W.S. CHONG1, S.Z.SIM2, Y.C.CHUA2
MOH Holdings Pte Ltd (MOHH)1, NHG Polyclinics2
Screening for mental illnesses may improve quality of life and reduce healthcare costs. We described a pilot screening programme for depression in a primary care population.
Patients from a polyclinic teamlet were screened for depression, mostly during their scheduled visits using PHQ-2(Patient Health Questionnaire). From 17/9/2020–13/11/2020, all with positive PHQ-2 were assessed with PHQ-9 and offered psychologist review. Those who scored 10 and above(PHQ-9) were referred urgently to the physician. From 14/11/2020-10/3/2021 the screening protocol was amended; patients who scored below 5 were given self-help pamphlets about depression, 5-9 were offered psychologist review, and 10 and above were referred to the physician. Screening outcomes and other bio-profile were collected and analysed.
534 patients were screened. From 17/9/2020–13/11/2020, 25 patients(4.7%) had positive PHQ-2 and all had PHQ-9 scores below 10. All were offered psychologist review and 5(0.9%) accepted. 3(0.6%) patients were already on specialist follow-up for depression. From 14/11/2020-10/3/2021, no patients had positive PHQ-2.During the entire screening period, none were diagnosed with depression in primary care.
Given a prevalence of major depressive disorder of 6.3% in the general population, it was unexpected that no one was diagnosed with depression in our patients with mostly scheduled visits. We hypothesise that patients with depression are more likely to make unscheduled visits to the polyclinic. Additionally, many patients declined psychologist review and the reasons were not explored. Studies involving more representative primary care populations and exploring patients’ views on depression and help-seeking can help us better understand depression in primary care.