Phq 9 And Gad 7 Pdf

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This easy-to-use self-administered patient questionnaire is used as a screening tool and severity measure for generalised anxiety disorder GAD. Arch Intern Med. Scores of 5, 10, and 15 are taken as the cut-off points for mild, moderate and severe anxiety, respectively.

Patient Health Questionnaire

In addition, questions regarding the screening process and instruments used were asked. The patients considered annual check-ups for mental health issues important. Although the screening results are reassuring, the group is heterogenic and younger individuals should be given extra attention. Follow-up over longer time will provide more robust data. Cystic fibrosis CF is a progressive, genetic disease with symptoms in many organs and a shortened expected life span [ 1 ]. Mutations in the cystic fibrosis transmembrane conductance regulator CFTR gene cause a dysfunctional CFTR protein, which functions as a chloride channel in cell membranes.

As a consequence, the mucus in various organs becomes thick and sticky. Severe, persistent, bacterial lung infection leading to respiratory failure is the major cause of death in this patient population. Liver cirrhosis, diabetes mellitus, sinus disease, and infertility are other CF-related complications. The necessary, daily treatment is time-consuming and cumbersome and includes inhalation of bronchodilators and mucus-solving drugs, mucus-mobilization, and physical exercise. The chronic airway infection is treated with oral, inhaled, and intravenous antibiotics.

Survival has increased dramatically and the majority of people with CF are now adults [ 2 ]. Centralized care with multidisciplinary care teams, improved drugs, and focus on prevention and early treatment of complications are key success factors.

Lung and liver transplantations are established treatment options in severe disease and the development of CFTR modulating drugs gives hope for the future [ 3 , 4 ]. CF is however still a severe disease requiring a demanding treatment, and access to specialized health care and new drugs is a challenge in many countries [ 5 ]. Anxiety and depression are common symptoms among adults with CF [ 6 , 7 , 8 ].

Depression is the most frequent psychiatric diagnosis for individuals experiencing psychological distress in high-income countries [ 9 ]. Depression and anxiety cover a broad spectrum of suffering, from individuals being mildly affected in their everyday life to severe conditions. To react with anxiety or depression is expected and common when faced with severe life events.

Anxiety and depression are fairly common in the general population and comorbidity is high Women, both CF and non-CF, tend to report higher levels than men regarding both depression [ 7 ] and anxiety [ 8 ].

The understanding of mental illness is complex and two previous Swedish studies did not indicate an elevated risk for anxiety and depression among adults with CF compared with the general Swedish population [ 11 , 12 ].

The previous studies may thus have underestimated depression. The guidelines published in recommend annual screening for mental health problems in patients with CF [ 13 ]. Little is known about the circumstances regarding implementation of the screening. Using questionnaires is time efficient but may lead to under-reporting of problems.

Verkleij et al. At the annual European cystic fibrosis congress in Seville , we presented our first experiences and impression of establishing the guidelines [ 16 ]. The new guidelines, recommending annual screening for mental health, were presented to the CF-team.

Any obstacles or opposition to screening, as well as the best way to implement the guidelines, were discussed. A strategy was agreed upon and patients were informed in a newsletter of the new guidelines and the planned process.

An action plan for patients with unexpected high scores was made. Evaluation of the implementation was scheduled to be performed once the majority of the patients had been screened once. All adult patients attending the Gothenburg CF-center between February and December were consecutively asked to complete the questionnaires regarding anxiety and depression, and three additional questions on patient acceptance, at the time of their annual comprehensive assessment.

The majority of the patients were screened within a year while a few patients with a postponed yearly assessment were included during the later study period. The forms were distributed and collected by the clinic nurses. The psychologist summarized and assessed the scores and wrote a short comment in the medical chart within a week for action when needed.

For these patients a personalized plan was created. Additionally, a brief check-in was carried out for patients scoring in the mild range 4— The PHQ-9 contains 9 items, with a total score ranging from 0 to Total scores of 0—4 indicate no depression, 5—9 mild depression, 10—14 moderate depression, 15—19 moderately severe depression, and 20—27 severe depression [ 17 ]. The PHQ-9 is considered a suitable instrument for detecting depression in the general population [ 19 ]. Symptoms of anxiety were measured using the Swedish version of Generalized Anxiety Disorder Scale GAD-7 [ 20 ], a 7-item measure with a total score of 21 and a cut-off of 10 to detect anxiety.

Data are presented in numbers, median, and range. All invited patients agreed to participate. Written informed consent was given prior the study.

The Helsinki ethical guidelines [ 22 ] were followed and the study was approved by the local ethical committee at the University of Gothenburg Dnr: The results were evaluated after inclusion of the first patients.

At the time, patients attended the clinic and, of the 32 not yet included, 15 were organ transplanted and had their main follow-up at the transplant clinic while 17 individuals either had mild disease and infrequent visits at the CF center or had a postponed assessment. See group comparisons in Table 1. Eight patients scored above 15 for GAD-7 indicating severe anxiety. There were 19 patients with scores 5—10 for PHQ-9 and 20 patients with scores 5—10 for GAD-7 no difference for sex or age group , indicating mild reported symptoms of depression and anxiety, respectively.

The results were discussed, as needed, with the patients at a follow-up visit at the clinic. It is good that attention is paid to mental health and that us patients get an opportunity to discuss it. I would have preferred more detailed questions about what made me feel stressed.

For example, is the cause CF, a situation at work or something in my family?. I think that the timing of the annual screening should vary from year to year since my CF is always much worse at this time of year. I would like to add that my experienced strain is not directly connected with CF. Over the last years, the importance of structured mental health screening among people with CF has been highlighted [ 6 , 7 , 8 , 13 , 14 ]. A recent Italian study reported more symptoms of anxiety for adult CF females and mothers to CF children, compared to CF males and fathers [ 23 ].

To the best of our knowledge, there are no published studies comparing depression and anxiety between different age groups among the adult population with CF. When comparing studies, it is important to consider the differences in study design, questionnaires used, and cut-off values reported.

We found higher scores for anxiety in the young age group, compared to the older group but overall the results indicated that the majority of the population had no symptoms of anxiety at all. However, anxiety and depression disorders are more common among adolescents and young adults in general [ 24 ], in part explained by an increased vulnerability during the biological maturation process as well as all the life changes and decisions for the future that this period of life entails [ 25 , 26 ].

Living with a chronic disease increases the vulnerability further but, in our opinion, the majority of young people with CF look forward to the anticipated life changes and the transition from pediatric to adult care.

The first severe infection in adult age, or just the sudden insight of how CF restricts daily life and future life perspectives, may cause intense stress and anxiety [ 27 , 28 ]. The present results are in contrast to a study by Besier, Goldbeck [ 29 ] that found life satisfaction to be lower and the burden of the illness to be greater in older patients with CF. We may speculate that easy access to the specialized CF health care team, including psychologist and social worker, and the Swedish social welfare system are protection factors.

Interestingly, and in contrast to the general Swedish population [ 10 ], no difference in anxiety or depression was found between men and women with CF.

This could have several explanations. In general, a combination of life stress such as adverse life events, chronic stress exposure, poor social support, and limited social networks coupled with limited psychosocial resources is associated with adverse psychological, physical, and quality of life outcomes [ 30 ].

In line with this, it is possible that the burden of living with CF could supersede other common reasons for anxiety and depression and, as such, erase the difference between men and women regarding mental health [ 31 ]. We found, in contrast to others, no gender difference [ 6 , 23 ] and will follow-up on this issue in future studies.

Overall, the patients were positive to participating in annual mental health screening. Constructive suggestions were in line with the findings by Verkleij et al.

It might also be a good idea to add a question to the questionnaires asking how the reported symptoms relate to CF. It is reassuring to find that those who gave negative comments did not form a specific group regarding age, gender, or screening results.

Those who gave negative feedback were also engaged in the questions and pointed out facts that are important to bear in mind. For example, mental health issues are not always connected to CF and may be better addressed elsewhere. Psychiatric health care or a visit to the general practitioners may sometimes be more appropriate ways to handle mental health problems.

The CF psychologist can act as a facilitator by addressing the mental health questions and discussing preferences regarding follow-up. A previous study found that hesitation in the CF-team to start up mental screening was associated with the fear of lack of referrals or the fear of not being able to manage the possible additional workload connected to the screening or the mental health problems in the patient population [ 14 ].

Our experience is that by involving the whole team in the process and informing the patients ahead of time, we could implement the guidelines in an efficient and reliable way.

The extra workload was less than expected. In our opinion, screening by questionnaires saves time and aids the psychosocial team in prioritizing patients. Screening is also possible to be conducted at CF centers with limited access to a psychosocial team. A limitation of our study is that only two patients having undergone lung transplantation were included. However, for this group, an annual check-up for health and mental health issues is performed at the transplant center.

Another limitation is that no health data are included for the group. Annual screening for anxiety and depression was considered important by the patients. Although the results are reassuring, the group is heterogenic and extra attention could be given to the vulnerable young adults, recently transferred to the adult clinic. Screening is not the answer to every question regarding mental health but it is a reliable and easy way to bring these questions upon a regular basis. Elborn, J.

Cystic fibrosis. The Lancet, , — Burgel, P. Future trends in cystic fibrosis demography in 34 European countries. European Respiratory Journal, 46 1 , — Clancy, J.

Patient acceptance and outcome of mental health screening in Swedish adults with cystic fibrosis

The present study evaluates whether or not differences occur for patients cared within a primary versus secondary mental health service. Pre-treatment scores for patients were included in a cross-sectional cohort design. Reliability and overall scores did not significantly differ between services. However many clients in both groups scored the maximum score on the GAD-7 and there were few differences in scores based on diagnosis for both measures. The PHQ-9 and the GAD-7 are reliable measures of depression and anxiety symptoms for patients cared within a primary or secondary mental health service. However, the GAD-7 has a ceiling effect and both measures may not distinguish between services and diagnosis and therefore may not be useful for screening purposes.

Recognizing signs of mental health disorders is not always easy. The Patient Health Questionnaire PHQ is a diagnostic tool for mental health disorders used by health care professionals that is quick and easy for patients to complete. In the mids, Robert L. Spitzer, MD, Janet B. They worked in collaboration with researchers at the Regenstrief Institute at Indiana University and with the support of an educational grant from Pfizer Inc.

PHQ-9 and GAD-7

Search for researchers:. Search for research:. Jennifer Breen. Department of Psychology.

As health care professional we respect your data. We apply 'research' principle to every case taking measure along the way. This helps to improve care and treatment on a case by case basis. Putting our data together demonstrates the services overall effectiveness and helps to benchmark against the industry standards, e. These are increasingly used in robust mental health research to indicate a diagnosis, a classification of severity and outcome monitoring within national CBT therapy services.

Baseline data from patients enrolled in 2 primary-care based trials of chronic pain and 1 oncology-practice based trial of depression and pain were analyzed. The internal reliability, standard error of measurement SEM , and convergent, construct, and factor structure validity, as well as sensitivity to change of the PHQ-ADS were examined. The PHQ-ADS may be a reliable and valid composite measure of depression and anxiety which, if validated in other populations, could be useful as a single measure for jointly assessing two of the most common psychological conditions in clinical practice and research.

User account

The Patient Health Questionnaire PHQ is a multiple-choice self-report inventory that is used as a screening and diagnostic tool for mental health disorders of depression , anxiety , alcohol , eating , and somatoform disorders. In addition to the PHQ, a nine-item version to assess symptoms of depression, a seven-item version to assess symptoms of anxiety GAD-7 , [3] and a item version to detect somatic symptoms PHQ [4] have been developed and validated. Though less commonly used, there are also brief versions of the PHQ-9 and GAD-7 that may be useful as screening tools in some settings.

CDP Patient Forms

In addition, questions regarding the screening process and instruments used were asked. The patients considered annual check-ups for mental health issues important. Although the screening results are reassuring, the group is heterogenic and younger individuals should be given extra attention. Follow-up over longer time will provide more robust data. Cystic fibrosis CF is a progressive, genetic disease with symptoms in many organs and a shortened expected life span [ 1 ]. Mutations in the cystic fibrosis transmembrane conductance regulator CFTR gene cause a dysfunctional CFTR protein, which functions as a chloride channel in cell membranes.

It contains the mood PHQ-9 , anxiety, alcohol, eating, and somatoform modules. The GAD-7 was subsequently developed as a brief scale for anxiety. All PHQ, GAD-7 screeners and translations in a multitude of languages are downloadable from this website and no permission is required to reproduce, translate, display or distribute them.

Шифровалка снова превратилась в затихшую черную пещеру. Скорее всего Северная Дакота попал в ловушку. Стратмор опустился на колени и повернул тяжелый винтовой замок. Теперь крышку не поднять изнутри. Подсобка компьютера надежно закрыта. Ни он, ни Сьюзан не услышали тихих шагов в направлении Третьего узла.

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 Рыжеволосая? - переспросила. Пауза.  - Это Servicio Social de Sevilla. Вы уверены, что ваш брат приходил именно к. - Да-да.

Настаивал Нуматака. - Никакой Цифровой крепости не существует! - сказал Стратмор. - Что. - Не существует алгоритма, не поддающегося взлому. - Нет, существует. Я видел его в Интернете. Мои люди несколько дней пытаются его взломать.

Фонтейн схватил со стола заседаний трубку внутреннего телефона и набрал номер шифровалки. В трубке послышались короткие гудки. В сердцах он швырнул трубку на рычаг. - Черт! - Фонтейн снова схватил трубку и набрал номер мобильника Стратмора. На этот раз послышались длинные гудки. Фонтейн насчитал уже шесть гудков.

Из-под колес взметнулся гравий. Мотоцикл начал подниматься по склону. Колеса неистово вращались на рыхлой земле.

Это заявление не оставляло места обвинениям в сексуальном домогательстве, однако как-то один из старших криптографов по глупости решил проверить справедливость слов шефа. Однажды, в первый год своей работы в агентстве, Сьюзан заглянула в комнату новых криптографов за какими-то бумагами. Уже направляясь к двери, она увидела свое фото на доске объявлений и едва не лишилась чувств. На фотографии она была изображена наклонившейся над постелью, в одних трусиках.

Тихий, едва различимый. Но этот голос был частью его. Слышались и другие голоса - незнакомые, ненужные.

Он надеялся, что она сядет. Но она этого не сделала. - Сьюзан, сядь. Она не обратила внимания на его просьбу.

Patient Health Questionnaire (PHQ) Screeners. Free Download

Стратмор замолчал, словно боясь сказать что-то, о чем ему придется пожалеть.

В нескольких метрах от них лежало тело Хейла. Выли сирены. Как весенний лед на реке, потрескивал корпус ТРАНСТЕКСТА. - Я спущусь вниз и отключу электропитание, - сказал Стратмор, положив руку на плечо Сьюзан и стараясь ее успокоить.  - И сразу же вернусь.

Токуген Нуматака воплощал старую Японию, его девиз - Лучше смерть, чем бесчестье. Он ненавидел американцев. Ненавидел американскую еду, американские нравы, но более всего ему было ненавистно то, что американцы железной хваткой держали мировой рынок компьютерных программ. У Стратмора был смелый план - создать всемирный стандарт шифрования с черным ходом для Агентства национальной безопасности.

ГЛАВНАЯ РАЗНИЦА МЕЖДУ ЭЛЕМЕНТАМИ, ОТВЕТСТВЕННЫМИ ЗА ХИРОСИМУ И НАГАСАКИ Соши размышляла вслух: - Элементы, ответственные за Хиросиму и Нагасаки… Пёрл-Харбор. Отказ Хирохито… - Нам нужно число, - повторял Джабба, - а не политические теории. Мы говорим о математике, а не об истории. Соши замолчала. - Полезный груз? - предложил Бринкерхофф.

1 Response
  1. Oseas C.

    mentUcate PHQ-9 & GAD Over the last 2 weeks, on how many days have you been bothered by any of the following problems? Not at all. Several. Days.

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