DR. EBER: Now that you’ve spoken with Antoine, what do you think is going on with him?
DR. RODGERS: Well, based on the warning signs we talked about, he seems to be suffering from PTSD and risky substance use. The stress he’s under is likely exacerbating his pain.
DR. EBER: (to users) If you believe a patient may have a mental health disorder, you can use a screening tool to further assess if the disorder is present, if you haven’t already. Although useful in aiding in the detection of a disorder, screening tools are not substitutes for thoughtful, clinical evaluations. Screenings can be administered by a doctor or nurse before an appointment begins or after talking with a patient. Some screening tools can even be filled out by patients while they’re in the waiting room. You can access these screening tools on the “Resources” page linked to at the end of this transcript.
The following evidence-based tools are recommended by SAMHSA , the Substance Abuse and Mental Health Services Administration:
Depression: The Patient Health Questionnaire (PHQ-2)
For assessing risk of depression/suicide
If patient screens positive on this 2-question screen, follow up with the PHQ-9, a 9-question tool that further evaluates criteria for a depressive disorder.
Substance Abuse: WHO-Assist V3.0
Screens for all levels of substance use, including use that is not dependent but is still harmful
Determines whether a brief intervention or referral to specialist treatment is appropriate
Alcohol Use: AUDIT-C Questionnaire
If patient screens positive on this 3-question screen, follow up with the full AUDIT, a 10-question tool that further evaluates criteria for alcohol use disorders.
Determines patient’s risk level and what intervention is appropriate, if any
Anxiety: Generalized Anxiety Disorder 7-item (GAD-7) Scale
7 questions
Patients rate frequency of anxious feelings and behavior over the last two weeks.
PTSD: PC-PTSD
4 questions
Designed for primary care, currently used by the VA to screen veterans
Positive if patient answers “yes” to three or more questions