For doctors working in the UK NHS, from April 1st patients over 18 with a new diagnosis of depression should have a full 'bio-psycho-social' assessment on the day that depression is diagnosed. This has to be recorded in the notes. Don't get us started on what we think about this (!), but let's try to keep things simple and pragmatic. We think the only way to practically do this is to do your usual patient-centred consultation, then give the patient a form to fill out before they leave. Then to hand it in to reception for filing in the notes when they make their appointment to be seen 10-35 days later. Please feel free to cut, adapt and paste into your own headed paper something along the lines of...
SOME QUESTIONS RELATING TO YOU AND YOUR MOOD
We
are very sorry that you may be suffering from depression. It’s horrible, but we
can help most people get better. We would like to collect some more information
from you to help us to help you. Please can you fill out this form before
you leave, and drop it off for me (in a sealed envelope) at reception. You may well have
discussed much of this already today, but do make an
appointment to come back and see us in 2 to 3 weeks time so that we can review you and we can discuss it
further then.
NAME…………………………………………………………………………
- What are your main current symptoms (including how long & how
severe; how would you rate your mood most days on a score of 1-10 out of
10?)
- Do you have any previous or family history of depression?
- Have you had any previous treatments for depression,
and what has been your response to them?
- What are your main personal/family relationships?
- What are your current living circumstances and
employment status? Do you have financial concerns?
- Do you have any current or previous issues with substance
or alcohol misuse?
- Do you have any suicidal ideas
- What treatment are you expecting/hoping for your
depression?
Thank you. We shall see you soon to
discuss this further.
Dr...........
This assessment could surely help those suffering from depression, but often there is a physiological cause that can be determined through a simple, non-invasive critical care test, as well.
ReplyDeleteSome of these causes could be related to hypertension, cardiac autonomic neuropathy, diabetic neuropathy, vascular abnormalities, orthostatic hypotension, syncope, and even exercise intolerance, all of which the simple test could provide indications of.
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