Can measurement-based care improve depression screening and treatment in primary care?
Conclusions: Well-validated as a diagnostic measure, the PHQ-9 has now proven to be a responsive and reliable measure of depression treatment outcomes. Its responsiveness to treatment coupled with its brevity makes the PHQ-9 an attractive tool for gauging response to treatment in individual patient care as well as in clinical research.
What is a response variable in research?
Currently, the HAM-D and the BDI are probably the best-validated scales to quantitatively assess response to treatment. Response has been defined as a 50% reduction in baseline score on the HAM-D or BDI in most clinical trials—in practice we ideally want to see our patients in remission (e.g., scores within the normal range) rather than just ...
What does the DSM–IV-based diagnosis change mean for minor depression?
Beck Depression Inventory (BDI) The Beck Depression Inventory (BDI) is widely used to screen for depression and to measure behavioral manifestations and severity of depression. The BDI can be used for ages 13 to 80. The inventory contains 21 self-report items which individuals complete using multiple choice response formats.
Is there a questionnaire to monitor depression treatment outcomes?
Nov 13, 2020 · Background. Depression is one of the most common mental disorders in the United States. The prevalence of at least 1 major depressive episode among US adults aged 18 years or older, was 17.3 million, representing 7.1% of all US adults. 1 Depression is disabling and costly, 2-9 with an estimated $210 billion annual medical care and lost productivity cost. 3,10 …
What would you need to measure to test for the effectiveness of depression treatment?
Is there a way to measure depression?
A brief questionnaire such as the free, online Patient Health Questionnaire (PHQ-9) aids diagnosis and assesses severity of the depression. As a screening tool, the PHQ-9 can assist in diagnosis, and also serve as a symptom severity tracker to help assess the effectiveness of the treatment plan.
What are variables of depression?
What is the most widely used test to measure the severity of depression?
What level of measurement is a depression scale?
What is the depression test called?
Is depression a quantitative variable?
What is the independent variable in depression?
Is depression a dependent or independent variable?
In the first regression analysis, anxiety was the dependent variable and in the second regression analysis, depression was the dependent variable.Jan 6, 2021
What is the screening tool for anxiety?
When do we use PHQ-9?
What does the PHQ-9 measure?
What is the purpose of depression assessment?
Depression Assessment Instruments. These instruments are relevant to the treatment of depression. Careful assessment is an important part of evidence-based practice. Initial assessments of depressive symptoms can help determine possible treatment options, and periodic assessment throughout care can guide treatment and gauge progress.
How many measures are there in the QIDS-SR?
The QIDS-SR measures the severity of depressive symptoms in adults 18 and older. There are 16 measures, selected from the Inventory of Depressive Symptomology (IDS, 2000). These symptoms correspond to the diagnostic criteria from the DSM-IV. Respondents use a 4-point Likert-type scale to assess their behaviors and mood over the course of the past week. It takes five to seven minutes to complete the report.
Why is careful assessment important?
Careful assessment is an important part of evidence-based practice . Initial assessments of depressive symptoms can help determine possible treatment options, and periodic assessment throughout care can guide treatment and gauge progress. Many of the instruments described below were used in the studies that served as the evidence base ...
What is the CES scale?
The Center for Epidemiologic Studies Depression Scale (CES-D) was designed for use in the general population and is now used as a screener for depression in primary care settings. It includes 20 self-report items, scored on a 4-point scale, which measure major dimensions of depression experienced in the past week. The CES-D can be used for children as young as 6 and through older adulthood. It has been tested across gender and cultural populations and maintains consistent validity and reliability. The scale takes about 20 minutes to administer, including scoring.
What is the EQ-5D?
The EQ-5D is a standardized, non-disease specific instrument for describing and evaluating health-related quality of life. The instrument measures quality of life in five dimensions: mobility, self-care, usual activities, pain/discomfort and anxiety/depression. It was introduced as a health-related quality of life measure by a group of European researchers, the EuroQol Group. Respondents can complete the questionnaire in under five minutes. There is a version for adults (age 16 and older) and the EQ-5D-Y for children/adolescents (8 to 15 years). The EQ-5D is available in a wide range of languages and is used worldwide.
How many questions are asked in the Social Problem Solving Inventory?
The revised version has both a long form (52 questions) and short form (25 questions). It takes 10 to 20 minutes to complete.
How long does it take to complete the Beck Hopelessness Scale?
The measure includes 20 items to which participants respond with “true” or “false.” It takes five to 10 minutes to complete.
Abstract
The National Committee for Quality Assurance recommends response and remission as indicators of successful depression treatment for the Healthcare Effectiveness and Data Information Set. Effect size and severity-adjusted effect size (SAES) offer alternative metrics.
Methods
Data were collected from the Colorado and Washington regions of Kaiser Permanente, two large integrated health care organizations serving a combined population of approximately 1.4 million members.
Results
We identified 2,559 eligible psychotherapy episodes at KPC and 2,995 at KPW (see flow diagram in online supplement ). The mean±SD baseline PHQ-9 score was similar at each site: 16.9±4.4 at KPC and 16.6±4.6 at KPW (see figure in online supplement ).
Discussion
Our analysis of treatment outcomes for 5,554 depression episodes at two large integrated health systems found that rates of treatment success varied considerably across measures. Effect size ≥0.8 was the success measure most likely to be met, whereas remission was the least likely.
Conclusions
MBC has the potential to improve depression treatment outcomes, but its implementation relies on identifying appropriate markers of treatment success. This study examined four measures previously shown to indicate clinically meaningful improvement in depression symptoms: response, remission, effect size ≥0.8, and SAES ≥0.8.
What is the difference between mild depression and moderate depression?
mild depression: few, if any, symptoms in excess of the five required to make the diagnosis, and the symptoms result in only minor functional impairment. moderate depression: symptoms or functional impairment are between ‘mild’ and ‘severe’.
What are the core symptoms of depression?
Core symptoms of depression. Depressed mood most of the day, nearly every day. Markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day.
How long does it take for a depressive episode to go away?
The duration of a depressive episode can vary considerably between individuals. The average course of an untreated depressive episode is between 6 and 8 months with much of the improvement occurring in the first 3 months, and 80% recovered by 1 year (Coryell et al.,1994).
What is the course of depression?
An influential model of the course of major depression proposes that the onset of an episode of depression consists of a worsening of symptoms in a continuum going from depressive symptoms through to major depression.
How long does it take for a person to have persistent symptoms?
By convention the duration of persistent symptoms is required to be at least 2 weeks and, once they have persisted for 2 years or more, they are called chronic in the case of major depression or dysthymia in the case of subthreshold depressive symptoms.
Is depression a comorbid disorder?
It is also common for people with depression to have a comorbid psychiatric diagnosis, such as anxiety, social phobia, panic and various personality disorders (Brown et al., 2001), and physical comorbidity, or for the depression to occur in the context of bipolar disorder (not considered in this guideline).
What does "diminished" mean?
8. Diminished ability to think or concentrate, or indecisiveness, nearly every day. 9. Recurrent thoughts of death (not just fear of dying), recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide.
How does depression affect work?
The negative impact of depression on work, productivity, interpersonal relationships , leisure activities, and a sense of well-being and enjoyment of life cannot be emphasized enough. With the expansion of treatment choices in both psychotherapy and pharmacotherapy, it is becoming increasingly important to monitor patients’ progress using both ...
Is depression a threat to health?
Depression is one of the most significant direct and indirect threats to health and wellness . The negative impact of depression on work, productivity, interpersonal relationships, leisure activities, and a sense of well-being and enjoyment of life cannot be emphasized enough. With the expansion of treatment choices in both psychotherapy ...
Is depression a chronic disorder?
Depressive disorders can be chronic and/or relapsing, which strengthens the argument for periodic assessment of intervention outcomes. However, a sole emphasis on symptom reduction seriously limits optimal outcome. The front-line clinician has an obligation to regularly monitor, measure, and optimize interventions.
What is outcome assessment?
Outcome assessment is a multidimensional proposition that incorporates the patient’s subjective report, clinical judgment, and measurement tools. Outcome assessment should incorporate changes in severity of symptoms, functioning, and quality of life.
What is modern counseling?
Modern counseling has evolved to be a diverse practice with clinicians who embrace various methods, theories, and populations. In your private practice, while you may subscribe to a particular model, such as cognitive behavioral therapy, holistic health, strength-based, or others, you still temper treatments based on an individual client needs. ...
How to use outcome methods in private practice?
The first step to using outcome methods in your private practice is to determine which specific standardized assessments suit your demands. Individual therapists will prefer different evaluation methods, so find the one you are most comfortable using. Then, create the goals—working with your new clients—to measure treatment effectiveness.
Who said "Our goals can only be reached through a vehicle of a plan, in which we must fer
There is no other route to success.” —Pablo Picasso
Example 1: Plant Growth
A botanist wants to compare the effect that two different fertilizers have on plant growth. She randomly selects 20 plants from a field and applies fertilizer A to them for one week. She also randomly selects another 20 plants from the same field and applies fertilizer B to them for one week.
Example 2: Max Vertical Jump
A basketball coach wants to compare the effect that three different training programs have on player’s max vertical jump. He randomly assigns 10 players to use training program A for one week, another 10 players to use training program B for one week, and another 10 players to use training program C for one week.
Example 3: Real Estate Prices
A real estate agent wants to understand the relationship between square footage of a house and selling price. She collects data about square footage and selling price for 100 houses in her city and analyzes the relationship between the two variables.
Summary
In each of the examples above, we changed the values of some explanatory variable and observed the resulting change in values of some response variable.
Additional Resources
What is a Lurking Variable?#N#What is a Confounding Variable?#N#Independent vs. Dependent Variables: What’s the Difference?
What is response variable?
Lesson Summary. In statistics, a response variable, also known as a dependent variable, is a concept, idea, or quantity that someone wants to measure. It depends on an independent variable. A question is proposed, usually stating that the response variable will (or will not) change based on other factors.
What is the purpose of an experiment?
An experiment is conducted to determine if the variable in question indeed responds to the factors being examined. A response variable might be affected by many different factors, known as explanatory variables. However, even if no change or a different change occurs, the response variable remains the same. Key Terms.
Who is Michelle from Prison?
Michelle is a corrections therapist at a state prison. She has also taught classes at community college. She holds a Master's degree in Psychology and a Bachelor's degree in Sociology.