PHQ-9

We measure a bunch of different outcomes.

PHQ-9 is movement on a depression scale.

GAD-7 is movement on an anxiety scale.

And what we saw is the people that were using Ash saw similar movements on those two scales as, as what you would get in traditional therapy.

She said she was easily distracted, had excessive worry and guilt, and she was unable to feel pleasure and unable to fall asleep.

Now, during this appointment, Lindsay completed three standard assessments: the GAD screening for anxiety, the PHQ-9 questionnaire for depression, and a suicide risk assessment, and her answers showed significant anxiety.

On the GAD, Lindsay reported feeling nervous, anxious, or on edge nearly every day.

She also reported that she was extremely worried all the time and had trouble controlling it.

Dr. Tufts would later testify that on the PHQ-9 assessment, there were also signs of depression.

But on the suicide risk assessment, Lindsay answered no to every question about suicidal thoughts, plans, or thoughts of harming others.

Now, during this first meeting with Dr. Tufts, she prescribed Lindsay 25 milligrams of Zoloft, an antidepressant that raises serotonin levels in the brain to balance your mood.

And knowing that those have slightly different best practices in terms of how to follow up on those, it's still really useful for us to be able to ask those questions of youth, to be able to find folks who are willing to tell us as trusted medical providers that they've experienced this so that we can really make sure that we are doing things in that episode of care that will be helpful for them to protect them from suicide, and also be connecting them to resources that will allow them to get treatment if they do have a mental health condition that would benefit from treatment.

So for those people who have not used the ASQ framework of questions, a lot of practices will use the PHQ system, the PHQ-2, the PHQ-9, PHQ-A, that also have some suicide risk questions.

How do those two tools differ?

That's a great question.

So the PHQ is very specific for asking about the DSM-5 criteria for a major depressive episode.

There's nine questions for that.

So where the PHQ-9 comes from.

The ninth question is one that relates to thoughts about death, dying, suicide.

I was wondering if you could tell us how risk is managed within the Silver Cloud programmes?

When users begin with SoundCloud, when they log in, they are invited to fill in some questionnaires, one of which is the PHQ-9, which is a well-validated measure of low mood.

And in the final question, the PHQ-9 asks about suicidal ideation.

If people score at a certain point on that, literally a little red flag appears, which is very, very useful because it means there's possibly gonna be some risk there.

People are then invited to complete further risk questionnaires.

And trying to, like I mentioned, trying to be best assistant for them.

so that they can spend more time, more quality time with our patients to take care of more, for purely focusing on care, not repeated tasks, such as checking vital, or there are structured assessments such as PHQ-9, mental health assessment, or there are a lot of...

Another example, if senior patients fall, after fall, for three days, nurses need to check the patients every 15 minutes.

That's a lot of work.

Therefore, modern measurement-based care has to capture both domains.

We use the PHQ-9 or the QIDs to track the depressive symptoms, but we must also use functional scales.

Like the LAPS.

Yeah, the LAPS, the Lamb Employment Absence and Productivity Scale, or the SDS, the Sheehan Disability Scale, to track whether we are actually restoring their ability to live their life.

So doctors, nurse practitioners, primary care providers, they are told the drugs will solve these problems.

If you screen a patient with this Pfizer-created personal health questionnaire, PHQ-2 or PHQ-9, and it scores this score, that means they are blah, right? And blah could be moderate depressive disorder or severe depressive disorder.

And if it's that, then you have to, you know, these drugs are the family of drugs that can help.

It can mirtazapine, bupropion, you know, SSRIs, whatever.