The guidelines provided by the New York State Workers Compensation Board offer fundamental principles for conducting screening and testing procedures. These directives are designed to assist healthcare professionals in identifying appropriate methods for assessing various conditions within the context of comprehensive healthcare.
Healthcare professionals with expertise in screening and testing can rely on the guidance outlined by the Workers Compensation Board to make informed decisions about the most suitable approaches for their patients.
It is crucial to emphasize that these guidelines are not meant to replace clinical judgment or professional expertise. The screening and testing processes should involve collaboration between the healthcare provider and the patient.
Screening Tools
Recommended Tool – PHQ-9:
- The PHQ-9 is recommended for identifying potential depressive disorders in patients at risk.
- Clinical judgement may suffice to establish the diagnosis, making the PHQ-9 unnecessary in some cases.
Benefits:
- Early identification of potential depressive disorders facilitates directing patients to appropriate mental health services for diagnostic confirmation and suicide prevention.
Frequency/Dose/Duration:
- Generally, a single administration of the PHQ-9 is sufficient. Repeat screening may be warranted if symptoms change, but routine screening is not advised.
- Clinical correlation is essential since screening tools alone cannot diagnose DDD; the diagnosis requires comprehensive evaluation, including a thorough history and clinical interview.
Monitoring
Recommended: PHQ-9 with Clinical Indicators:
- PHQ-9, along with clinical indicators, is recommended to monitor treatment progress in DDD.
- Patients with DDD should be monitored monthly after initiating or changing treatment until remission, defined as a PHQ-9 score of four or less sustained for at least one month.
- Monitoring should continue periodically after remission to detect relapse, recurrence, or suicide risk.
Benefits:
- PHQ-9 scores guide treatment decisions by assessing depression severity and treatment response.
- Monitoring should encompass symptom assessment, PHQ-9 completion, medication and psychotherapy adherence, and adverse effect monitoring.
Psychometric Testing
Recommended:
- Psychometric testing is advised for individuals with signs of DDD and potential comorbid psychiatric conditions like anxiety disorders, bipolar disorder, or substance use disorders.
- It provides evidence for potential depressive disorders and other mental health conditions, aiding in directing patients to appropriate services.
Frequency/Dose/Duration:
- Typically administered once, unless significant symptom changes occur, and requires professional administration by a mental health expert.
Pharmacogenomics Testing
Recommended:
- Pharmacogenomics testing is recommended for select patients with Major Depressive Disorder (MDD) who are resistant to treatment despite prior antidepressant use or experience repeated intolerance of antidepressant side effects.
- Assessment, particularly of CYP2D6 and CYP2C19, is warranted in such cases.
