Term Paper: Current State of Major Depression Screening, Treatment, and Prevention

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[. . .] The PHQ-2 contains just two simple questions about a patient's symptoms within the past two weeks: (1) reduced interest or pleasure in daily activities and (2) feeling depressed, down, or hopeless. The frequency of these symptoms within the past two weeks generates a severity score, which may indicate the existence of clinical depression. If the score on the PHQ-2 registers a single episode of either symptom, however, the more comprehensive PHQ-9 can be administered. In addition to the two questions on the PHQ-2, the PHQ-9 contains questions about sleep quality, fatigue, appetite, self-esteem, concentration difficulties, abnormal psychomotor experiences, and suicidal ideation. Scoring at least 5 on the PHQ-9 would indicate mild to severe depression and the patient would then be referred to a mental health professional for a more definitive diagnosis.

Diagnosing Depression

The DSM-V is the current diagnostic manual for mental health clinicians tasked with evaluating patients who might be suffering from clinical depression, although there are only minor changes from the previous version, the DSM-IV-TR (APA, 2013). The most important criteria are A and C. In DSM-IV-TR, because they deal with the primary symptoms and the impact of depressive symptoms on daily activities, respectively (Maurer, 2012). Criteria A covers the previous two weeks and whether five or more symptoms were experienced. These symptoms are: (1) depressed mood for most of the day and on most days, (2) reduced interest and pleasure in daily activities, (3) significant changes in body weight, (4) sleep irregularities, (5) psychomotor agitation or retardation observed by others, (6) persistent fatigue, (7) cognitive impairments, (8) low self-esteem, and (9) ruminating about death or suicide. Either criterion 1 or 2 must be present for a diagnosis of major depressive episode.

Preventing Depression

Despite the existence of effective treatments for depression, not everyone benefits to the same degree. In addition, effective treatments cannot recoup the damage a depressive episode will inflict upon the lives of the patient and loved ones; therefore, preventive strategies are needed. Munoz, Beardslee, and Leykin (2012) outlined the aims they recommend for preventing depression and the two main strategies are to develop methods to identify high-risk individuals and reduce incidence. Currently, 25 to 40% of individuals at risk for developing depression within the next year can be identified; therefore, much more needs to be done to improve screening clinical screening methods. Recent studies have also shown that the incidence of major depression can be reduced by as much as 50 to 80% using a variety of interventions, including cognitive-behavioral therapy or interpersonal psychotherapy. Both forms of therapy can help at-risk individuals to manage their moods better. Other interventions include helping children cope with depressed parents and counseling adolescents who may be at risk for developing this disease. Among the most powerful interventions is reducing the amount of exposure to stress at home, school, and work. Communities can also structure the lived environment to create a more nurturing environment. Preventive interventions are therefore based exclusively on helping at-risk individuals to cope with endogenous and exogenous factors that contribute to depression risk.


Clinical depression is the most common mental illness and the effects on the patient and loved ones can be devastating. Although the neurological correlates of depression have not been identified, the effectiveness of antidepressants and psychotherapy, along with the genetic contributions, provides some indication that the serotonergic neurotransmitter system, hypothalamic-pituitary-adrenal axis, and factors involved in neurogenesis contribute to the prevalence of depression; however, the strongest predictor of depression is exposure to severe or chronic stressors. Effective treatments are available, but the efficacy varies widely between individuals. Accordingly, the best approach for reducing the morbidity and mortality associated with major depression would be to develop and implement preventive strategies that identify high-risk individuals and provide effective interventions.


APA. (2013). Highlights of changes from DSM-IV-TR to DSM-5. Retrieved 15 May 2014 from http://www.dsm5.org/Documents/changes%20from%20dsm-iv-tr%20to%20dsm-5.pdf.

CDC. (2013a). Depression: Surveillance data sources. Retrieved 15 May 2014 from http://www.cdc.gov/mentalhealth/data_stats/depression.htm.

CDC. (2013b). Mental health: Depression. Retrieved 15 May 2014 from http://www.cdc.gov/mentalhealth/basics/mental-illness/depression.htm.

Insel, T. (2011). Director's Blog: The global cost of mental illness. Retrieved 15 May 2014 from http://www.nimh.nih.gov/about/director/2011/the-global-cost-of-mental-illness.shtml.

Keers, R. & Uher, R. (2012). Gene-environment interaction in major depression and antidepressant treatment response. Current Psychiatry Reports, 14(2), 129-37.

Maurer, D.M. (2012). Screening… [END OF PREVIEW]

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Current State of Major Depression Screening, Treatment, and Prevention.  (2014, May 15).  Retrieved July 17, 2019, from https://www.essaytown.com/subjects/paper/current-state-major-depression-screening/9847819

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"Current State of Major Depression Screening, Treatment, and Prevention."  15 May 2014.  Web.  17 July 2019. <https://www.essaytown.com/subjects/paper/current-state-major-depression-screening/9847819>.

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"Current State of Major Depression Screening, Treatment, and Prevention."  Essaytown.com.  May 15, 2014.  Accessed July 17, 2019.