Expert Commentary

Screening for Depression in the Primary Care Setting

Allan Tasman, MD

Professor and Chairman
Department of Psychiatry and Behavioral Sciences
University of Louisville
Louisville, Kentucky
President, Pacific Rim College of Psychiatrists
Secretary for Education, World Psychiatric Association
Past President, American Psychiatric Association

 

Screening for depression in the busy primary care setting remains a challenge for many practices. Here, Dr Allan Tasman gives an overview of applying a two-question screener in the context of a routine office visit to raise the index of awareness of the treating physician to the presence of a depressive disorder. A patients answers to these two questions can indicate the presence of depression, at which point a 9-question screening instrument (the PHQ-9) can be used. The PHQ-9 is patient-completed, allows assessment of severity as well as response to treatment, and is not a time barrier for the busy primary care practice.  The PHQ-9 is part of the Macarthur Foundation Initiative of Depression and Primary Care’s toolkit, freely available at http://depression-primarycare.org/. The Toolkit contains materials for the primary care clinician to download including screening tools, medication guides and how to implement change in practice. Dr Tasman also discusses the importance in primary care of assessing for and addressing suicide risk. Suicidality is a challenging situation for many practitioners to address, and Dr Tasman provides useful clinical pointers on how to address different risk levels with patients and their family and caregivers.

References

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