Depression or sadness is a common psychosocial condition seen in the primary care setting. People use the term “depression” to describe a variety of negative emotions or experiences ranging from sadness to disinterest in pleasurable activities to self-hate. The hallmark signs of major depression are sadness and apathy, but symptoms presented in the primary care setting may include fatigue, loss of appetite, and change in sleep. (Dunphy, Winland-Brown, Porter, Thomas, 2019).
The PHQ-9 is a common screening toll for depression. The Patient Health Questionnaire (PHQ) is an instrument for making criteria-based diagnoses of depressive and other mental disorders commonly encountered in the primary care setting. (Kroenke, Spitzer, Williams, 2001). The PHQ-9 is the depression module, which scores each of the 9 DSM-IV criteria as “0” not at all to “3” nearly every day. The diagnosis of depression is often overlooked and can be complicated by many factors in life. Depression significantly affects not only the patient’s quality of life but also the family and community and takes an economic toll as well. (Edlund, Lauerer, Drayton, 2015). As the NP, awareness of predisposing and precipitating factors should be acknowledged. Using the appropriate screening tools and evidence-based treatment recommendations will enable us as the nurse practitioner to accurately diagnose depression and initiate early treatment in order to avoid a missed opportunity in the primary care setting.
Dunphy, L. M., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2019). Primary Care: The Art and Science of Advanced Practice Nursing-An Interprofessional Approach (5th ed.). Philidelphia, PA: F.A. Davis Company.
Edlund, B., Lauerer, J., & Drayton, S. (2015). Recognizing depression in late life. The Nurse Practitioner, 40(2), 36-42. doi:10.1097/01.NPR.0000459729.92650.ce
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9 Validity of a Brief Depression Severity Measure. Journal of General Internal Medicine, 16(9), 606-613. doi:10.1046/j.1525-1497.2001.016009606.x
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