When evaluating the effectiveness of the patient’s treatment plan during follow-up appointments, the patient’s subjective report, your objective assessment (mental status examination - MSE), and the PHQ-9 score should be used for pre- and post- treatment comparison. As this patient’s initial PHQ-9 score was 17, what would be a realistic PHQ-9 score in 3 months, if patient is actively participating and is responding to the overall treatment plan?
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Expert Answer
The clinical significance index for PHQ-9 is post-treatment score of ≤9 combined with improvement of 50%, or 5 points reduction. In this case, the patient has been having depressive symptoms since age 16 post-transplant, even when he was stable on medications and high functioning. Considering his current life stressors, it is unlikely he will be depression free in 6 months. A realistic PHQ-9 goal for this case would be a 5-point reduction from the baseline score.