MN 576 Purdue University Primary Care of Women Health Discussion Major depressive disorder is a prevalent issue in the United States. The National Institut

MN 576 Purdue University Primary Care of Women Health Discussion Major depressive disorder is a prevalent issue in the United States. The National Institute of Mental Health estimates that 16.2 million adults that are 18 and older have experienced at least one occurrence of a major depressive episode in the United States (Schadewald, Pritham, Youngkin, Davis & Juve, 2020). Since this issue is so prevalent it is extremely important for primary care providers to identify patients experiencing depression. They can do this by using screening tools to identify patients that have depression. The U.S. Preventative Services Task Force recommends that two questions be asked as a preliminary screen for depression, these include if the patient has felt down or helpless over the past month or if over the past month they have little interest in doing things (Dunphy, Winland-Brown, Porter & Thomas, 2015). One tool that can be used in the primary care setting is the patient health questionnaire (PHQ-9). The PHQ-9 can be filled out by the patient while they wait in the waiting room or exam room before they are seen by the provider. This questionnaire asks the patient about symptoms they have been experiencing over the past 2 weeks. Each answer provides a number which is totaled up for a score which describes the severity of the patient’s depression. The depression severity ranges from minimal depression to severe depression (UpToDate, 2020). Some patients may have a hard time listing their symptoms so there are other screening tools that can be used in these situations such as the Zung Self-Rating Depression Scale (SDS), direct observation of the patient, yes-or-no questions or the Beck Depression Inventory (BDI) (Dunphy et al., 2015). Once a major depressive disorder has been diagnosed it is the responsibility of the primary care provider to work with the patient to identify which symptoms that they are experiencing are top priority in treating and helping the patient to a remission of symptoms. If the patient has a remission of symptoms then it is considered a successful treatment of depression (Dunphy et al., 2015). It is also the responsibility of the provider to assess for suicidal ideation and if the patient is started on antidepressants to make sure that the patient is called during the start of treatment to re-assess for suicidal ideation. Patients that do have suicidal ideations or attempts should be referred to a psychiatrist or behavioral specialist. The provider should also offer the patient reassurance and hope and explain to them that their depression can be treated. This will help the patient feel supported and help them work towards treatment goals. It is essential that the provider follow-up with patients with depression and that they ensure the patient is adherent to the treatment plan. Patients should be monitored if they are prescribed medication to make sure that they are filling their medications. Patients symptoms and treatment outcomes should be re-assessed at every follow-up appointment. Providers should also give the patient and their support members emergency phone numbers in case symptoms get worse. ReferencesDunphy, L. M. H., Winland-Brown, J. E., Porter, B. O., & Thomas, D. J. (2015). Primary Care: The Art and Science of Advanced Practice Nursing (4th ed.). Philadelphia, PA: F.A. Davis Company.Schadewald, D. M., Pritham, U. A., Youngkin, E. Q., Davis, M. S., & Juve, C. (2020). Women’s Health: A Primary Care Clinical Guide (5th ed.). Hoboken, NJ: Pearson Education, Inc. UpToDate. (2020). Calculator: Depression screening by a nine-item Patient Health Questionnaire (PHQ-9) in adults. Retrieved from https://www.uptodate.com/contents/calculator-depre…