I have been watching the way people fill in their depression questionnaires. Today I saw X who had to check each answer with me before she would mark a box, which I think was about her dependency. Other people known to be at the histrionic end sometimes fill in all their answers in the right hand column when in fact they don't appear that different from their usual selves. Then their answers may be more about their very overwhelming emotional world - or else about their need to shout, to get heard maybe. But sometimes, especially with men, I get a surprise and it looks as if they are genuinely more affected by depression then they seem. That is quite a useful consequence of the questionnaire.I shall have to keep my eyes open a bit more.
Wednesday, 6 June 2007
I have already mentioned the depression questionnaire which we are now obliged to administer to patients when we make a diagnosis of depression (on pain of losing some of our annual QOF payment). I have mixed feelings about this. On the one hand I dislike being forced to do things inflexibly, it is one more thing to remember, and the questionnaire may be difficult to administer if the patient has a poor command of English or lower than average intelligence. On the other hand it can help to corroborate my assessment of the depth of depression at the initial consultation when I am considering treatment options, and it is helpful later when I want to assess progress and can look back at a semi-quantitative score. I had noticed that people fill in the form in different ways, but had not really thought about what this might reveal. Typically Martha (my remarkable colleague) has thought more deeply about the subject. She writes: