What is the role of the primary care provider in mental health? - ANSWER--- Screen for mental health issues
- Improve outcomes and reduce health care costs
- Assess and give care to mild-moderate disorders or patients with stable severe mental disorders
- From strong links with mental health specialty care for complex cases
Sharing patient info (ex: meds used)
about PHQ2
- what does it screen for, what are the questions, scoring - ANSWER--- Screens for MDD
- It is the first two questions of the PHQ9
- In the last two week, have you been feeling these (not at all, several days, more than half the day, nearly everyday):
- Little interest or pleasure in doing things?
- Feeling down, depressed, or hopeless?
What are characteristics of major depressive disorder or MDD? 9 - ANSWER--Diagnostics need 5 or more of the following:
- SS occur more days than not in a 2 week period
- SS cause significant impairment in any realm of functioning
- Depressed mood
- Loss of interest
- Significant unintended ▲ in weight or appetite
- Significant ▲ sleep
- ▲ psychomotor activity (restlessness)
- Fatigue, loss of energy
- Worthlessness, guilt
Scoring:
A single yes or score >3 (out of 0-6) = possible clinical depression ⇒ due the PHQ9
If the pt screens (+) ⇒ continue to eval with the PHQ9
about PHQ9
- what its used for, questions, scoring - ANSWER--Used for screening, diagnosing, and treating
- It asks about functioning impairments which is needed for the DSM-based diagnosis
Includes asking about suicide or hurting self
Scoring:
0-27 available
0-4: Minimal/none
Monitor; may not require treatment
5-9: Mild
Use clinical judgment; follow-up in one month
10-14: Moderate
Use clinical judgment; may need meds if functionally impaired
15-19: Moderately Severe
Warrants active treatment with psychotherapy, meds, or combo
20-27: Severe
Warrants active treatment with psychotherapy, meds, or combo
what would you do for high risk of CAD using the clinical decision rule (4-5 score) - ANSWER--Order EKG; give O2 and ASA; arrange EMS to ER
anaphylaxis ss - ANSWER--Occurs within 5-30 minutes of exposure to:
Generalized itching with or without hives
Swollen lips, throat, body part
Difficulty breathing, cough
Chest tightness
Abdominal cramping
NVD
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