The estimated prevalence of depressive disorders is 13-22% in primary care clinics but is only recognized in approximately 50% of cases. [, ] The US Preventative Services Task Force recommendations were updated in 2016. The USPSTF published a level B recommendation for screening for depression in the general adult population (18 years and older), including older patients and pregnant and postpartum women. Screening should be implemented with adequate systems in place to ensure accurate diagnosis, effective treatment, and appropriate follow-up. [] Use of patient-administered screening tools has increased as a quick and reliable option in the first step of depression assessment or as a treatment monitor. [] An initial screen must be followed by a clinical interview to make the diagnosis of depression. The Diagnostic and Statistical Manual of Mental Disorders ( DSM-5) criteria for major depression are reviewed below. In the original clinician-administered scale, the first 17 items are tallied for the total score, while items 18-21 are used to further qualify the depression.

The scale takes 20-30 minutes to administer. Scores of 0-7 are considered normal, and scores greater than or equal to 20 indicate moderately severe depression. Each item either is scored on a 5-point scale, representing absent, mild, moderate, or severe symptoms, or on a 3-point scale, representing absent, slight or doubtful, and clearly present symptoms. The HDRS contains a relatively large number of somatic symptoms and relatively few cognitive or affective symptoms. [,, ] The 21 items it assesses are as follows: •. The BDI consists of 21 items of emotional, behavioral, and somatic symptoms that takes 5-10 minutes to administer.

Beck Depression Inventory ® (BDI. Beck Institute for Cognitive Behavior Therapy is a leading international source for training, therapy, and resources in CBT. Beck Anxiety Inventory Below is a list of common symptoms of anxiety. Please carefully read each item in the list. Indicate how much you have been bothered by that. Download Song U Smile Justin Bieber.

The items are scored from 0 to 3 and measure mood, pessimism, sense of failure, lack of satisfaction, guilty feelings, sense of punishment, self hate, self accusations, self-punitive wishes, crying spells, irritability, social withdrawal, indecisiveness, body image, work inhibition, sleep disturbance, fatigability, loss of appetite, weight loss, somatic preoccupation, and loss of libido. Scores of 10-18 indicate mild depression, 19-29 indicate moderate depression, and greater than 30 indicate severe depression. [] Other versions have been developed, including the Beck Depression Inventory II (BDI-II), a revision of the BDI in 1996 in response to the fourth edition of the DSM, and the Beck Depression Inventory for Primary Care (BDI-PC). The BDI-II is scored in the same manner as the BDI, but the cutoffs differ slightly. The BDI-PC is a screening 7-item scale for primary care outpatients, with a cut-off of 4 points for major depression. One study found a 97% sensitivity and 99% specificity rate for identifying patients with major depression.

[] (The BDI is copyright protected and cannot be reproduced here. It can be purchased from.). A PHQ-2 score of greater than 3 had a sensitivity of 83% and a specificity of 92% for major depression. [, ] The PHQ 9 establishes the clinical diagnosis of depression and can additionally be used over time to track the severity of symptoms over time.

The cut point of the PHQ9 is equal or greater than 10, which has a sensitivity of 88% and a specificity of 88% for major depression. PHQ-9 scores of 5, 10, 15, and 20 are representative of mild, moderate, moderately severe, and severe depression, respectively (see the image below). For the diagnosis of major depression, either item 1 or 2 should be among the 5 of 9 items present. Items 4 and 5 are combined, with only the highest answer category is considered and a total number of items of nine. As a diagnostic tool, the 10 items are dichotomized for the presence (1) or absence (0) of each symptom. As a measuring tool, the items are given a value (0-5) and summed up to a theoretical score of 0 to 50.