Depression Screening and Assessment

Question 1

What 2 questions can be used to screen for depression?

Answer 1

1. During the last month, have you often been bothered by feeling down, depressed or hopeless?
2. During the last month, have you often been bothered by having little interest or pleasure in doing things?

(Answering yes to either of these should prompt further assessments)

Question 2

What 2 tools can be used to assess the degree of depression?

Answer 2

HADS (Hospital Anxiety and Depression Scale)

Patient Health Questionnaire (PHQ-9)

Question 3

Tell me about the HAD Scale

Answer 3

1. Consists of 14 questions, 7 for anxiety and 7 for depression.
2. Each item is scored from 0-3
3. Produces a score out of 21 for both anxiety and depression.
4. Severity
   
   • 0-7 is normal.
   • 8-10 is borderline
   • 11+ sever
5. Patients should be encouraged to answer the questions quickly.

Question 4

Tell me about the PHQ-9

Answer 4

1. Asks patients ‘over the last 2 weeks’…
2. 9 items which can be scored 0-3
3. Includes items asking about thoughts of self harm.
4. Depression severity
   
   • 0-4 none
   • 5-9 mild
   • 10-14 moderate
   • 15-19 moderately severe
   • 20-27 severe

Question 5

What criteria do NICE use to grade depression?

Answer 5

The 9 Criteria of the DSM-IV which used as part of the PHQ-9

Question 6

What are the 9 criteria of the DSM-IV

(That are used as part of the PHQ-9)

Answer 6

1. Depressed mood or irritable most of the day, nearly every day, as indicated by either subjective report (e.g., feels sad or empty) or observation made by others (e.g., appears tearful).
2. Decreased interest or pleasure in most activities, most of each day
3. Fatigue or loss of energy
4. Significant weight change (5%) or change in appetite
5. Change in sleep: Insomnia or hypersomnia
6. Change in activity: Psychomotor agitation or retardation
7. Guilt/worthlessness: Feelings of worthlessness or excessive or inappropriate guilt
8. Concentration: diminished ability to think or concentrate, or more indecisiveness
9. Suicidality: Thoughts of death or suicide, or has suicide plan

Question 7

How do you diagnose subthreshold depressive symptoms?

Answer 7

Fewere than 5 symptoms.

Question 8

How do you diagnose mild depression?

Answer 8

Atleast 5 symptoms plus a minor functional impairment.

Question 9

How do you diagnose moderate depression?

Answer 9

5 or more symptoms plus a moderate fucntional impairement.

Question 10

How do you diagnose severe depression?

Answer 10

5 or more symptoms plus a severe functional impairement.