Discussion on Patient Health Questionnaire (PHQ-9)

This week we will discuss the psychiatric evaluation and evidence-based rating scales. Assessment tools are essential to diagnosis and evaluating response to treatment. You should consider the strength and weaknesses of a tool in order to select the best one for your client. Your assigned assessment tool is listed below.

Patient Health Questionnaire (PHQ-9)
Post a brief explanation of three important components of the psychiatric interview and why you consider these elements important. Explain the psychometric properties of the rating scale you were assigned. Explain when it is appropriate to use this rating scale with clients during the psychiatric interview and how the scale is helpful to a nurse practitioner’s psychiatric assessment. Support your approach with evidence-based literature.

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Solution

Psychiatric Evaluation and Evidence-Based Rating Scales

Everybody conducts interviews in a unique manner; nonetheless, clinicians should make certain that the questions they ask have a specific aim in mind. It is vital to strike a balance between showing compassion and raising the appropriate questions during a psychiatric assessment. Psychiatric interviews are designed to detect and define the patient’s demeanor, behavior, and concerns so that a diagnostic categorization and other treatment judgments may be made. Throughout the interview, competent clinicians ought to make certain that they do not pose any superfluous questions. Additionally, they must make each question matter while ensuring that the interview does not lack compassion.

Diagnosis is made possible in part by the dimensional, etiological, and categorical elements of the interview. There are three parts to this dimensional element, which include the real psychiatric interview of the client. A greeting and introduction are made by the clinician, who then asks the client a few basic questions to get an idea of who the patient is. Furthermore, the clinician inquires about the client’s key concerns while letting the client narrate the course of the ailment (Aboraya et al., 2016). The second stage involves posing screening questions to determine whether or not there are any symptoms. The third step involves the utilization of the discovered symptoms to make a diagnosis of a mental condition.

The interview’s etiological element focuses on finding out what may be causing the patient’s symptoms. It is the therapist’s job to establish if the symptoms are caused by any particular medical problem by using clinical expertise and medical skills (Aboraya et al., 2016). When determining the cause, they may employ whatever concept they choose, provided they have empirical evidence to back it. The categorical element, which entails disease categorization, comes last. This is when the clinician decides if the client’s symptoms create substantial discomfort and whether the client satisfies the requirements for a condition as defined by the ICD or the DSM.

The Patient Health Questionnaire (PHQ-9)

The Patient Health Questionnaire (PHQ) is a self-administered measure designed to determine the degree of depression in patients. The PHQ-9 assesses depression using the DSM-IV as well as other depressive indicators as a baseline. The reliability and validity of the PHQ -9 have been shown in research, including more than five primary care and one obstetrical facility. Major depression was more likely to be diagnosed if the score was more than or equivalent to 10. There is additionally an extra question, which is included in the evaluation but is not scored. The extra question is used to determine how well the client is dealing with the difficulties of daily living and the pressures that they are experiencing (Levis et al., 2019).

The evaluation scoring is carried out after the client has finished the assessment. In this assessment tool, the scores range from 0-27, with a maximum of 27 points. Minimal depressive symptoms are represented by scores spanning from 5 to 9. Mild depression is defined as a score running from 10 to 14. Moderately severe depression is indicated by scores spanning from 15 to 19. Severe depression is indicated by a score higher than 20 (Bélanger et al., 2019).

Healthcare professionals may utilize this tool to address a number of mental health conditions, especially depression and panic disorder. It is also effective in the assessment of pharmacological therapy. It is possible to evaluate adherence with psychopharmacological interventions using this technique.

 

References

Aboraya, A., El-Missiry, A., Barlowe, J., John, C., Ebrahimian, A., Muvvala, S., Brandish, J., Mansour, H., Zheng, W., Chumber, P., Berry, J., Elswick, D., Hill, C., Swager, L., Abo elez, W., Ashour, H., Haikal, A., Eissa, A., Rabie, M., … Price, E. (2014). The reliability of the standard for clinicians’ interview in psychiatry (SCIP): A clinician-administered tool with categorical, dimensional and numeric output. Schizophrenia Research, 156(2-3), 174-183. https://doi.org/10.1016/j.schres.2014.04.025

Bélanger, E., Thomas, K. S., Jones, R. N., Epstein‐Lubow, G., & Mor, V. (2019). Measurement validity of the patient‐health questionnaire‐9 in US nursing home residents. International Journal of Geriatric Psychiatry, 34(5), 700-708. https://doi.org/10.1002/gps.5074

Levis, B., Benedetti, A., & Thombs, B. D. (2019). Accuracy of patient health questionnaire-9 (PHQ-9) for screening to detect major depression: Individual participant data meta-analysis. BMJ, l1476. https://doi.org/10.1136/bmj.l1476

 

 

 

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