Introduction Depression is a mood disorder affecting the way an individual feels, thinks, behaves and can affect social and occupational functioning (Canadian Medical Association CMA, 2013). Public Health Agency of Canada (PHAC), 2002 reports approximately 8% of Canadian adults will experience major depression at some time in their lives and that it is the leading cause of years lived with disability worldwide. The Patient Health Questionnaire-9 (PHQ-9) was chosen for this critique to improve knowledge and understanding of this tool for practicing and new clinicians working in Primary Care. The goal is to increase confidence in utilizing the PHQ-9, increase diagnostic and monitoring accuracy, and ultimately to improve health outcomes. Description of Tool The PHQ-9 is a widely utilized tool in Primary Care to assist clinicians with the detection, diagnosing, monitoring, and measuring of severity of depression in adults (Kroenke, Spitzer, Williams 2001). It is a nine item self-administered questionnaire based on the Diagnostic Statistic Manual IV (DSM-IV) criteria for diagnosing depression in adults. There is a tenth question at the end regarding effect, if any, on functioning. It has also been used in many medical specialty populations for adults presenting with, or suspicion of depressive symptoms. It may be completed in clinic by the patient and takes two to five minutes (Nease et al. 2003). It is reviewed by the clinician and interpretation of the score is made using the algorithm that accompanies the questionnaire in 1-3 minutes. The expense of the paper is the only cost. The training is simply the clinician becoming familiar with the questions and the scoring. Literature Review The PHQ-9 is a version of the orig... ... middle of paper ... ...ion and diagnosis of depression but does not negate the need for clinician interview and assessment. Gilbert et. al 2007 cautioned that screening procedures alone will not improve client outcomes. One bias is that much of the research regarding the PHQ-9 has been by the developers of the tool and funded by Pfizer, however in view of several other studies supporting that it is evidence- based, this is not an ethical concern. Overall the PHQ-9 has been shown to have a positive effect on health outcomes by aiding clinicians in detection, diagnosing and monitoring depression with a consistent reliable tool. The scope of advanced practice nursing has increased over the last decade and mental health has become a common reason to see a healthcare professional. Nurse practitioners can feel confident in using this tool as an adjunct to their clinical assessment skills.
In order to collect data a counselor must first decide on which symptom and functioning domain to assess on. Many measures are used to assess treatment outcome focus from one particular symptom or diagnosis such as depression and to which these measures only apply to one subset of clients. In response, many clinical settings that see a wide range of clients tend to measure a broader range of symptoms to provide a more complete assessment of each client. The researcher must then decide what source of dates should be used as well as whom perspective should be assessed. As a result of the complexities of measuring clinical outcomes clinicians have begun to integrate an increased number of brief, standardized, and validated measures that are provided at the beginning of treatment and throughout in intervals.
Included in the treatment of psychiatric patients, differing levels of observation have also been used. These levels of observation include: “routine or general observation, 30- to 15-min checks, and constant or continuous observation” (Manna, 2009, p. 268). While a mental health professional such as a Licensed Professional Counselor, Licensed Clinical Social Worker, Psychiatrist, or Advance...
The Beck Depression Inventory-II (BDI-II) is the latest version of one of the most extensively used assessments of depression that utilizes a self-report method to measure depression severity in individuals aged thirteen and older (Beck, Steer & Brown, 1996). The BDI-II proves to be an effective measure of depression as evidenced by its prevalent use in both clinical and counseling settings, as well as its use in studies of psychotherapy and antidepressant treatment (Beck, Steer & Brown, 1996). Even though the BDI-II is meant to be administered individually, the test administration time is only 5 to 10 minutes and Beck, Steer & Brown (1996) remark that the interpretive guidelines presented in the test manual are straightforward, making the 21 item Likert-type measure an enticing option to measure depression in appropriate educational settings. However it is important to remember that even though the BDI-II may be easy to administer and interpret, doing so should be left to highly trained individuals who plan to use the results in correlation with other assessments and client specific data when diagnosing a client with depression. An additional consideration is the response bias that can occur in any self-report instrument; Beck, Steer & Brown (1996, pg. 1) posit that clinicians are often “faced with clients who alter their presentation to forward a personal agenda that may not be shared.” This serves as an additional reminder that self-report assessments should not be the only assessment used in the diagnoses process.
Clinical depression, which affects about 10% of the adult population (Holtz, Stokes, 1138), is charact...
Zung, W. W. K., (1965). A self-rating depression scale. Arch. Gen. Psychiatry. 12:63-70.[Duke Univ. Med. Ctr., Dept. Psychiatry, Durham, NC]
There are many tools for assessing mental health needs of patients at pre- and post-intervention on various scales including Beck Depression Inventory (BDI), Spielberger State Trait Anxiety Inventory (STAI), Standardised Psychiatric Interview (SPI) and Zung Self-Rating Depression Scale (ZSDS) to obtain outcome data apart from CPA. The BDI and the ZSDS are the main self-administered instruments for the assessment of depression (Beck et al., 1961; Beck and Steer, 1987, Spielberger, Gorsuch &Lushene, 1970, Zung and Durham, 1965).
In this essay the author will be discussing a case study of a patient with a condition of major depression. The author will also discuss what depression is; the assessment that was done on the patient, interventions and medications as well as the effects of the condition on the focused patient in my case study. The author has chosen to use this condition for their case study because they find depression interesting in terms of what and how much impact it had on this patient’s physical, sociological and mental state. Moreover, using this patient’s condition for the case study will enable the author to know the care needs of the patients with this condition in the future. Also studying depression for the case study will also help improve the author’s theoretical and practical knowledge of depression. Names that are used in this case study have been changed in order to meet up with the requirements of Nursing & Midwifery Council code of conduct (NMC, 2008) on privacy and confidentiality. Mrs Smith had been admitted to the community hospital for rehab following a discharge from Hospital; she had recently been diagnosed with a condition of major depression in January 2014. She already was suffering from a condition of anxiety just after she had lost her mother in August 2013.
Depression is a common mental disorder that affects approximately 350 million people worldwide (World Health Organization (WHO), 2014). At its worst, depression may lead to suicide, with an approximate 1 million deaths per year (WHO, 2014). Since depression is a mood disorder, it can affect many aspects of health, and it may prevent older adults from enjoying life (Public Health Agency of Canada, 2010). Older adults living with depression may suffer from sleep disturbances, aches and pains, fatigue, and changes in weight...
The Beck Depression Inventory is a self-report inventory that attempts to understand the severity of depression in adults and or adolescents. The original Beck Depression Inventory was created in 1961 by Aaron Beck and his associates and was revised in 1971. In 1971, the Beck Depression Inventory was introduced at the Center for Cognitive Therapy, CCT, at the University of Pennsylvania Medical School. Much of the research on the Beck Depression Inventory has been done at the University of Pennsylvania Medical School. In the current version, of the Beck Depression Inventory, the subject rates 21 symptoms and attitudes on a 4 point scale depending on severity. Test takers rate the items listed in the inventory according to a one week timeframe, which includes the day the test takers took the test. The items that that the inventory measures covers cognitive, somatic, affective and vegetative dimensions of depression and although it was developed atheoretically, the items correspond with depression symptoms as outlined in the Diagnostic and Statistical Manual of Mental Disorders (4th ed.) (DSM-IV, American Psychiatric Association, 1994). The Beck Depression Inventory is widely known and is well known by psychiatric populations and clinicians. The BDI can be administered in a group or individual format by oral or written form. The 1993 version targets more trait aspects of depression versus the previous and earlier versions measured state aspects of depression. The test is to be administered with no more than 15 minutes to take the test, regardless of the mode administered. The 21 symptoms that are rated on the 4 point scale are then totaled and the range can vary from 0 to 63. Patients that score...
Depression is a mental disorder that currently affects more than 350 million people worldwide (who, 2012). With such a staggering amount of people suffering from depression it is important for people to know about it. While some people think that depression is just short term differences in one’s mood that is not the case at all (who, 2012). Someone suffering from depression can have their disorder have negative effects on their life and other people’s lives. Luckily for most people suffering from depression there is treatment available Sadly though because many people don’t understand depression they may not seek treatment at all (NIH, n.d). In order to truly understand depression you need to understand what it is, signs and symptoms, causes, how to diagnose it, and treatment.
Clinical depression is very common. Over nine million Americans are diagnosed with clinical depression at some point in their lives. Many more people suffer from clinical depression because they do not seek treatment. They may feel that depression is a personal weakness, or try to cope with their symptoms alone. On the other hand, some people are comfortable with admitting their symptoms and seeking help. Such a discrepancy may account for the differences in reported cases of depression between men and women, which indicate that more than twice the numbers of women than men are clinically depressed. According to the numbers of reported cases of depression, 25% of women and 10% of men will have one or more episodes of clinical depression during their lifetimes.
Simpson, C. (2007) ‘Mental Health part3: Assessment and Treatment of Depression’ British Journal of Healthcare assistants. pp 167-171.
NICE (2009) Depression in Adults: the treatment and management of depression in adults. National Institute for Clinical Excellence, London
Depression is a serious mental health illness which affects an individuals’ mind, body and mood. It is a chronic and lifelong health condition (NICE, 2006) thought to be caused by a number of biological factors including neurotransmitter disturbances in the brain and an element of genetic vulnerability; these are often in addition to psychosocial factors such as the occurrence of undesirable life events, limited social network options, poor self esteem and the occurrence of any adverse life events during a persons’ lifetime (Bernstein, 2006). Depression can have an impact on a persons’ ability to do many things including working, engaging with others, participating fully in family life or maintaining relationships, and it can also impact on a person...
Mental and behavioural disorders (expressed in disability adjusted life years, or DALY'S) represented 11% of the total disease burden in 1990, and this is likely to rise to 15% by 2020. Five of the 10 leading causes of disability worldwide in 1990 were mental or behavioural disorders. Depression was the fourth largest contributor to the disease burden in 1990 and is expected to rank second after ischaemic heart disease by 2020. It is estimated that one in four people will develop one or more mental or behavioural disorders in their life-time and that one in four families has one member suffering from a mental or behavioural disorder (Murray et al., 1996; WHO,