Screen tools 2

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Read our disclaimer for full disclosure. Download Free Medication Pocket Cards. Online Courses Graduate Success Stories! Rationale of the Week Contact Us. Student Login. Screening Tools for Diabetes. Categories Apps 8. BC-ADM Cardiovascular 8. CDCES COVID Using valid suicide risk screening tools that have been tested in the medical setting and with youth, will help clinicians accurately detect who is at risk and who needs further intervention.

In another multisite research study was launched to validate the ASQ among adults. For medical settings, one of the biggest barriers to screening is how to effectively and efficiently manage the patients that screen positive. Prior to screening for suicide risk, each setting will need to have a plan in place to manage patients that screen positive.

The ASQ Toolkit was developed to assist with this management plan and to aid implementation of suicide risk screening and provide tools for the management of patients who are found to be at risk. The Ask Suicide-Screening Questions ASQ toolkit is designed to screen medical patients ages 8 years and above for risk of suicide As there are no tools validated for use in kids under the age of 8 years, if suicide risk is suspected in younger children a full mental health evaluation is recommended instead of screening.

The ASQ is free of charge and available in multiple languages. For all patients, any other visitors in the room should be asked to leave the room during screening.

Patients who screen positive for suicide risk on the ASQ should receive a brief suicide safety assessment BSSA conducted by a trained clinician e. The BSSA should be brief and guides what happens next in each setting.

Any patient that screens positive, regardless of disposition, should be given the Patient Resource List. For questions regarding toolkit materials or implementing suicide risk screening, please contact: Lisa Horowitz, PhD, MPH at horowitzl mail. These materials can be used in other settings with youth e. Horowitz, L. Psychosomatics, 61 6 , Hospital Pediatrics, 10 9 , Aguinaldo, L.

General Hospital Psychiatry, 68 , 52— Brahmbhatt, K. Suicide risk screening in pediatric hospitals: Clinical pathways to address a global health crisis. Psychosomatics , 60 1 , Roaten, K. Universal pediatric suicide risk screening in a health care system: 90, patient encounters.

Journal of the Academy of Consultation-Liaison Psychiatry. Screening pediatric medical patients for suicide risk: Is depression screening enough? Journal of Adolescent Health, SX 21 Mournet, A. A, Pao, M. Limitations of screening for depression as a proxy for suicide risk in adult medical inpatients. Thom, R. By asking yes-or-no questions, primary care physicians could elaborate on the results of the Patient Health Questionnaire, thereby providing a more thorough examination for the presence of depression.

For example, consider the possibility of a patient who has atypical depression. The DSM-IV gives the following criteria for atypical depression: significant weight gain or increase in appetite, hypersomnia, leaden paralysis ie, heavy, leaden feelings in arms or legs , and extreme sensitivity to perceived interpersonal rejection that often results in angry outbursts.

Comprehensive self-reporting tools are needed to help primary care physicians screen for both the psychological and somatic symptoms of depression. Ideally, such a screening tool would be useful in the routine examination of all patients, although whether it should be used on all patients during every consultation remains unclear. An ideal screening tool would assess the possibility of depression even in a patient presenting primarily with somatic symptoms. The reliability of a depression screening tool is affected by patients' interpretation of its emotional terms and their cultural conception of depression.

Primary care physicians' familiarity with the terms that their patients use to describe emotional problems, as well as how relevant questions are in determining a patient's mental state, could assist in the identification of depression in diverse populations.

Regardless of the limitations of self-reported depression screening tools, it is better to use them to screen for depression than risk missing patients who are suffering from a depressive disorder. Nevertheless, primary care physicians should remember that diagnoses should not be based solely on the findings of depression screening questionnaires. Competing interests: None declared. Summary points.

Semantic differences between the terminology of depression screening tools and the language of some cultures may limit the diagnostic power of these tools. Somatic symptoms may be more reliable indicators of depression than a patient's emotional state.

Scores from depression screening tools should be used to indicate the need for further evaluation—not as a basis for diagnosis. Despite their limitations, self-reported depression screening tools are useful for detecting depression in the primary care setting.

National Center for Biotechnology Information , U. Journal List West J Med v. West J Med. The effects of culture, gender, and somatic symptoms on the detection of depression.

Author information Copyright and License information Disclaimer. Correspondence to: Dr Laura Kerr ude. See " Treating depression in patients with chronic disease " on page See " Psychological aspects of living with HIV disease " on page This article has been cited by other articles in PMC.

Open in a separate window. Cross-cultural validity of the tools One shortcoming of the Beck Depression Inventory arises with linguistic translations of its questions. In particular, the authors suggested the following: The high endorsement of question 6 could result from the central role of Catholicism in Latino culture and the belief that suffering may be the result of God punishing you for your sins Question 10 might be highly endorsed because, in Latino culture, crying has symbolic value and is appropriate and often expected in certain circumstances The high endorsement of question 14 might be due to Latinos' exclusion from stereotypic representations of beauty in Western society.

Furthermore, Latino attitudes toward beauty, argued the authors, change dramatically with age: in Latino culture, as a woman ages, beauty becomes associated with inner qualities rather than physical appearance Latinos' strong work ethic might explain why they predominantly score 0 on question Even limited absenteeism could have a profound effect on themselves and their dependents This study is particularly relevant to primary care physicians.

Gender bias in screening tools It is estimated that twice as many women as men are diagnosed with depressive disorders. Table 3 Depressive disorders that should be picked up by a screening tool for depression Major depressive disorder Chronic depressive disorder Dysthymic disorder Adjustment disorder with depressed mood Adjustment disorder with anxiety and depressed mood Atypical depressive disorder Melancholia Postpartum depressive disorder.

Table 4 Somatic symptoms that sometimes present with depression Headache, migraines Sexual dysfunction Appetite changes Menstrual-related symptoms Chronic pain Chronic medical conditions eg, diabetes, Parkinson's disease, alcoholism Digestive problems eg, diarrhea, constipation Fatigue Sleep disturbances. Figure 1. Gender bias in screening tools may lead to overdiagnosis of depression in women Israel Castro. Acknowledgments Gus M Garmel assisted with research and provided editorial suggestions.

Notes Competing interests: None declared see also p , Summary points Semantic differences between the terminology of depression screening tools and the language of some cultures may limit the diagnostic power of these tools Somatic symptoms may be more reliable indicators of depression than a patient's emotional state Scores from depression screening tools should be used to indicate the need for further evaluation—not as a basis for diagnosis Despite their limitations, self-reported depression screening tools are useful for detecting depression in the primary care setting.

References 1. World Health Organization.