Week 3 Psychiatric Screening
Depression and anxiety are the most common psychiatric problems affecting patients in primary care. Data from the National Alliance on Mental Illness (NAMI) places the prevalence of depression among American adults at 7.8 percent (representing 19.4 million people), and that of anxiety disorders at 19.1 percent (representing 48 million people) (NAMI, 2021). This weeks assignment focuses on administering relevant screening tools to detect symptoms of depression and anxiety on the presenting client, a 56-year-old Caucasian female. The Beck Depression Inventory (BDI) was selected to screen for symptoms of depression, while the Generalized Anxiety Disorder (GAD-7) scale was selected to screen for anxiety symptoms.
The BDI is a 21-item questionnaire that assesses the intensity of symptoms associated with psychoanalytic aspects of depression including social withdrawal, suicidal ideas, guilt, feelings of failure and sadness (Park et al., 2020). It measures the severity and frequency of depression symptoms experienced in the past 2 weeks on a 4-point scale. It is one of the most widely studied measures for assessing depression, with well-established psychometric properties (Garcia-Batista et al., 2018). The 21 items are scored from 1 to 3, yielding a maximum score of 63 and a minimum score of zero. Scores between 1 and 10 indicate normal ups and downs, scores of 21 to 30 indicate moderate depression, 31-40 indicate severe depression, and over 40 indicate extreme depression. The BDI was selected not just for its high validity and reliability, but also because it can be used both as a screening tool and as a measure of severity of depressive symptoms (Park et al. 2020). As such, the clinician does not have to administer a different tool to measure the effect of prescribed medication on symptoms at the time of review. Further, the BDI allows for self-rating, allowing the client to regularly measure the progression of their symptoms.
KFs BDI Score
I feel sad
The client reports feeling sad mostly in the morning, but snaps out of it as the day progresses
Sense of failure
As I look back on my life, I see a lot of failures
Client feels like a failure for losing her sons custody to her abusive husband and not playing an active role in bringing him up
I do not enjoy things the way I used to
She no longer enjoys yoga and meditation
I feel guilty most of the time
Reports feeling very guilty about divorcing and leaving her son in treatment plans (Johnson et al. 2019).
KFs GAD-7 Scores
Feeling anxious, nervous or on edge 3
Not being able to control or stop worrying 2
Worrying too much about different things 0
Trouble relaxing 0
Being so restless that it is hard to sit still - 0
Being easily irritable or annoyed 0
Feeing afraid as if something awful might happen - 0
The client is employed as a full-time consultant and mentions that she cannot stay focused anymore and is unable to complete projects for work. The inability to stay focused was interpreted as a sign of anxiety or nervousness and since she works full-time, the effect is felt nearly every day. However, it is not every day that she is unable to control worrying at least once a week, she takes part in social events, although she finds these activities really exhausting. She has no means to control the worry the rest of the days, which are more than half the days of the week. The client was not scored on the remaining 5 items because there is no information to support such…
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