Are you depressed?
In the United States, depression affects about 9% of patients and accounts for more
than $43 billion in medical care costs. The United States Preventive Health Task Force
recommends screening for depression in adolescents and adults. The PHQ-2 (Patient
Health Questionnaire 2) and PHQ-9 (Patient Health Questionnaire 9) are the most common
screening tools used for depression.
So, how do you know if you are depressed? Common symptoms of depression include:
• abdominal pain
• back pain
• change in weight
Another mnemonic for depression is SIG E CAPS. This explains the vegetative signs of
nterest (loss of interest in activities and daily things)
nergy (lack of energy)
ppetite disturbance or weight loss
How do you know if you are at risk for depression?
• chronic medical illness
• chronic minor daily stress
• chronic pain syndrome
• family history of depression
• female sex
• low social support
• traumatic brain injury
If you have any of these symptoms along with some risk factors, you should talk
to your primary care physician about depression. Your primary care physician will
administer the PHQ-2, (below).
The PHQ-2 inquires about the frequency of depressed
mood and anhedonia over the past two weeks. The PHQ-2 includes the first two
items of the PHQ-9. The purpose of the PHQ-2 is not to establish final a diagnosis
or to monitor depression severity, but rather to screen for depression in a “first step”
approach. Patients who screen positive should be further evaluated with the PHQ-9 to
determine whether they meet criteria for a depressive disorder.
If you have a positive PHQ-2, then you should proceed to PHQ-9.
Once you have taken these questionnaires, you should discuss the results thoroughly with your
primary care physician. A treatment plan can be tailored to your needs.
Next issue, we will discuss treatment options for depression.