBW, Löwe B. (2009). Psychosomatics, 50(6):613–621.
Frequently Asked Questions
What is the PHQ-4?
The PHQ-4 (Patient Health Questionnaire-4) is a validated ultra-brief screening tool that checks for both anxiety and depression using just 4 questions. It combines the first 2 items of the GAD-7 (anxiety) with the first 2 items of the PHQ-9 (depression). It is widely used in primary care, research, and population health settings.
How is the PHQ-4 scored?
Each of the 4 questions is scored 0–3 (Not at all, Several days, More than half the days, Nearly every day). Total scores range from 0–12: 0–2 is minimal, 3–5 is mild, 6–8 is moderate, and 9–12 is severe. The anxiety subscale (questions 1–2) and depression subscale (questions 3–4) each range from 0–6, with a score of 3 or higher suggesting possible difficulty in that area.
Is the PHQ-4 clinically validated?
Yes. The PHQ-4 was validated by Kroenke, Spitzer, Williams, and Löwe (2009) in a study of over 6,000 patients. It has strong psychometric properties for detecting anxiety and depressive disorders. However, it is a screening instrument, not a diagnostic tool.
When should I use the PHQ-4 vs. the full PHQ-9 or GAD-7?
The PHQ-4 is ideal as a first-step screener when time is limited or when you want a quick overall check. If the PHQ-4 indicates possible anxiety or depression (subscale score of 3 or higher), following up with the full GAD-7 or PHQ-9 provides a more detailed assessment of symptom severity.
Can this tool diagnose anxiety or depression?
No. The PHQ-4 is a screening instrument, not a diagnostic tool. Only a qualified healthcare professional can provide a diagnosis through a comprehensive evaluation. A positive screen is a starting point for a conversation with your doctor.
Is my data stored or shared?
No. All scoring happens entirely in your browser using client-side JavaScript. Your answers are never sent to any server, stored in any database, or shared with anyone. When you close or reset this page, your responses are gone.
How often should I take the PHQ-4?
Some people find it helpful to complete the PHQ-4 periodically (e.g., every 2–4 weeks) to notice patterns over time. You can share results with your healthcare provider to support ongoing conversations about your mental health.
Crisis Resources
- 988 Suicide & Crisis Lifeline: Call or text 988 — free, 24/7, confidential
- Crisis Text Line: Text HOME to 741741
This screening tool is for educational purposes only — it is not a diagnosis. Only a licensed healthcare professional can diagnose anxiety or depression. Your responses are processed entirely in your browser and are never stored or transmitted.
Reviewed by a Certified Drug and Alcohol Counselor (CADC-II).
Last reviewed: March 2026