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Impact and utility of PHQ-9 in identifying depression
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Since unrecognized depression impact individuals’ overall health, the implementation of depression screening provides an avenue for patients with depression to seek the necessary treatments (Thombs et al, 2014). On the other hand, many patients who receive treatments for depression in primary care do not meet the diagnostic criteria (Institute for Clinical Systems, 2016). As the result, one must consider the validity and diagnostic accuracy of the screening instrument during the planning stage of the scholarly project. Health providers are able to use Patient Health Questionnaire-9 (PHQ-9) as a part of diagnostic criteria during initial diagnosis and periodically administer the PHQ-9 to assess the effectiveness of mental health interventions
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.
Rao, S., Ferris, F., & Irwin, S. (2011). Ease of screening for depression and delirium in patients enrolled in
In the United States alone, 57.7 million individuals suffer from mental illness. These illnesses range anywhere from mood disorders to anxiety disorders or to personality disorders and so on (The Numbers Count: Mental Disorders in America). 18 to 25 year olds make up about 30% of these individuals alone (Survey Finds Many Living with Mental Illness Go Without Treatment). These individuals require care from medication to psychiatry or even to confinement. However, of these 57.7 million individuals with mental illness, studies have found that less than one in three of these individuals receive proper treatment (Studies Say Mental Illness Too Often Goes Untreated).
U.S. Public Health Service.(1999). The Surgeon General’s Report on Mental Health. Retrieved June,5,2000, from http://www.surgeongeneral.gov/library/mentalhealth/home.html
Kendell, R. and Jablensky, A. (2003), Distinguishing between the validity and utility of psychiatric diagnoses, American Journal of Psychiatry, Vol. 160, No. 1, pp. 4-12.
Eack, S. M., Singer, J. B., & Greeno, C. G. (2008). Screening for Anxiety and Depression in Community Mental Health: The Beck Anxiety and Depression Inventories. Community Mental Health Journal, 44(6), 465-474.
Depression is the leading cause of disability globally. 18 million adults in US are affected by it, twice as many women as men. It is ranked right after high blood pressure in terms of chronic medical condition. Even though many people are affected by it, millions more cases are not diagnosed because people are reluctant to seek help, fearing the stigma which is attached to mental illness or they simply do not realize they are ill. The symptoms can range from mild to severe, feeling hopelessness and despair.
Simpson, C. (2007) ‘Mental Health part3: Assessment and Treatment of Depression’ British Journal of Healthcare assistants. pp 167-171.
Psychiatric diagnosis determined by panel of 6 psychiatrists using a 2 stage census (validated screening instrument followed by patient interview) compared against opinion by medical and nursing staff via questionnaire
My experience in mental health clinical was very different from any other clinical I had before. In a mental health clinical setting, I am not only treating client’s mental illnesses, I am also treating their medical problems such as COPD, diabetes, chronic renal failure, etc. Therefore, it is important to prepare for the unexpected events. In this mental health clinical, I learned that the importance of checking on my clients and making sure that they are doing fine by performing a quick head-to toes assessment at the beginning of my shift. I had also learned that client’s mental health illness had a huge impact on their current medical illness.
Total scores range from 0 to 60, with higher scores indicating the experience of more severe depressive symptoms (Radloff, 1977). A score of 16 or higher indicates the experience of a clinical depressive disorder (Radloff, 1977). The CES-D was originally developed and tested on a sample of 4,000 individuals within the general population and psychiatric settings (Radloff, 1977). Original evaluations of the CES-D displayed good discriminant validity between the general population and psychiatric inpatient samples. Researchers have also established excellent concurrent validity (Brantley, Mehan, & Thomas, 2000), criterion validity (Harringsma, Engels, Beckham, & Spinhoven, 2004) and construct validity (Cheung, & Bagley, 1998).
Pertaining to veterans, depression is one of the leading causes for disability. It is also one of the most costly chronic conditions when it comes to health care expenditures and lost productivity (Desai, Rosenheck, & Thomas, 2006). There are several reasons for why a veteran can be facing depression. Factors can come from war and some can be from coming back home. Depression is a serious disorder that typically goes undiagnosed and untreated. Because of this, routine screening for depression has been advised so that more occurrences for depression could be found and more people can be assisted. Pertaining to veterans, the Department of Veterans Affairs (also known as the VA), requires annual depression screening for veterans who are not already receiving treatment. This will ensure that those who are in need of services will have the appropriate ones for the exact issue that they are facing.
Mental health is just as important as physical health in a person’s life. Mental health is critical to a person’s well-being, their ability to live a productive life and to keep a healthy family and interpersonal relationships. Mental health does not just affect the mind it also affects people’s physical health. Some physical health diseases can cause a mental health disorder and vice versa. Mental health disorders are associated with the occurrence, development, and outcome of some of the today’s most chronic diseases such as diabetes, heart disease, and cancer. When people go untreated from a mental health disorder are at a higher risk for many unhealthy behaviors such as alcohol and drug use, violent behavior, and suicide.
Family is the basic unit of society. A family is a set of interacting individuals related by blood, marriage, cohabitation, or adoption who interdependently perform relevant functions by fulfilling expected roles. Health practices are those activities performed by individuals or families as a whole to promote health and prevent diseases. The relationship between members of family influences the understanding of behavior, which is demonstrated in family’s structural, functional, communicational, and developmental patterns (American Academy of Pediatrics, 2003; Bonell et al., 2003).Within families, children and adults are nurtured and taught about health values by word and by example, and it is within families that members first learn to make choices to promote health (Edelman & Mandle, 2010, p. 172).
Mental disorders are rapidly becoming more common with each new generation born in the world. Currently, nearly one in two people suffer from some form of depression, anxiety, or other mental health problem at some point in their lives (Editor). With so many people suffering from their mental illnesses, steps have been taken in order to get help needed for these people but progress has been slow. In the medical world, hospitals are treating those with physical problems with more care than those with mental problems. Prescription drugs can only do so much helping the mentally ill go through their daily lives and more should be done to help those who need more than medicine to cope with their illness. Mental health should be considered just as important as physical health because of how advanced physical healing is, how the public reacts to those with mental illness, and due to the consequences that could happen if the illness is not correctly helped.