The MetroHealth System, Cleveland, Ohio mraddock@metrohealth.org
The authors reported no potential conflict of interest relevant to this article.
The authors received funding from the MEDTAPP Healthcare Access (HCA) Initiative and utilized federal financial participation funds through the Ohio Department of Medicaid. The views stated here are those of the authors and not of the Ohio Department of Medicaid or the Federal Medicaid Program. MEDTAPP HCA Initiative funding supports teaching and training to improve the delivery of Medicaid services and does not support the delivery of Medicaid eligible services.
The resources provided here can help you determine if depression is to blame for your patient’s symptoms. A handy antidepressant guide can inform your Tx choices.
As you get ready to see your next patient, 52-year-old Jim M, you see in his chart that during an annual routine nurse screening (per office protocol), he scored positive for depressed mood/anhedonia on the Patient Health Questionnaire-2 (PHQ-2) and scored a 21 out of 27 on the full version (PHQ-9), suggesting that he has severe major depressive disorder and that antidepressants should be considered.
When you enter the exam room, you notice his sad expression, poor eye contact, and stooped posture. Mr. M says his wife “made him” come to see you. He reports low energy and not wanting to leave his house, which started about a year earlier after he lost his job. When you discuss his job loss and the impact it has had on him, he sheepishly admits to sometimes thinking that things would be better if he were dead. Upon further questioning, you learn that he does not have suicidal intentions or plans.
