INFORMATION ON DEPRESSION IN PRIMARY CARE

Recognizing that a patient is depressed can be challenging, as often patients are concerned about social stigma or career issues when told their symptoms suggest a depression diagnosis. To aid with identification of depression, Primary Care Clinicians should look for “red flags”, such as multiple unexplained somatic symptoms, recent major stress or loss, chronic pain, chief complaint of insomnia, fatigue or appetite change. Recognition begins with a two-question screen, which can then be followed up with a more detailed diagnostic screen, the PHQ-9, if warranted.

In addition to the PHQ-9 results, the Primary Care Clinician should also obtain additional medical and mental health history from the Soldier. As with the PTSD patient, Soldiers who present depression symptoms must be screened for suicide risk.

Just as with PTSD, Soldiers with depression will be involved with coordinated care from their Primary Care Clinicians, Care Facilitators, and Behavioral Health Specialists.