Psycho-Babble Medication Thread 44042

Shown: posts 1 to 8 of 8. This is the beginning of the thread.

 

Are you depressed ? Ask the question !

Posted by stjames on August 30, 2000, at 2:05:48

I read a great study showing if doc's will just ask people
"Are you or have you ever been depressed?" the sucsess of finding
signifant depression goes up. Bedside manor helps. If a cold doc is wipping down a check list,
no one says "Yes" or "I, don't know". I would like to see primary docs
ask more questions of every patient, at least once while that person is in their care or every 5 years or so.

 

Re: Are you depressed ? Ask the question !

Posted by JohnL on August 30, 2000, at 5:30:57

In reply to Are you depressed ? Ask the question !, posted by stjames on August 30, 2000, at 2:05:48

> I read a great study showing if doc's will just ask people
> "Are you or have you ever been depressed?" the sucsess of finding
> signifant depression goes up. Bedside manor helps. If a cold doc is wipping down a check list,
> no one says "Yes" or "I, don't know". I would like to see primary docs
> ask more questions of every patient, at least once while that person is in their care or every 5 years or so.

I agree completely!

To take it one step further, I think each time a patient has a regular physical exam, they should also be given a depression inventory written test. Like the Beck's test, or the one at Depression Central. Something that can objectively identify depression, the severity of the depression, and the primary symptoms of that person's depression. But, when they are asked to take 5 minutes to fill out the test questions, any hint of depression in the test's title should be removed. The patient should not be aware they are taking a depression test. It should instead be viewed as a routine generic questionnaire that goes along with any physical exam.

It could very well pinpoint problems the doctor and the patient may never have identified otherwise. The test could easily, for example, identify problems in appetite, insomnia, depression, anxiety, occassional suicidal thoughts, productivity at work, etc. The patient might have some physical or mental problem that should be identified and addressed. It could highlight problems that were totally missed in casual questioning and missed in a physical exam.

 

Re: Are you depressed ? Ask the question !

Posted by Phil on August 30, 2000, at 8:10:01

In reply to Re: Are you depressed ? Ask the question !, posted by JohnL on August 30, 2000, at 5:30:57

Great idea. It could have helped me long before I got help.
I can see about 10% of doctors actually doing that. Too bad.

Phil

 

Re: Are you depressed ? Ask the question !

Posted by noa on August 30, 2000, at 9:57:03

In reply to Re: Are you depressed ? Ask the question !, posted by Phil on August 30, 2000, at 8:10:01

National Depression Screening Day is coming up soon. I just don't remember the date. Anyone know?

 

Re: Are you depressed ? Ask the question !

Posted by Phil on August 30, 2000, at 11:47:57

In reply to Re: Are you depressed ? Ask the question !, posted by noa on August 30, 2000, at 9:57:03

> National Depression Screening Day is coming up soon. I just don't remember the date. Anyone know?

Hey Noa...Oct. 5th.
http://www.nmisp.org/depression.htm

 

Re: Are you depressed ? Ask the question ! » JohnL

Posted by Sigolene on August 30, 2000, at 13:01:56

In reply to Re: Are you depressed ? Ask the question !, posted by JohnL on August 30, 2000, at 5:30:57

I agree with your general idea, but please NOT THE BECK TEST ! I hate it.
The worst thing they (doctors) did to me, is when i was feeling awful, and they give me the Beck test, and it says i have "nothing" it's just my "imagination". It's the worst thing to hear when you feel bad and no one is tacking your case in consideration because the Beck test says "nothing".
In fact, it was because this test is made to diagnose only one kind of depression, in accordance with Beck own theorical thinking about what a depression is. And my depression wasn't that kind.
It's the danger to use such tests, because doctors don't listen any more to what patient says or feels.
A depression could also be completely transformed into somatic symptoms, but for the Beck test if you don't cry at least 3 times a day,... you are not depressed.
The real problem is, to my mind, that doctors have no formation in psychology, and they don't want to send their clients to psychologists because they loose them. So they don't want to see any psychological problems.
That's the point here in Europe, but maybe not in US, i don't know.
Sigolene.

> > I read a great study showing if doc's will just ask people
> > "Are you or have you ever been depressed?" the sucsess of finding
> > signifant depression goes up. Bedside manor helps. If a cold doc is wipping down a check list,
> > no one says "Yes" or "I, don't know". I would like to see primary docs
> > ask more questions of every patient, at least once while that person is in their care or every 5 years or so.
>
> I agree completely!
>
> To take it one step further, I think each time a patient has a regular physical exam, they should also be given a depression inventory written test. Like the Beck's test, or the one at Depression Central. Something that can objectively identify depression, the severity of the depression, and the primary symptoms of that person's depression. But, when they are asked to take 5 minutes to fill out the test questions, any hint of depression in the test's title should be removed. The patient should not be aware they are taking a depression test. It should instead be viewed as a routine generic questionnaire that goes along with any physical exam.
>
> It could very well pinpoint problems the doctor and the patient may never have identified otherwise. The test could easily, for example, identify problems in appetite, insomnia, depression, anxiety, occassional suicidal thoughts, productivity at work, etc. The patient might have some physical or mental problem that should be identified and addressed. It could highlight problems that were totally missed in casual questioning and missed in a physical exam.

 

Re: Are you depressed ? Ask the question !

Posted by noa on August 30, 2000, at 15:59:56

In reply to Re: Are you depressed ? Ask the question ! » JohnL, posted by Sigolene on August 30, 2000, at 13:01:56

I agree, I don't think giving a Beck is a good idea for everyone. I think asking the question, starting the dialogue, is what is most important. Doctors can use the Beck questions to keep themselves mindful of signs and symptoms, etc. , but a more personal asking and attentive listening is probably what most patients would appreciate.

This would involve spending more than 2 1/2 minutes with the patient, of course. And, it should follow up with referrals to mental health professionals for further eval. Both of which are unlikely in most managed care environments.

 

Re: Are you depressed ? Ask the question !

Posted by stjames on September 1, 2000, at 2:51:05

In reply to Re: Are you depressed ? Ask the question !, posted by noa on August 30, 2000, at 15:59:56

> I agree, I don't think giving a Beck is a good idea for everyone.

James here....

I found the Beck (or something like it) useful when I first
started AD's. First visit was and hour so the pdoc read the test
to me. This helps, I think. We ran thru it quickly at every visit to gage
how an AD was doing. It gave me concrete proof this were better.
I was suprised at my pre med score. Who was that person ?

The MMPI drives me crazy ! It is scary to realize
someone answers yes to "They are putting thoughts in my head"
and how in all hell do you answer "Sometimes I have queer thoughts" ?
Does this mean gay, funny, unusual, or wacky, really crazy thoughts ?

James


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