When should you screen for mood disturbance?
- SIGN 118 (2010) and RCP Guidelines (2016) recommend that all stroke patients should be screened for mood disturbance initially and then at regular intervals particularly before discharge and when active rehabilitation is stopped.
What does a mood screening tool do?
- A number of different standardised mood screening tools exist. The aim of these tools is to screen for the possibility of the presence of a mood disturbance.
- Screening questionnaires are not diagnostic. All of them have limitations meaning sometimes patients’ problems will be missed or overestimated. Screening questionnaires are designed to be used to help decide who to refer for clinical interview and more specialist assessment.
- Assessment of mood disturbance following a stroke in complicated. There is significant overlap between symptoms of depression and anxiety, and common physical and cognitive consequences of a stroke (e.g. reduced concentration, disturbed sleep, increased fatigue, reduced levels of motivation).
- Always consider the reason why someone may give a particular response to a question on a screening or may be displaying a certain behaviour and discuss fully with multi-disciplinary colleagues.
Which mood screening questionnaire should I use?
- There is a lack of consensus both within the research literature and within clinical practice over the best mood screening tool to use. However, RCP (2016) guidelines suggest the use of validated simple measures such as the GHQ-12 or PHQ-9 for screening for depression while SIGN 118 suggest the SAD-Q or GHQ-12.
- No recommendation is made for screening for anxiety or emotional lability.
- Many questionnaires are subject to copyright conditions that should be adhered to. Further information on the screening tools used throughout each case study can be found in additional information boxes.