Ask patients whether they have experienced depressed mood or anhedonia during the last month (PHQ-2).
Consider using the four “SALSA” questions to assess for the presence of four symptoms of depression: sleep disturbance, anhedonia, low self-esteem, and change in appetite in patients with a positive PHQ-2. Two of the four symptoms can confirm depression.
Use additional instruments, such as the PHQ-9, in patients with symptoms.
Recognize the elderly as a high-risk group for depression and screen them appropriately, generally using the Geriatric Depression Scale.
Assess the severity of depression and functional impairment using the PHQ-9.
Assess suicidal ideation, intent, and risk.
Consider screening for hypothyroidism in patients with depression; base other laboratory testing for secondary causes of depression on clinical evaluation.
Recognize that the syndrome of major depression can be a presenting feature of other major mental disorders and substance abuse.