How can I effectively screen for comorbid conditions in adults presenting with depressive symptoms?

To effectively screen for comorbid conditions in adults presenting with depressive symptoms, a comprehensive assessment is crucial, moving beyond a simple symptom count ¹,².

• Conduct a Comprehensive Assessment: Do not rely solely on a symptom count when assessing a person who may have depression ¹,². Instead, take into account the severity of symptoms, previous history, duration, and course of illness, as well as the degree of functional impairment and/or disability associated with the possible depression ¹,².
• Inquire About Coexisting Conditions: Discuss with the person any history of coexisting mental health or physical disorders ¹. Specifically ask about any new symptoms of other mental health disorders, including anxiety, eating disorders, bipolar disorder, or psychosis ³.
• Assess for Bipolar Disorder: Always inquire about any history of mood elevation to determine if the depression may be part of bipolar disorder ¹.
• Consider Chronic Physical Health Problems: Be particularly alert to possible depression in people with a past history of depression or a chronic physical health problem with associated functional impairment ¹.
• Utilise Validated Measures: Consider using a validated measure (for example, for symptoms, functions, and/or disability) when assessing a person with suspected depression to inform and evaluate treatment ¹. A validated depression questionnaire, such as PHQ-9, can be used to assess for depression, symptom severity, and response to treatment ³.
• Review Treatment Response: If there is no improvement in symptoms after 4 weeks of antidepressant medication or 4–6 weeks of psychological therapy, consider whether an alternative diagnosis or comorbid condition may be limiting the person's response to or engagement with treatment ³.
• Refer if Necessary: If, after initial depression identification questions, the practitioner is not competent to perform a mental health assessment, refer the person to an appropriate professional who can ¹.