Initial evaluation for depression
- Comprehensive assessment: The initial diagnostic evaluation should include a history of the present illness and current symptoms; psychiatric history; general medical history; personal history; social, occupational, and family history; review of the patient's prescribed and over-the-counter medications; review of systems; mental status examination; physical examination; and appropriate diagnostic tests as indicated to rule out possible general medical causes of depressive symptoms
- Functional evaluation: The patient's activity in life—including work, school, family, social relationships, leisure activities, or maintenance of health and hygiene—should be assessed, and the presence, type, severity, and chronicity of any dysfunction should be determined
In conclusion, depression in primary care is characterized by persistent sadness, loss of interest, alterations in cognition, sleep, and appetite, and suicidal ideation. The diagnostic criteria for depression include the DSM-IV criteria and the PHQ-9. The initial evaluation for depression should include a comprehensive assessment and a functional evaluation.