| |
Problem
6.2
The
patient also completes the nine-item Patient Health Questionnaire,
known as the PHQ-9, and her responses are illustrated in Figure
6.2 below.
| Figure
6.2: Patient's Responses on the PHQ-9
|
|---|
| Over
the last 2 weeks, how often have you been bothered by
any of the following problems?
|
|---|
| Symptom
| Not
at all
| Several
days
| More
than half the days
| Nearly
every day
|
|---|
| 1.
Little interest or pleasure in doing things |
|
|
|
X
|
| 2.
Feeling down, depressed, or hopeless |
|
X
|
|
|
| 3.
Trouble falling or staying asleep, or sleeping too much |
|
|
X
|
|
| 4.
Feeling tired or having little energy |
|
|
|
X
|
| 5.
Poor appetite or overeating |
|
X
|
|
|
| 6.
Feeling bad about yourself - or that you are a failure
or have let yourself or your family down |
|
X
|
|
|
| 7.
Trouble concentrating on things, such as reading the
newspaper or watching television |
|
|
X
|
|
| 8.
Moving or speaking so slowly that other people could
have noticed? Or the opposite - being so fidgety or
restless that you have been moving .around a lot more
than usual |
|
|
X
|
|
| 9.
Thoughts that you would be better off dead or of hurting
yourself in some way |
X
|
|
|
|
| (
For office coding: Total Score 15 = 3 + 6 + 6 )
|
|---|
| If
you checked off any problems, how difficult have these
problems made it for you to do your work, take care
of things at home, or get along with other people?
|
|---|
| Not
difficult at all
| Somewhat
difficult
| Very
difficult
| Extremely
difficult
|
|---|
| m.
Nausea, gas, or indigestion | | X
| |
| From
the Primary Care Evaluation of Mental Disorders Patient
Health Questionnaire (PRIME-MD PHQ). The PHQ was developed
by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt
Kroenke and colleagues. PRIME-MD® is a trademark
of Pfizer Inc. Copyright© 1999 Pfizer Inc. All
rights reserved. Reproduced |
|
Question
6.2
| The
most likely diagnosis in this patient based upon her PHQ-9
and PHQ-15 responses is: |
 | Somatization
disorder |
 |
Major depressive disorder |
 |
Generalized anxiety disorder |
 |
Borderline personality disorder |
|