Depression Screening in Primary Care

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Topic: Health & Medicine
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Screening for depression in patients suffering from long term conditions (LTCs) or persistent health problems of the body, could largely be erroneous (Sullivan, 2011). Additionally, when screening for depression in patients with with LTCs is not adequately done, the result may significantly trigger substantial worsening of the victim’s health. This may be due to improper prescriptions and implementation of medical solutions to remedy the condition (Robinson, 2011).

Further, from curative point of view, because depression is connected to weaker self-care, failure to follow prescriptions for medication and abandonment of better lifestyle activities and protective may be rife (Mozes, 2011). Despite facts that uphold the value of antidepressants and watertight forms of psychiatric help, depression normally remains hard to detect. Under-detection of the condition leads to prescription of less effective medication by non-psychiatric medical experts and general practitioners (GPs) (Gurr, 2011; Choate, & Gintner, 2011; U.S. News & World Report, 2011).

Primary Care facilities provide innovative ways and equipment for accurate and time-saving equipment for screening depression (Naeem, Javed, Arshad, Bandial, & Mujtaba, 2011). In an effort to employ integration strategies aimed at merging depression screening processes with straightforward intake and profound evaluation in an Electronic Patient Interview manner, PCP collects and offers response to a variety of patient details, that the victims normally lack the time to speak about (Rao, Ferris, & Irwin, 2011). This practical, more professional application of the PCP, results to improved patient life, limited costs and more access to healthcare. Computerized in-depth diagnosis method, supported by the QPD Panel, reduces time wastage and avails an imperative tool to efficiently combine with MH and BHC’s services in an effort to organize their basic function as MH providers (Dozois, 2011).

McAllister (2011) believes there is increasing acknowledgment of the fact that the screening and control of depression can be challenging among persons with LTCs (Gurr, 2011). For example, in Britain, the National Institute of Health and Clinical Excellence (NICE) published some regulations two years ago that encompass better care strategies to ease the provision of reachable and proper remedies for screening depression in individuals with other chronic illnesses (Mitchell, 2011; Hitsman et al, 2011; Hewitt et al, 2011).

Moreover, for five years now, the broad medical services convention has licensed and supported GPs to be more proactive in diagnosing for depression in individuals with diabetes and other cardiac illnesses because they are at higher risk. Nonetheless, under the general practice that guides operations in Britain, levels of antidepressant medication remain undersubscribed by older individuals and patients with chronic medical conditions (Rao, Ferris, & Irwin, 2011; DiCecco, 2011; Gurr, 2011).

Although, in some cases GPs are sentient of the dangers of emotional comorbidity, findings show that lack of adequate time, lost faith in diagnostic expertise, and notion that the sick resist discussing opening up their psychological problems complicates the screening process (Gurr, 2011; Mental Health Business Week, 2011). Rising above these challenges remains a problem. The reasons on which primary care practitioners base their efforts to identify, screen and control depression in LTC patients remain in doubt (Dozois, 2011; Hewitt et al, 2011; Kozhimannil, Adams, Soumerai, Busch, Huskamp, 2011).

According to Dozois (2011), and Hitsman et al (2011), impediments to effective diagnosis and management of depression in LTCs arise from the inability of the GPs and patients to identify depression; a tendency to normalize depression worsened by LTCs; and the manner in which highly effective and organized primary care fights the common knowledge of depression (Swidwa, 2011). Enhancement of the value of healthcare for patients with depression and LTCs are expected to be based on new intervention measures and restructured services that encourage and support practitioners to be more proactive in the engagement of the sick, through more integrated and participatory screening strategies (Mitchell, 2011; Hewitt et al, 2011; Leavens, Arthurs, Thombs, Kozhimannil, Soumerai, & Huskamp, 2011).

Conclusion

Generally, screening for depression has in the past been treated lightly in patients with LTCs, leading to the use of ordinary and less effective screening machines and processes. Further, structural limitations triggered by such actions resulted to reductionist approaches to screening of depression vis-à-vis LTCs. Future screening methods might be based on better and more accurate technologies. Integrated approach care could also be incorporated in the process of diagnosing depression: this strategy could support PCPs to better screen and manage depressive disorder in sick people with chronic illnesses, more effectively (Rao, Ferris, & Irwin, 2011; Hewitt et al, 2011).

References

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DiCecco, K. (2011). The clinical maxim: depression. Journal of Legal Nurse Consulting, 22(1), 19-22. Web.

Dozois, D.J.A. (2011). Review of “Depression.” Canadian Psychology, 52(2), 142-143. Web.

Gurr, B. (Jan, 2011). Stroke mood screening on an inpatient stroke unit. British Journal of Nursing, 20 (2), 94-100. Web.

Hewitt et al, (2011). Screening and case finding for depression in offender populations: a systematic review of diagnostic properties. Journal of Affective Disorders, 128(1/2), 72-82. Web.

Hitsman et al (2011). Accuracy of a brief screening scale for lifetime major depression in cigarette smokers. Psychology of Addictive Behaviors, 25(3), 559-564. Web.

Kozhimannil, K.B., Adams, A.S., Soumerai, S.B., Busch, A.B., Huskamp, H.A. (2011). New Jersey’s Efforts to Improve Postpartum Depression Care Did Not Change Treatment Patterns For Women On Medicaid. Health Affairs 30(2), 293-301. Web.

Leavens, A., Arthurs, E., Thombs, B.D., Kozhimannil, K.B., Soumerai, S.B., & Huskamp, H.A. (2011). Should Postpartum Depression Screening Policies Be Reevaluated? Evidence For Postpartum Depression Screening: The Authors Reply. Health Affairs 30(6), 1216-1217. Web.

McAllister, J. (2011). Screen patients for depression – and you’ll see them less often. Medical Post, 47(11), 35. Web.

Mental Health Business Week. (2011). “Depression; 8-question survey can help predict post-traumatic stress disorder.” Print.

Mitchell, A. (2011). Recognition of depression and distress in primary care: are clinical skills adequate in the absence of screening?Healthcare Counselling & Psychotherapy Journal, 11(3),13-16. Web.

Mozes, A. (2011). Hospitals Urged to Check for Depression before Discharging Heart Patients. U.S. News & World Report, 1. Web.

Naeem, F., Javed, Z., Arshad, N., Bandial, A., & Mujtaba, M. (2011). Screening for Depression in the Community by Lady Health Workers. Interdisciplinary Journal of Contemporary Research in Business 3(1), 180-188. Web.

Rao, S., Ferris, F.D., & Irwin, S.A., (2011). Ease of screening for depression and delirium in patients enrolled in inpatient hospice care. Journal Of Palliative Medicine 14 (3), 275-279. Web.

Robinson, S. (2011). ‘Reductionist’ QOF approach may undermine patient care. GP (Apr 1, 2011): 12. Web.

Sullivan, K. (2011). “Primary care facilities to target youth depression in with screenings.” McClatchy – Tribune Business News [Washington]. Web.

Swidwa, J. (2011). “Lessons to share.” McClatchy – Tribune Business News. Print.

U.S. News & World Report (2011). Simple Screen May Help Spot Depression in College Students, 1. Web.