Part 1: Depression Screening in Primary Care

Size: px
Start display at page:

Download "Part 1: Depression Screening in Primary Care"

Transcription

1 Part 1: Depression Screening in Primary Care Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN MetroHealth System

2 Objectives Part 1: Improve ability to screen and diagnose Depression in Primary Care Increase ability to use PHQ-2 and PHQ-9 tools in Primary Care

3 Why screen for depression in primary care?

4 Depression Facts -- Epidemiology Lifetime prevalence of 10-24% in women and 5-12% in men 19 million Americans diagnosed each year 151 million people affected worldwide 2 nd leading cause of disability by 2020 Depressive disorders are 2-fold more prevalent in patients with diabetes, CAD, HIV, and stroke Depression associated with 2x increase in risk of type 2 diabetes Depression associated with 64% increase in risk of CAD Untreated symptoms of depression exacerbate chronic illness

5 Depression in Primary Care <5% of clinical instruction for 20-33% of primary care practice Only 30-50% of patients with depression are recognized by PCPs Only 50% of patients with depression receive treatment New England Journal of Medicine March; 354 (12)

6 Challenges for Depression Screening in Primary Care Provider time Provider knowledge about depression Responding to score on screening tool Appropriate treatment (antidepressant) Provider concern about suicide risk and liability Provider concern about ability to refer to Psychiatry or to receive timely direction (curbside consultation)

7 Depression Screening Recommended

8 Better Health Greater Cleveland Recommendations Every adult with diabetes, heart failure or hypertension at least once a year for depression using the Patient Health Questionnaire (PHQ-2/PHQ-9). All patients who screen positive for depression will be provided with appropriate diagnosis, treatment, and follow-up. Eligible patients with an established diagnosis of depression should have follow-up monitoring using the PHQ-9 at least annually.

9 Depression Screening: Tool The Patient Health Questionnaire: PHQ-2 and PHQ-9 The PHQ-9 is a screening tool studied in the primary care setting (3000 primary care patients and 3000 OB/GYN patients) Used to screen and monitor treatment for Major Depression Contains 9 items, with scores ranging from 0-3 (depending on frequency of symptoms which reflects severity) #9 asks about death/ suicide thinking Includes item #10, to measure the impact severity of symptoms on work, home life, and relationships

10 PHQ-2 (Patient Health Questionnaire-2) It is the first 2 questions of the PHQ-9 asked as yes/ no Inquires about the frequency of depressed mood and anhedonia (lack of interest or pleasure) over the preceding 2 weeks The PHQ-2 is a first step in screening and is not for diagnosis or monitoring Patients who screen positive (i.e. answer yes to either question) should be evaluated further with a PHQ-9 to determine whether they meet criteria for a depressive disorder diagnosis

11 (PHQ-9)Patient Health Questionnaire 9 Over the last 2 weeks, how often have you been bothered by any of the following problems? Not at all, Several days, More than half the days, Nearly every day: 1. Little interest or pleasure in doing things 2. Feeling down, depressed, or hopeless 3. Trouble falling or staying asleep, or sleeping too much 4. Feeling tired or having little energy 5. Poor appetite or overeating 6. Feeling bad about yourself or that you are a failure or have let yourself or your family down 7. Trouble concentrating on things, such as reading the newspaper or watching television 8. Moving or speaking so slowly that other people could have noticed? Or the opposite being so fidgety or restless that you have been moving around a lot more than usual. 9. Thoughts that you would be better off dead or of hurting yourself in some way. =Total Score: If you checked off any problems, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people? Not difficult at all (score = 0) Somewhat difficult (score = 1) Very difficult (score = 2) Extremely difficult (score = 3) Scoring Totals: 1-4 = Minimal 5-9 = Mild = Moderate = Moderately Severe =Severe Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues

12 Screening for suicidality in primary care The PHQ-9 (question #9) asks about suicidal thoughts Screening tools (PHQ-9) do not predict which patients with suicidal thoughts will actually attempt suicide Positive response should proceed to questions about intention and plan

13

14 Best Practice Alert in Epic For Providers

15 BPA Smartset for Providers

16 PHQ-9 Sample Workflow

17 Diagnosis of Depression

18 Phases of Major Depressive Disorder

19 Major Depressive Disorder (commonly referred to as Major Depression or Depression) DSM IV Criteria Depressed mood or anhedonia (loss of interest/ pleasure) every day, all day for at least 2 weeks At least 4 additional symptoms: Sleep changes Fatigue Appetite or weight changes Psychomotor agitation or retardation Helplessness Hopelessness (excessive guilt) Difficulty concentrating or making decisions Recurrent thoughts of death or suicide Significant functional impairment (in occupational, educational, social/ relationship areas of life) Rule out other cause such as substances or general medical

20 Recurrence of Depression Recurrence of episode of depression is 50-85% after 1st episode. Risk of recurrence increases with each successive depressive episode. Untreated episodes are associated with treatment resistant recurrence. Schneider RK and Levenson JL. ACP

21 Depressive episode of Bipolar Disorder? Bipolar disorder has either manic or hypo-manic episodes in addition to major depressive episodes. Patients with bipolar disorder may present in the depressive phase with symptoms that appear to be major depression. Bipolar depression requires different treatment than major depression. The Mood Disorder Questionnaire (MDQ) can provide clues to bipolar disorder but is not a diagnostic tool. You can find the MDQ at BETTERHEALTHCLEVELAND.ORG

22 DSM-IV Criteria for Mania Abnormally and persistently elevated, expansive or irritable mood for at least 1 week. At least 3 symptoms listed (4 symptoms if mood is only irritable): Distractibility Irresponsibility: Involvement in pleasurable activities with high potential for painful consequences Grandiosity or inflated self-esteem Flight of ideas or reports racing thoughts Increase in activity level (goal-directed) or psychomotor agitation Decreased need for sleep Talkative: pressured to keep talking Significant functional impairment (occupational, social, relationships, educational, recreational) Rule out other cause such as substances, or general medical

23 Screening for Mania or Hypomania Has there ever been a period of 4 days or more when you were feeling so good, high, excited, or hyper that you:..did not need to sleep (for long)?..made illogical (impulsive) decisions you later regretted?..did things you normally would not do (spending, sexual, high risk)?..got into trouble (legal or social)?..had family or friends worried, irritated with you?..had a doctor tell you that you were manic or bipolar? Not related to substance use or medical condition

24 Some Medical Mimics or Causes of Exacerbation of Mood Disorders (Depression and Bipolar) Endocrinopathies (hypo- or hyperthyroidism) Substance use/abuse/dependence Medications (opiates, corticosteroids, hormonal therapies, interferon/ chemotherapy, stimulants, antidepressants) Chronic viral infections (HIV, Hep C) Liver disease Neurological diseases (Parkinson s, Multiple Sclerosis, seizure disorders, dementias)

25 End of Part One

26 Thank You! Questions or Comments? Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN 26

27 Toolkit Availability A hardcopy of our Behavioral Health Toolkit is available for any Better Health Greater Cleveland member practice at no charge. E-copies also are available. Please contact Bonnie at or

Depression Screening in Primary Care

Depression Screening in Primary Care Depression Screening in Primary Care Toni Johnson, MD Kristen Palcisco, BA, MSN, APRN MetroHealth System Our Vision Make Greater Cleveland a healthier place to live and a better place to do business. 2

More information

Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7

Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7 Quick Guide to PRIME-MD Patient Health Questionnaire (PHQ) PHQ9 and GAD7 Purpose The Patient Health Questionnaire (PHQ) is designed to facilitate the recognition and diagnosis of the most common mental

More information

PCORE Depression Post Survey

PCORE Depression Post Survey PCORE Depression Post Survey 1. Please enter your UNI. 467 answered question 467 skipped question 0 2. Please fill in the name of institution you are working at for your Clerkship. 467 answered question

More information

Diagnosis and Treatment of Bipolar Disorder. Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016

Diagnosis and Treatment of Bipolar Disorder. Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016 Diagnosis and Treatment of Bipolar Disorder Marissa Mariano-Mejia, M.D. Adult Psychiatrist July 2, 2016 Points to Cover What is the defining characteristic of Bipolar Disorder? Bipolar I vs. Bipolar II

More information

Measure #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care

Measure #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care Measure #370 (NQF 0710): Depression Remission at Twelve Months National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS F INDIVIDUAL MEASURES: REGISTRY ONLY DESCRIPTION: Adult patients

More information

Office Workflow Examples Overview

Office Workflow Examples Overview Office Workflow Examples Overview These office workflow examples are shared from the Pittsburgh Regional Health Initiative (PRHI) teams in Pennsylvania. These documents represent the local workflows and

More information

BIPOLAR DISORDER IN PRIMARY CARE

BIPOLAR DISORDER IN PRIMARY CARE E-Resource January, 2014 BIPOLAR DISORDER IN PRIMARY CARE Mood Disorder Questionnaire Common Comorbidities Evaluation of Patients with BPD Management of BPD in Primary Care Patient resource Patients with

More information

Major Depression: Screening and Diagnosis in Primary Care

Major Depression: Screening and Diagnosis in Primary Care BARRY J. WU, MD, FACP Yale University Major Depression: Screening and Diagnosis in Primary Care Dr Wu is clinical professor of medicine at Yale School of Medicine. He is also associate program director

More information

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1

Presently, there are no means of preventing bipolar disorder. However, there are ways of preventing future episodes: 1 What is bipolar disorder? There are two main types of bipolar illness: bipolar I and bipolar II. In bipolar I, the symptoms include at least one lifetime episode of mania a period of unusually elevated

More information

Treating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health

Treating Depression to Remission in the Primary Care Setting. James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health Treating Depression to Remission in the Primary Care Setting James M. Slayton, M.D., M.B.A. Medical Director United Behavioral Health 2007 United Behavioral Health 1 2007 United Behavioral Health Goals

More information

B i p o l a r D i s o r d e r

B i p o l a r D i s o r d e r B i p o l a r D i s o r d e r Professor Ian Jones Director National Centre for Mental Health www.ncmh.info @ncmh_wales /WalesMentalHealth 029 2074 4392 info@ncmh.info Robert Schumann 1810-1856 Schumann's

More information

Feeling Moody? Major Depressive. Disorder. Is it just a bad mood or is it a disorder? Mood Disorders. www.seclairer.com S Eclairer 724-468-3999

Feeling Moody? Major Depressive. Disorder. Is it just a bad mood or is it a disorder? Mood Disorders. www.seclairer.com S Eclairer 724-468-3999 Feeling Moody? Is it just a bad mood or is it a disorder? Major Depressive Disorder Prevalence: 7%; 18-29 years old; Female>Male DDx: Manic episodes with irritable mood or mixed episodes, mood disorder

More information

Bipolar Disorder. When people with bipolar disorder feel very happy and "up," they are also much more active than usual. This is called mania.

Bipolar Disorder. When people with bipolar disorder feel very happy and up, they are also much more active than usual. This is called mania. Bipolar Disorder Introduction Bipolar disorder is a serious mental disorder. People who have bipolar disorder feel very happy and energized some days, and very sad and depressed on other days. Abnormal

More information

Caring for depression

Caring for depression Caring for depression Aetna Health Connections SM Disease Management Program Get information. Get help. Get better. 21.05.300.1 B (6/08) Get back to being you How this guide can help you Having an ongoing

More information

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource

DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource E-Resource March, 2015 DEPRESSION Depression Assessment PHQ-9 Screening tool Depression treatment Treatment flow chart Medications Patient Resource Depression affects approximately 20% of the general population

More information

Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing

Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Dr. Anna M. Acee, EdD, ANP-BC, PMHNP-BC Long Island University, Heilbrunn School of Nursing Overview Depression is significantly higher among elderly adults receiving home healthcare, particularly among

More information

`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí=

`çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå. aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= `çããçå=jéåí~ä= aáëçêçéêëw=^åñáéíó=~åç= aééêéëëáçå aêk=`=f=lâçåü~ jéçáå~ä=aáêéåíçê lñäé~ë=kep=cçìåç~íáçå=qêìëí= Overview: Common Mental What are they? Disorders Why are they important? How do they affect

More information

Mental Health Screening in Primary HIV Care

Mental Health Screening in Primary HIV Care Mental Health Screening in Primary HIV Care Francine Cournos, M.D. Professor of Clinical Psychiatry, Columbia University Principal Investigator, Northeast Caribbean AETC fc15@cumc.columbia.edu September

More information

Mood Disorders. Ch. 6- Mood Disorders. What do you know about depression? True or false? Depression is not a common psychological disorder.

Mood Disorders. Ch. 6- Mood Disorders. What do you know about depression? True or false? Depression is not a common psychological disorder. Ch. 6- Mood Disorders OBJECTIVE: Depressive Disorders: Major depressive Disorder Post Partum Disorder Mood Disorders Mood disorders are a group of disorders involving severe and enduring disturbances in

More information

Major Depressive Disorder (MDD) Guideline Diagnostic Nomenclature for Clinical Depressive Conditions

Major Depressive Disorder (MDD) Guideline Diagnostic Nomenclature for Clinical Depressive Conditions Major Depressive Disorder Major Depressive Disorder (MDD) Guideline Diagnostic omenclature for Clinical Depressive Conditions Conditions Diagnostic Criteria Duration Major Depression 5 of the following

More information

Bipolar disorders: Changes from DSM IV TR to DSM 5

Bipolar disorders: Changes from DSM IV TR to DSM 5 Bipolar disorders: Changes from DSM IV TR to DSM 5 M. Amin Esmaeili, MD, MPH Iranian Research Center for HIV/AIDS (IRCHA) Iranian National Center for Addiction Studies (INCAS) Mood disorders committee

More information

Michigan Depression Outreach and Collaborative Care (MDOCC) Over the past two weeks how often have you been bothered by any the following problems?

Michigan Depression Outreach and Collaborative Care (MDOCC) Over the past two weeks how often have you been bothered by any the following problems? Michigan Depression Outreach and Collaborative Care (MDOCC) PHQ-9 Over the past two weeks how often have you been bothered by any the following problems? 1. Little interest or pleasure in doing things?

More information

PSYCHIATRY FOR PCPs BIPOLAR DISORDER

PSYCHIATRY FOR PCPs BIPOLAR DISORDER PSYCHIATRY FOR PCPs BIPOLAR DISORDER David A Harrison, MD, PhD Assistant Professor Dept of Psychiatry & Behavioral Sciences University of Washington School of Medicine Mood Disorders: Diagnosis & Treatment

More information

Depression Overview. Symptoms

Depression Overview. Symptoms 1 of 6 6/3/2014 10:15 AM Return to Web version Depression Overview What is depression? When doctors talk about depression, they mean the medical illness called major depression. Someone who has major depression

More information

How to Recognize Depression and Its Related Mood and Emotional Disorders

How to Recognize Depression and Its Related Mood and Emotional Disorders How to Recognize Depression and Its Related Mood and Emotional Disorders Dr. David H. Brendel Depression s Devastating Toll on the Individual Reduces or eliminates pleasure and jo Compromises and destroys

More information

ENTITLEMENT ELIGIBILITY GUIDELINE

ENTITLEMENT ELIGIBILITY GUIDELINE ENTITLEMENT ELIGIBILITY GUIDELINE BIPOLAR DISORDERS MPC 00608 ICD-9 296.0, 296.1, 296.4, 296.5, 296.6, 296.7, 296.8, 301.13 ICD-10 F30, F31, F34.0 DEFINITION BIPOLAR DISORDERS Bipolar Disorders include:

More information

Mood Disorders. 1. Major Depressive Disorders 2. Dysthymic Disorder 3. Bipolar Disorder Bipolar I disorder Bipolar II disorder 4. Cyclothymic Disorder

Mood Disorders. 1. Major Depressive Disorders 2. Dysthymic Disorder 3. Bipolar Disorder Bipolar I disorder Bipolar II disorder 4. Cyclothymic Disorder Mood Disorders 1. Major Depressive Disorders 2. Dysthymic Disorder 3. Bipolar Disorder Bipolar I disorder Bipolar II disorder 4. Cyclothymic Disorder 1. Major Depressive Disorders Introduction Major depressive

More information

MOLINA HEALTHCARE OF CALIFORNIA

MOLINA HEALTHCARE OF CALIFORNIA MOLINA HEALTHCARE OF CALIFORNIA MAJOR DEPRESSION IN ADULTS IN PRIMARY CARE HEALTH CARE GUIDELINE (ICSI) Health Care Guideline Twelfth Edition May 2009. The guideline was reviewed and adopted by the Molina

More information

REVISED E-Health Patient Screening Survey

REVISED E-Health Patient Screening Survey REVISED E-Health Patient Screening Survey The Patient screening survey will be administered online after the patient has electronically signed the patient consent form. 1 E-Health Patient Screening Survey

More information

Symptoms of mania can include: 3

Symptoms of mania can include: 3 Bipolar Disorder This factsheet gives information on bipolar disorder. It explains the symptoms of bipolar disorder, treatments and ways to manage symptoms. It also covers what treatment the National Institute

More information

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca

Mental health issues in the elderly. January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault etheriau@lakeheadu.ca Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late

More information

Mood Disorders and Different Kinds of Depression

Mood Disorders and Different Kinds of Depression Mood Disorders and Different Kinds of Depression We ve been there. We can help. In any given year, nearly one in 10 American adults will suffer from a mood disorder. These illnesses involve changes in

More information

A Depression Education Toolkit

A Depression Education Toolkit A Depression Education Toolkit Facts about Depression in Older Adults What is Depression? Depression is a medical illness. When sadness persists or interferes with everyday life, it may be depression.

More information

3/17/2014. Pediatric Bipolar Disorder

3/17/2014. Pediatric Bipolar Disorder Pediatric Bipolar Disorder 1 Highlighted Topics 1. Review the current DSM-5 definition and criteria for bipolar disorder 2. Highlight major historical developments in the scientific understanding of bipolar

More information

PATIENT HEALTH QUESTIONNAIRE PHQ-9 FOR DEPRESSION

PATIENT HEALTH QUESTIONNAIRE PHQ-9 FOR DEPRESSION PATIENT HEALTH QUESTIONNAIRE PHQ- FOR DEPRESSION USING PHQ- DIAGNOSIS AND SCORE FOR INITIAL TREATMENT SELECTION A depression diagnosis that warrants treatment or treatment change, needs at least one of

More information

Clinical features - Depression

Clinical features - Depression Mood CRS Formulation Depression The word depression is used to describe a variety of states ranging from normal unhappiness after a loss up to severe major depressive illness with physical and psychotic

More information

Bipolar Disorder UHN. Information for patients and families. Read this booklet to learn:

Bipolar Disorder UHN. Information for patients and families. Read this booklet to learn: Bipolar Disorder UHN Information for patients and families Read this booklet to learn: what bipolar disorder is what causes it the signs or symptoms of bipolar disorder what treatments can help Please

More information

Unipolar versus Bipolar Depression. Carey Crill, MSN, CPNP, CFMHNP

Unipolar versus Bipolar Depression. Carey Crill, MSN, CPNP, CFMHNP Unipolar versus Bipolar Depression Carey Crill, MSN, CPNP, CFMHNP Objectives Define Unipolar depression Define Bipolar Disorder and Bipolar Depression Differentiate between bipolar depression and unipolar

More information

D0100: Should Resident Mood Interview Be Conducted?

D0100: Should Resident Mood Interview Be Conducted? SECTION D: MOOD Intent: The items in this section address mood distress, a serious condition that is underdiagnosed and undertreated in the nursing home and is associated with significant morbidity. It

More information

Depression in Older Persons

Depression in Older Persons Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression

More information

A Manic Episode is defined by a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood.

A Manic Episode is defined by a distinct period during which there is an abnormally and persistently elevated, expansive, or irritable mood. Bipolar disorder Bipolar (manic-depressive illness) is a recurrent mode disorder. The patient may feel stable at baseline level but experience recurrent shifts to an emotional high (mania or hypomania)

More information

Bipolar Disorder. Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include:

Bipolar Disorder. Mania is the word that describes the activated phase of bipolar disorder. The symptoms of mania may include: Bipolar Disorder What is bipolar disorder? Bipolar disorder, or manic depression, is a medical illness that causes extreme shifts in mood, energy, and functioning. These changes may be subtle or dramatic

More information

Depression Assessment & Treatment

Depression Assessment & Treatment Depressive Symptoms? Administer depression screening tool: PSC Depression Assessment & Treatment Yes Positive screen Safety Screen (see Appendix): Administer every visit Neglect/Abuse? Thoughts of hurting

More information

FACT SHEET 4. Bipolar Disorder. What Is Bipolar Disorder?

FACT SHEET 4. Bipolar Disorder. What Is Bipolar Disorder? FACT SHEET 4 What Is? Bipolar disorder, also known as manic depression, affects about 1 percent of the general population. Bipolar disorder is a psychiatric disorder that causes extreme mood swings that

More information

Understanding. Depression. The Road to Feeling Better Helping Yourself. Your Treatment Options A Note for Family Members

Understanding. Depression. The Road to Feeling Better Helping Yourself. Your Treatment Options A Note for Family Members TM Understanding Depression The Road to Feeling Better Helping Yourself Your Treatment Options A Note for Family Members Understanding Depression Depression is a biological illness. It affects more than

More information

The Clinical Presentation of Mood Disorders. Bob Boland MD

The Clinical Presentation of Mood Disorders. Bob Boland MD The Clinical Presentation of Mood Disorders. Bob Boland MD 1 The Clinical Presentation of Mood Disorders 2 Concentrating On Depression Major Depression Mania Bipolar Disorder (Manic-Depression) For the

More information

Bipolar Disorder. in Children and Teens. Does your child go through intense mood changes? Does your child have

Bipolar Disorder. in Children and Teens. Does your child go through intense mood changes? Does your child have Bipolar Disorder in Children and Teens Does your child go through intense mood changes? Does your child have extreme behavior changes too? Does your child get too excited or silly sometimes? Do you notice

More information

Depression: What You Need to Know

Depression: What You Need to Know Depression: What You Need to Know What is a Depressive Illness? A depressive illness is a whole-body illness, involving your body, mood, thoughts, and behavior. It affects the way you eat and sleep, the

More information

Self Assessment: Substance Abuse

Self Assessment: Substance Abuse Self Assessment: Substance Abuse Please respond TRUE (T) or FALSE (F) to the following items as they apply to you. Part 1 I use or have used alcohol or drugs for recreational purposes. I use alcohol despite

More information

Understanding Mental Illness Healing Friends Training Module 1

Understanding Mental Illness Healing Friends Training Module 1 Understanding Mental Illness Healing Friends Training Module 1 Objectives To know the myths about mental illness To know the causes of mental illness To have a basic knowledge of common mental illnesses

More information

Chapter 7. Mood Disorders. An Overview of Mood Disorders

Chapter 7. Mood Disorders. An Overview of Mood Disorders Chapter 7 Mood Disorders An Overview of Mood Disorders Gross Deviations in Mood 2 Fundamental states: & Mania : The Low Major Depressive Episode The most commonly diagnosed & most severe depression Depressed

More information

WHAT IT MEANS TO BE A TEAM LEADER. Presented by: Arthur Berger, Ed.D Director of Behavioral Health

WHAT IT MEANS TO BE A TEAM LEADER. Presented by: Arthur Berger, Ed.D Director of Behavioral Health WHAT IT MEANS TO BE A TEAM LEADER Presented by: Arthur Berger, Ed.D Director of Behavioral Health Overview of Urban Health Plan (UHP) Federally Qualified Community Health Center JCAHO accredited Located

More information

Depression, Mental Health and Native American Youth

Depression, Mental Health and Native American Youth Depression, Mental Health and Native American Youth Aisha Mays, MD UCSF Department of Family And Community Medicine Native American Health Center Oakland, CA July 8, 2015 Presenter Disclosures No relationships

More information

CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014. 2014 MVP Health Care, Inc.

CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014. 2014 MVP Health Care, Inc. CHAPTER 5 MENTAL, BEHAVIOR AND NEURODEVELOPMENT DISORDERS (F01-F99) March 2014 2014 MVP Health Care, Inc. CHAPTER 5 CHAPTER SPECIFIC CATEGORY CODE BLOCKS F01-F09 Mental disorders due to known physiological

More information

Effective monitoring & evaluation tools to assess the impact of emotional support services provided for carers

Effective monitoring & evaluation tools to assess the impact of emotional support services provided for carers Effective monitoring & evaluation tools to assess the impact of emotional support services provided for carers WEST CUMBRIA CARERS CLARE EDWARDS & ABBEY WILLIAMSON Background West Cumbria Carers (WCC)

More information

New Patient Information. Address: City: State: Zip: Ph#: Cell#:

New Patient Information. Address: City: State: Zip: Ph#: Cell#: Patient Information: Last Name: New Patient Information First Name: Address: City: State: Zip: Ph#: Cell#: S.S.N: Email: May we contact you by email? Yes No Date of Birth: May we send you information about

More information

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City

Depression and its Treatment in Older Adults. Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City Depression and its Treatment in Older Adults Gregory A. Hinrichsen, Ph.D. Geropsychologist New York City What is Depression? Everyday use of the word Clinically significant depressive symptoms : more severe,

More information

Depression Definition

Depression Definition Depression Definition Depression may be described as feeling sad, blue, unhappy, miserable, or down in the dumps. Most of us feel this way at one time or another for short periods. Clinical depression

More information

Bipolar Disorders. Poll Question

Bipolar Disorders. Poll Question Bipolar Disorders American Counseling Association DSM-V Webinar Series July 10, 2013 Dr. Todd F. Lewis, Ph.D., LPC, NCC The University of North Carolina at Greensboro Poll Question Who are you? Clinical

More information

Bipolar Disorder. Some people with these symptoms have bipolar disorder, a serious mental illness. Read this brochure to find out more.

Bipolar Disorder. Some people with these symptoms have bipolar disorder, a serious mental illness. Read this brochure to find out more. Bipolar Disorder Do you go through intense moods? Do you feel very happy and energized some days, and very sad and depressed on other days? Do these moods last for a week or more? Do your mood changes

More information

Self Monitoring for Relapse Prevention Contents

Self Monitoring for Relapse Prevention Contents Keeping Your Balance Self Monitoring for Relapse Prevention Contents Page Self Monitoring 2 Mood Monitoring Worksheet 3 Symptom Monitoring Worksheet 4 Being Prepared 5 Early Warning Signs Worksheet 6 A

More information

Irritability and DSM-5 Disruptive Mood Dysregulation Disorder (DMDD): Correlates, predictors, and outcome in children

Irritability and DSM-5 Disruptive Mood Dysregulation Disorder (DMDD): Correlates, predictors, and outcome in children Irritability and DSM-5 Disruptive Mood Dysregulation Disorder (DMDD): Correlates, predictors, and outcome in children Ellen Leibenluft, M.D. Chief, Section on Bipolar Spectrum Disorders National Institute

More information

Psychiatric Disorders

Psychiatric Disorders Psychiatric Disorders Learning about the brain from diagnosis to treatment Tedi Asher Harvard Medical School Talk overview Part I: Defining psychiatric disorders Part II: Biological underpinnings of depression

More information

Depression Remission at Six Months Specifications 2014 (Follow-up Visits for 07/01/2012 to 06/30/2013 Index Contact Dates)

Depression Remission at Six Months Specifications 2014 (Follow-up Visits for 07/01/2012 to 06/30/2013 Index Contact Dates) Description Methodology Rationale Measurement Period A measure of the percentage of adults patients who have reached remission at six months (+/- 30 days) after being identified as having an initial PHQ-9

More information

BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS: A REVIEW OF THE CURRENT KNOWLEDGE BASE

BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS: A REVIEW OF THE CURRENT KNOWLEDGE BASE BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS: A REVIEW OF THE CURRENT KNOWLEDGE BASE DSM Manic Episode Distinct period with abnormally and persistent elevated, expansive or irritable mood that lasts at

More information

Depression Flow Chart

Depression Flow Chart Depression Flow Chart SCREEN FOR DEPRESSION ANNUALLY Assess for depression annually with the PHQ-9. Maintain a high index of suspicion in high risk older adults. Consider suicide risk and contributing

More information

Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome

Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome Dr. May Lam Assistant Professor, Department of Psychiatry, The University of Hong Kong Psychosis Psychosis-substance use Bipolar Affective Disorder Programmes EASY JCEP EPISO Prodrome a mental state in

More information

Ways to support the person with bipolar disorder

Ways to support the person with bipolar disorder Ways to support the person with bipolar disorder People differ in what help they need and want from caregivers. Caregivers differ in how involved they are in providing support. Finding ways to provide

More information

Personality Disorders

Personality Disorders Personality s The Good, the Bad and the Really, Really Ugly: Borderline and other Cluster B Personality s BY CHRIS OKIISHI, MD! Long standing! Often life long! Developmental origins! Genetic origins! Resistant

More information

Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N.

Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N. Dual Diagnosis Nursing Care: Treating the Patient with Co-Occurring Addiction & Mental Health Disorders. Deborah Koivula R.N. Webinar Overview & Objectives I. Review current trends in co-occurring disorders

More information

Depression. What Causes Depression?

Depression. What Causes Depression? National Institute on Aging AgePage Depression Everyone feels blue now and then. It s part of life. But, if you no longer enjoy activities that you usually like, you may have a more serious problem. Feeling

More information

Depression and Bipolar Disorder

Depression and Bipolar Disorder The Canadian Mental Health Association (CMHA) is a nation-wide, charitable organization that promotes the mental health of all and supports the resilience and recovery of people experiencing mental illness.

More information

Older Adults and Depression

Older Adults and Depression Older Adults and Depression Do you feel very tired, helpless and hopeless? Are you sad most of the time and take no pleasure in your family, friends, or hobbies? Are you having trouble working, sleeping,

More information

Depre r s e sio i n o i n i a dults Yousuf Al Farsi

Depre r s e sio i n o i n i a dults Yousuf Al Farsi Depression in adults Yousuf Al Farsi Objectives 1. Aetiology 2. Classification 3. Major depression 4. Screening 5. Differential diagnosis 6. Treatment approach 7. When to refer 8. Complication 9. Prognosis

More information

Mental Health and Older Adults

Mental Health and Older Adults Mental Health and Older Adults Working effectively with clients who have a mental illness. Kathleen Renfree, LCPC What is Mental Health? Mental Health is the successful performance of mental function,

More information

Mood disorders. Unlike emotions that are intense and short-lived, moods are relatively long-lasting, nonspecific emotional states.

Mood disorders. Unlike emotions that are intense and short-lived, moods are relatively long-lasting, nonspecific emotional states. LP 14BC: mood disorders 1 Mood disorders Unlike emotions that are intense and short-lived, moods are relatively long-lasting, nonspecific emotional states. Mood disorders: Mental disorders that have mood

More information

Depression Signs & Symptoms

Depression Signs & Symptoms Depression Signs & Symptoms Contents What Is Depression? What Are The Signs And Symptoms Of Depression? How Do The Signs And Symptoms Of Depression Differ In Different Groups? What Are The Different Types

More information

DEPRESSION AND ANXIETY STATUS IN KANSAS

DEPRESSION AND ANXIETY STATUS IN KANSAS DEPRESSION AND ANXIETY STATUS IN KANSAS 2008 Behavioral Risk Factor Surveillance System This report was prepared by the Bureau of Health Promotion, Kansas Department of Health and Environment December

More information

MEDGUIDE SECTION. What is the most important information I should know about SEROQUEL? SEROQUEL may cause serious side effects, including:

MEDGUIDE SECTION. What is the most important information I should know about SEROQUEL? SEROQUEL may cause serious side effects, including: MEDGUIDE SECTION Medication Guide SEROQUEL (SER-oh-kwell) (quetiapine fumarate) Tablets Read this Medication Guide before you start taking SEROQUEL and each time you get a refill. There may be new information.

More information

Mood Disorders. What Are Mood Disorders? Unipolar vs. Bipolar

Mood Disorders. What Are Mood Disorders? Unipolar vs. Bipolar Mood Disorders What Are Mood Disorders? In mood disorders, disturbances of mood are intense and persistent enough to be clearly maladaptive Key moods involved are mania and depression Encompasses both

More information

What Is Bipolar Disorder? Dha. Dat. DJane F. Mountain, MD

What Is Bipolar Disorder? Dha. Dat. DJane F. Mountain, MD Bip at W t What Is Bipolar Disorder? D DD Ds Dis DIDIsDsD D DJane F. Mountain, MD DWh Dha Dat Dt What Is Bipolar Disorder? Jane F. Mountain, MD PLEASE NOTE: This book is not meant to substitute for medical

More information

Psychological Assessment Intake Form

Psychological Assessment Intake Form Cooper Counseling, LLC 251 Woodford St Portland, ME 04103 (207) 773-2828(p) (207) 761-8150(f) Psychological Assessment Intake Form This form has been designed to ask questions about your history and current

More information

Older Adult, Family, and Caregiver Guide

Older Adult, Family, and Caregiver Guide Older Adult, Family, and Caregiver Guide on Depression The Treatment of Depression in Older Adults Older Adult, Family, and Caregiver Guide on Depression The Treatment of Depression in Older Adults U.S.

More information

SCID-I (for DSM-IV-TR) Current MDE (JAN 2010) Mood Episodes A. 4

SCID-I (for DSM-IV-TR) Current MDE (JAN 2010) Mood Episodes A. 4 SCID-I (for DSM-IV-TR) Current MDE (JAN 2010) Mood Episodes A. 4 IF UNCLEAR: Has (DEPRESSIVE EPISODE/OWN WORDS) made it hard for you to do your work, take care of things at home, or get along with other

More information

DISCLOSURES BEING A ZERO: MENTAL ILLNESS AND HIV. Warren Y.K. Ng, MD Zero Disclosures. Albany NY December 5, 2014

DISCLOSURES BEING A ZERO: MENTAL ILLNESS AND HIV. Warren Y.K. Ng, MD Zero Disclosures. Albany NY December 5, 2014 BEING A ZERO: MENTAL ILLNESS AND HIV WARREN Y.K. NG, MD ASSOCIATE PROFESSOR OF PSYCHIATRY AT CUMC Albany NY December 5, 2014 DISCLOSURES Warren Y.K. Ng, MD Zero Disclosures 1 2 DISCLOSURE OF UNLABELED

More information

NORTH DAKOTA NURSING FACILITY PAYMENT SYSTEM

NORTH DAKOTA NURSING FACILITY PAYMENT SYSTEM NORTH DAKOTA NURSING FACILITY PAYMENT SYSTEM North Dakota Department of Human Services Medical Services 600 E Boulevard Ave Dept 325 Bismarck ND 58505 BACKGROUND State law requires all nursing facilities

More information

Welcome New Employees. Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders

Welcome New Employees. Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders Welcome New Employees Clinical Aspects of Mental Health, Developmental Disabilities, Addictive Diseases & Co-Occurring Disorders After this presentation, you will be able to: Understand the term Serious

More information

Depression in Women. National Institute of Mental Health

Depression in Women. National Institute of Mental Health Depression in Women National Institute of Mental Health Large-print Version Do you feel very tired, helpless, and hopeless? Are you sad most of the time, and take no pleasure in your family, friends, or

More information

Bipolar Disorder. Manic Episode

Bipolar Disorder. Manic Episode Bipolar Disorder Manic Episode A distinct period of abnormally and persistently elevated, expansive, or irritable mood lasting at least one week and including at least three of the following: inflated

More information

Guide for family and friends of people affected by bipolar disorders. www.douglas.qc.ca

Guide for family and friends of people affected by bipolar disorders. www.douglas.qc.ca Guide for family and friends of people affected by bipolar disorders www.douglas.qc.ca This guide is intended for families, friends and other people who are interested in understanding the different aspects

More information

Billy. Austin 8/27/2013. ADHD & Bipolar Disorder: Differentiating the Behavioral Presentation in Children

Billy. Austin 8/27/2013. ADHD & Bipolar Disorder: Differentiating the Behavioral Presentation in Children ADHD & Bipolar Disorder: Differentiating the Behavioral Presentation in Children Judy Goodwin, MSN, CNS Meadows Psychiatric Associates Billy Austin 1 Introduction Distinguishing between ADHD and Bipolar

More information

Effective Care Management for Behavioral Health Integration

Effective Care Management for Behavioral Health Integration Effective Care Management for Behavioral Health Integration Title: Effective Care Management for Behavioral Health Integration A process improvement initiative focused on improving mental health outcomes

More information

Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too.

Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too. The Family Library DEPRESSION What is depression? Depression is a medical illness that causes a persistent feeling of sadness and loss of interest. Depression can cause physical symptoms, too. Also called

More information

Assessment of depression in adults in primary care

Assessment of depression in adults in primary care Assessment of depression in adults in primary care Adapted from: Identification of Common Mental Disorders and Management of Depression in Primary care. New Zealand Guidelines Group 1 The questions and

More information

Sex and Love Addiction

Sex and Love Addiction Sex and Love Addiction Yes, love and sex can be addictive and as destructive, at least socially, as compulsive substance use. The high hinges on physical or psychological arousal, and relationships can

More information

Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health beth.buxton@state.ma.us

Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health beth.buxton@state.ma.us Postpartum Depression (PPD) Beth Buxton, LCSW Massachusetts Department of Public Health beth.buxton@state.ma.us Mental Health Disorders An estimated 57.7 million adults (26.2% of adult population) suffer

More information

What to do when a Colleague is depressed

What to do when a Colleague is depressed What to do when a Colleague is depressed 1. Find Out More About Depression. What is depression? Depression is more than the blues or the blahs; it is more than the normal, everyday ups and downs. When

More information

Recognition and Treatment of Depression in Parkinson s Disease

Recognition and Treatment of Depression in Parkinson s Disease Recognition and Treatment of Depression in Parkinson s Disease Web Ross VA Pacific Islands Health Care System What is depression? Depression is a serious medical condition that affects a person s feelings,

More information

Accommodation and Compliance Series. Employees with Bipolar Disorder

Accommodation and Compliance Series. Employees with Bipolar Disorder Accommodation and Compliance Series Employees with Bipolar Disorder Preface The Job Accommodation Network (JAN) is a service of the Office of Disability Employment Policy of the U.S. Department of Labor.

More information