Screening tool for depression in adults, and primary care treatment op

Clinical answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Screening tools for depression in adults:

The PHQ-9 is a validated measure recommended for assessing depression severity and response to treatment in primary care .
Other screening questions include asking if the person has often been bothered by feeling down, depressed, or hopeless, and if they have little interest or pleasure in doing things, over the past month .

Primary care treatment options for depression:

The NICE guideline recommends psychological interventions such as guided self-help, group and individual cognitive behavioural therapy (CBT), and behavioural activation (BA) as first-line treatments for less severe depression .
If the person prefers medication or if psychological therapies are unsuitable, a selective serotonin reuptake inhibitor (SSRI) is recommended as the first-line pharmacological treatment .
For more severe depression, a combination of psychological therapy and antidepressant medication is advised, with options to switch or augment treatments if there is limited response .
Monitoring and follow-up are essential, with review usually within 2–4 weeks, and assessment of treatment response and adverse effects .

Screening tool for depression in adults, and primary care treatment options?