There are numerous psychiatric tools to test for depression and anxiety. However, not every single one of it is appropriate for all patients. There are different parameters to gauge the suitability of a tool based on the patient’s profile and the signs and symptoms manifested (Steel et al. 288-300). In the case of patient KB, the Patient Health Questionnaire-9 and the Primary Care PTSD are the most suitable. The PHQ-9 is a test based on nine identified criteria of depression classified by DSM-IV (Jin, 2016). Each patient makes a personal analysis of how the nine signs and symptoms significantly affect their lives. According to a study conducted on the reliability and validity of the PHQ-9, it has been proven effective in assessing and diagnosing depression especially among women and patients experiencing chronic medical conditions (Heerema, 2018). On the other hand, the PC-PTSD aims to determine an individual’s exposure to a traumatic event that may cause anxiety or trauma (Prins et al., 2016). This is effective for people who do not seem to think that they have been affected by a traumatic experience or for those who believe that they have already coped with the trauma like Patient KB.
The PHQ-9 is recommended for Patient KB because aside from being a woman, she has almost all the manifestations of someone who is suffering from depression. For example, KB would score 3 for question number 1, which states that the patient lack interest or pleasure in doing things. According to KB, since her husband died, she no longer enjoys social events especially those where it involved couples. She even added that engaging in such activities makes her symptoms worse. KB would also score three on item number 7 which affects her ability to concentrate on things. This is assumed with KB’s statement that she has “difficulty staying on task and completing projects for work.” KB would score two on item number 4 because while she admitted to feeling tired and does not have the energy, she said that it gets better throughout the day. KB would also score 3 in item 5 due to her lack of appetite for the last three months. She would even score a three on item 3 which is indicative of the inability to sleep. This was the reason why she was prescribed with Excedrin PM to help her sleep. With just a few of the items, KB already scored 15 of the possible 27, which is indicative of major depression (Heerema, 2018).
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Patient KB believes that it has been a while since she experienced the trauma in her life. Thus, KB seemed to think that she has recovered from the depression. Although she was very vocal and open about missing her son, KB does not seem to believe that the reason she was experiencing all these symptoms has something to do with depression. She seemed to think that it is a natural process of grieving even though it has already been two years since her husband died. According to her, it is natural to feel bad because she is now alone and she has nobody to turn to when she is feeling lonely. However, KB does not seem to think that what she went through was traumatic. She calls it or refers to it as overwhelming.
References
Heerema, E. (2018). The PHQ-9: Patient Healthcare Questionnaire for Depression. Retrieved from https://www.verywellmind.com/phq-9-patient-healthcare-questionnaire-for-depression-4149685
Jin, J. (2016). Screening for Depression. JAMA , 315 (4), 428. doi: 10.1001/jama.2015.19234
Prins, A., Bovin, M., Smolenski, D., Marx, B., Kimerling, R., & Jenkins-Guarnieri, M. et al. (2016). The Primary Care PTSD Screen for DSM-5 (PC-PTSD-5): Development and Evaluation Within a Veteran Primary Care Sample. Journal Of General Internal Medicine , 31 (10), 1206-1211. doi: 10.1007/s11606-016-3703-5
Steel, J., Dunlavy, A., Stillman, J., & Pape, H. (2011). Measuring depression and PTSD after trauma: Common scales and checklists. Injury , 42 (3), 288-300. doi: 10.1016/j.injury.2010.11.045
