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Perioperative issues
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
Gordon A. G. McKenzie, David J. H. Shipway
Screening for depression perioperatively is recommended [5]. Commonly used screening tools include the Patient Health Questionnaire-9 (Figure 3.3). Scoring 10 or above indicates high depression risk, with sensitivity and specificity of 88% prompting appropriate referral [42]. It is currently unknown whether preoperative treatment of depression influences surgical outcomes [41]. Caution is advised regarding initiating selective serotonin uptake inhibitor antidepressants before surgery, as these have been associated with increased rates of perioperative haemorrhage. Where preoperative treatment of depression is indicated, our practice is to commence mirtazapine [43–45].
Musculoskeletal system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
The patient health questionnaire can be used to record information regarding smoking and alcohol consumption. Smoking effects osteoclast activity and the production of osteoblasts and can lower BMD. It is important to establish how long the patient has smoked. Excess alcohol consumption can affect peak bone mass, particularly in younger patients that have regularly exceeded the Department of Health’s recommended weekly alcohol limits for both males and females. Dietary consumption of calcium is important in maintaining good bone health. It is important to establish how much dietary calcium an individual consumes and if this is minimal whether due to intolerance, in which case supplementation with calcium and vitamin D may be necessary. Maternal history of osteoporosis or maternal/paternal hip fracture is an important predictor for low bone mass and future fracture risk (Fig. 3.69).
Mental health
Published in Gina Johnson, Ian Hill-Smith, Chirag Bakhai, The Minor Illness Manual, 2018
Gina Johnson, Ian Hill-Smith, Chirag Bakhai
Ask patient to complete a validated questionnaire: Patient Health Questionnaire 9 (https://patient.info/doctor/patient-health-questionnaire-phq-9) or Hospital Anxiety and Depression Scale which, despite its name, has been validated for use in primary care
A Comparison of Suicide Attempt Histories of Pediatric and Adult Medical Inpatients and Implications for Screening
Published in Archives of Suicide Research, 2022
Annabelle M. Mournet, Jeffrey A. Bridge, Abigail Ross, Daniel Powell, Deborah J. Snyder, Cynthia A. Claassen, Elizabeth A. Wharff, Maryland Pao, Lisa M. Horowitz
Data collection for the two studies took place between August 2013 and October 2019. Data collectors received the patient census from charge nurses for pre-selected units on designated data collection days and all potentially eligible participants were approached for study enrollment. Informed consent was obtained directly from participants who were 18 years or older and informed assent was obtained for participants 17 years or younger, along with informed consent from a parent/guardian (hereafter referred to as “parents”). Following the assent/consent process, parents and other visitors were instructed to leave the room to allow for privacy. Participants completed a battery of self-report questionnaires including a demographics questionnaire, the ASQ, and the Patient Health Questionnaire (PHQ). All measures were administered orally to participants by trained bachelor’s or master’s level research assistants. Participants who were identified as at risk for suicide received a follow-up suicide risk assessment and patient safety was managed as clinically indicated. This study received approval from an institutional review board (IRB) at the National Institutes of Health and the IRBs at all data collection sites.
Initial Session Effects of Brief Cognitive Behavioral Therapy for Insomnia: A Secondary Analysis of A Small Randomized Pilot Trial
Published in Behavioral Sleep Medicine, 2021
Todd M. Bishop, Hugh F. Crean, Jennifer S. Funderburk, Wilfred R. Pigeon
The Patient Health Questionnaire-2 (PHQ-2) (Kroenke et al., 2003) is a two-item depression screen that is administered at least annually to veterans receiving primary care services within VHA. For the present study, PHQ-2 data were extracted from the medical record and used to identify potentially eligible participants. Participants were later administered the Patient Health Questionnaire-9 (PHQ-9) (Kroenke et al., 2001) during an in-person screening process and again at each of the assessment timepoints. The PHQ-9 is a scale that measures depressive symptomatology and consists of nine items. A total score indicating how much the participant has been bothered by past-month depressive symptoms is calculated by summing the nine items (0 = “not at all” to 3 = “nearly every day”) which are based on the criteria for a depressive episode (total score range 0–27).
Barriers to college success among students that experienced adverse childhood events
Published in Journal of American College Health, 2019
Ramon Hinojosa, Jenny Nguyen, Kyle Sellers, Heba Elassar
The 9-item Patient Health Questionnaire (PHQ-9) was administered to survey participants. The PHQ-9 is a psychometrically tested and validated instrument that has been used widely in primary care settings to identify depression and depressive disorders.46 The 9-items include the following: little interest of pleasure in doing things; feeling down, depressed or hopeless; trouble falling or staying asleep, or sleeping too much; feeling tired or having little energy; poor appetite or overeating; feeling bad about yourself; trouble concentrating on things such as reading the newspaper or watching television; moving or speaking so slowly that other people have noticed, or the opposite, being so fidgety or restless that you move around more than usual; and thoughts that you would be better off dead or hurting yourself. As the last item in the PHQ-9 addresses self-harm or suicidal ideation, we had a protocol in place (registered with the IRB) to provide local on and off campus resources to students who scored high on this item. This issue, however, did not arise with our sample of participants. Each of the 9-items ask individuals to indicate how many days over the past 2 w they had been bothered by these things, with answers coded as follows; “0”=not bothered at all, “1”=several days, “2”=more than half of the days, “3”=nearly every day. The scale ranges from “0” indicating no symptoms to “27” indicating the presence of all symptoms. The general cutoff for indications of depression is “10”.47 This scale has high internal consistency in this sample (a Cronbach alpha of 0.88).