Assessing Depression

Assessing Depression
This approach is adapted for use in a geriatric psychiatry population, but could also be used in general psychiatry.

Using "SIGECAPS" often leads to a checklist kind of interview that does not build rapport. SIGECAPS does not facilitate exploring depressive symptoms in depth. The following approach is much more like a "real" psychiatric interview, and is informed by an understanding of the concept of depression.

Simply put, depression can be understood better by considering 3 domains:

Mood Symptoms
Psychological Symptoms
Physical Symptoms (Neurovegetative)

In the interview, this can be done systematically to be sure that all of the SIGECAPS symptoms (and much more) are covered.

A. Mood Symptoms
Depression often comes in different subtypes:

a.) Sad, tearful, down, blue
b.) Irritable
(Differentiate from hypomanic or paranoid irritability)

c.) Loss of interest, apathy, melancholia spectrum

d.) Suicidality
Ideas
Plans
Actions/attempts
Supportive Factors - "what holds you back?"

B. Psychological Symptoms
Worrying thoughts
Guilty thoughts
Low-self confidence/esteem thoughts
Self doubting thoughts – indecisive, second-guessing

C. Psychosomatic (Neurovegetative) Symptoms
Pain
Agitation or psychomotor withdrawal
Concentration and memory
Appetite
Energy
Sleep
Libido