Assessment Guidelines Depression 1. Always evaluate the patient's risk of harm to self or others.

Overt hostility is highly correlated with suicide (see Chapter 20). 2. A thorough medical and neurological examination helps determine if the depression is primary or secondary to another disorder. Depression can be secondary to a host of medical or other psychiatric disorders, as well as medications. Essentially, evaluate whether: The patient is psychotic The patient has taken drugs or alcohol Medical conditions are present

The patient has a history of a comorbid psychiatric syndrome (eating disorder, borderline or anxiety disorder) 3. Assess history of depression and determine what happened as well as what worked and did not work. Have you ever gone through or felt anything like this before? What seemed to help you at that time?

4. Assess support systems, family, and significant others and the need for information and referrals. 5. deaths? With whom do you live? Whom do you trust? To whom do you talk when you are upset? Assess for any events that might have triggered a depressive episode. Has anything happened recently to upset you? Have you had any major changes in your life? Have you had any recent losses: job, divorce, loss of partner, child moving away,

6. Include a psychosocial assessment that includes cultural beliefs related to mental health and treatment, and spiritual practices and how the depression is affecting the patient's beliefs and practice. How do you view depression?

Have you tried taking any over-the-counter remedies [e.g., herbs] to help with your depression? Do you find solace in spiritual activities or find in a place of worship [e.g., church, temple, mosque]?