AMI Depression Resource Navigator

You may use a flowchart to help you choose a depression screener or consider reviewing the screening models below.

The Basic Screening Model Approach

If you prefer to simply screen your patients and refer those who score positive, the next step is to select the depression screener that best fits your needs.

You may want to consider using the Beck Depression Inventory-II (BDI-II), which can be considered the "gold standard" as it was used the most in the studies with cardiac patients. There are royalties associated with this instrument (cost approximately $1.30 per scoring sheet; manual cost is separate). How do I order the BDI-II (go to The Psychological Corporation web-site)? If you do not have the financial resources for the BDI-II. There are several other excellent options.
Are all or nearly all of your patients age 55 or over? If so you many want to consider using the Geriatric Depression Scale (GDS). If yes, would you like to see or down load the GSD now?.
Otherwise you may want to consider using the Center for Epidemiological Center - Depression Scale (CES-D) or the Zung Self Rating Depression Scale (SDS).
Review ways to talk to patients with positive screens to help ensure that they are more likely to follow up with recommendations.
The regular referral process for many centers using the Basic Screening Model Approach is to notify their referring physician (i.e., cardiologist, PCP), Primary Care Provider Care, of the positive screening result.

The Advanced Screening Model Approach

If you prefer a more active depression management approach, you may want to consider using the Patient Health Questionnaire (PHQ). This tool was developed for the Primary Care Physician setting in which the caregiver is interested in making a diagnosis and initiating treatment. The PHQ will assist you in determining a diagnosis of Major Depressive Episode, which is suggested prior to initiating some treatments (e.g., antidepressant medication).

How can we use the Patient Health Questionnaire to make a diagnosis of depression and/or rule out other competing disorders?
Review ways to talk to patients with positive screens to help ensure that they are more likely to follow up with recommendations.
The referral process for centers using the Advance Screening Model Approach is to work with and/or inform the referring physician, that the patient is being treated at the cardiac rehabilitation facility or being referred to a Behavioral Health Provider: On-site Care, Shared Care, Referred Care.