Intended for healthcare professionals

Primary Care

Screening for depression in primary care with two verbally asked questions: cross sectional study

BMJ 2003; 327 doi: (Published 13 November 2003) Cite this as: BMJ 2003;327:1144
  1. Bruce Arroll, associate professor (b.arroll{at},
  2. Natalie Khin, PhD student2,
  3. Ngaire Kerse, senior lecturer1
  1. 1Department of General Practice and Primary Health Care, Faculty of Medical and Health Sciences, University of Auckland, PB 92019, Auckland, New Zealand,
  2. 2Department of Psychiatry, University of Auckland
  1. Correspondence to: B Arroll
  • Accepted 18 September 2003


Abstract Objective To determine the diagnostic accuracy of two verbally asked questions for screening for depression.

Design Cross sectional criterion standard validation study.

Setting 15 general practices in New Zealand.

Participants 421 consecutive patients not taking psychotropic drugs.

Main outcome measures Sensitivity, specificity, and likelihood ratios of the two questions compared with the computerised composite international diagnostic interview.

Results The two screening questions showed a sensitivity and specificity of 97% (95% confidence interval, 83% to 99%) and 67% (62% to 72%), respectively. The likelihood ratio for a positive test was 2.9 (2.5 to 3.4) and the likelihood ratio for a negative test was 0.05 (0.01 to 0.35). Overall, 37% (157/421) of the patients screened positive for depression.

Conclusion Two verbally asked questions for screening for depression would detect most cases of depression in general practice. The questions have the advantage of brevity. As treatment is more likely when doctors make the diagnosis, these questions may have even greater utility.


  • Contributors All authors wrote the paper. AB had the original idea for the study and analysed the data; he will act as guarantor for the paper. NKhin assisted with the study design and funding. NKerse analysed the data. S Brighouse interviewed the patients.

  • Funding Oakley Mental Health Foundation and Charitable Trust of the Auckland Faculty of the Royal New Zealand College of General Practitioners. The guarantor accepts full responsibility for the conduct of the study, had access to the data, and controlled the decision to publish.

  • Competing interests None declared.

  • Ethical approval Ethical approval was obtained from the Auckland ethics committees

View Full Text