Care Manager discussed with patient not to harm self, assessed and reinforced social support, persons to contact, and what patient has done in the past to feel better or resist suicide.
Transient low mood; does not have depression Sxs at this time (PHQ-9 score less than 5). Not currently appropriate for care management, but please re-consult if symptoms worsen.
Bereavement, lost a spouse, close relative in last two months. Major depression treatment not appropriate. Care manager will provide education and watchful waiting with recheck at 2 months.
Dysthymia with feelings of depression and impaired functioning over last two years and PHQ-9 between 4 and 9. Treat with antidepressant meds or psychotherapy and care management.
Probable major depression (PHQ-9 score above 9) or incipient relapse (PHQ-9 between 5 and 9 with history of depression). Patient prefers watchful waiting.
Probable major depression (PHQ-9 score above 9) or incipient relapse (PHQ-9 between 5 and 9 with history of depression). Treat with antidepressant meds or psychotherapy and care management.
Dysthymia plus major depression; feelings of depression and impaired functioning over last two years and PHQ-9 score above 9. Treat with antidepressant meds or psychotherapy and care management.
Patient is actively participating in depression care management and will be contacted by care manager over the next six months to monitor depressive symptoms, treatment compliance and self-help activities
Mental health follow-up has been initiated; patient will be followed in mental health from now on, but care manager will encourage and monitor appointment compliance and re-assess at 24 weeks
Patient is ready for discharge from panel as indicated by low PHQ-9 scores on two successive assessments over one to two months, no MDD trigger symptoms, and compliant with medication and appointments
Patient is actively participating in depression care management and will be contacted by care manager over the next six months to monitor depressive symptoms, treatment compliance and self-help activities.
Mental health follow-up has been initiated; patient will be followed in mental health from now on, but care manager will encourage and monitor appointment compliance and re-assess at 24 weeks.
Patient is ready for discharge from panel as indicated by low PHQ-9 scores on two successive assessments over one to two months, no MDD trigger symptoms, and compliance with medication and appointments.
Transient low mood; does not have depression Sxs at this time (PHQ-9 < 5). Not currently appropriate for care management, but please re-consult if symptoms worsen.
Sxs of depression (PHQ 5-9) but not MDD; no prior history, no dysthymia. Likely to respond to PC interventions such as stress reduction, social support, exercise. DCM will provide education and watchful waiting and recheck at 3 mos.
Probable major depression (PHQ-9 > 9) or incipient relapse (PHQ-9 is 5-9 with history of depression). Treat with antidepressant meds or psychotherapy and care management.
Dysthymia plus major depression; feelings of depression and impaired functioning over last two years and PHQ-9 > 9. Treat with antidepressant meds or psychotherapy and care management.
Goes to \"toilet room\", cleans self, and arranges clothes without assistance (may use object for support such as cane, walker, or wheelchair, and may manage own night bedpan or commode, emptying same next morning).
No assistance needed (may use object for support such as cane, walker, or wheelchair, and may manage own night bedpan or commode, emptying same next morning).
I want to live by myself or with other people getting mental health care, where I am responsible for taking care of my needs with occasional home visits from a mental health provider.
I live by myself or with other people getting mental health care, where I am responsible for taking care of my needs with occasional visits from a mental health provider.
Goes to \"toilet room,\" cleans self, and arranges clothes without assistance (may use object for support such as cane, walker, or wheelchair and may manage night bedpan or commode, emptying same in morning)
Goes to 'toilet room', cleans self, and arranges clothes without assistance (may use object for support such as cane, walker, or wheelchair and may manage night bedpan or commode, emptying same in morning)
Extremely short (or no) symptom-free interval, constant to near constant (less than a minute symptom-free); freedom from obsessions measured in seconds. May experience only momentary relief.
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Much avoidance, but at least one area of functioning is relatively free from avoidance.
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Good insight. Readily acknowledges absurdity or excessiveness of thoughts or behaviors but does not seem completely convinced that there isn't something besides anxiety to be concerned about (i.e., has lingering doubts).
Fair insight. Reluctantly admits thoughts or behavior seem unreasonable or excessive, but wavers. May have some unrealistic fears, but no fixed convictions.
Poor insight. Maintains that thoughts or behaviors are not unreasonable or excessive, but acknowledges validity of contrary evidence (i.e., overvalued ideas present).
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times.Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Severe, causes significant impairment in one or more (but not all) domains (or aspects) of functioning; e.g., OK at work, but social life on hold. Compulsions are noticeable to careful observers at times. Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning, i.e., social, family, and occupational/school performance. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Severe, causes significant impairment in one or more (but not all) functional domains. Compulsions are noticeable to careful observers at times. Much avoidance, but at least one area of functioning is relatively free from avoidance.
Very severe, causes significant impairment in ALL domains of functioning. Compulsions are very difficult to disguise and are often apparent to others. Leads narrowly circumscribed existence.
Very severe - Appeared \"spacey\" or \"out of it\" (total absence of emotional relatedness) and is disproportionately uninvolved or unengaged in the interview.
Mild - Strange behavior but not obviously bizarre, e.g., infrequent head-tilting (from side to side) in a rhythmic fashion, intermittent abnormal finger movements.
Mild - Definite hallucinations, but insignificant, infrequent, or transient (e.g., occasional formless visual hallucinations, a voice calling the patient's name).
Moderately severe - Flattening of affect, including at least two of the three features: Severe lack of facial expression, monotonous voice, or restricted body gestures.
Mild to moderate. Barely expressed and noticeable through to being present/undeniable. Pt still can provide some orientating information to time, place and/or person.
Moderate to severe. Pt not orientated to time/place; i.e., not able to tell you the date, month, day, year, season, floor, name of hospital, city, state, country.
Mild to moderate. Patient's speech is slightly difficult to follow; responses to questions are slightly off target, to disorganized speech being clearly present.
Mod to severe. Conversation impossible due to disorganized thinking or speech (e.g., irrelevant, incoherent speech, or tangential, circumstantial, or faulty reasoning).
4 Decreased ability to perform complex tasks, e.g. planning dinner for guests, handling personal finances (such as forgetting to pay bills), difficulty marketing, etc.
5 Requires assistance in choosing proper clothing to wear for the day, season, or occasion, e.g. patient may wear the same clothing repeatedly, unless supervised.
6a Improperly putting on clothes without assistance or cuing (e.g. may put street clothes on over night clothes, or put shoes on wrong feet, or have difficulty buttoning clothing) occasionally or more frequently over the past weeks.
6c Inability to handle mechanics of toileting (e.g., forgets to flush the toilet, does not wipe properly or properly dispose of toilet tissue) occasionally or more frequently over the past weeks.
7a Ability to speak limited to approximately a half a dozen intelligible different words or fewer, in the course of an average day or in the course of an intensive interview.
7b Speech ability limited to the use of a single intelligible word in an average day or in the course of an interview (the person may repeat the word over and over).
(C) You were directly affected by someone doing something or failing to do something that went against your moral code or values (e.g., being betrayed by someone you trusted).
Severe - Subject chokes on distressing topics, frequently sighs deeply and cries openly, or is persistently in a state of frozen misery if examiner is sure that this is present.
None of these apply. (If so, for the remaining items, please think about another type of very stressful event that is currently distressing and answer questions while keeping in mind the worst and most currently distressing event.)
My reasons for wanting to commit suicide are primarily aimed at influencing other people, such as getting even with people, making people pay attention to me, etc.