Using the PHQ-9 to identify and manage depressive symptoms in patients with sport-related concussion

Abstract

\uf07d Les médecins de famille devraient envisager d’intégrer le Questionnaire sur la santé du patient PHQ-9 dans les évaluations des commotions cérébrales liées aux sports pour prévenir des séquelles graves en santé mentale. Concussion patients might present with different constellations of symptoms, making management challenging. Two recent cases of college students, one with suicidal thoughts and one with panic attack, demonstrate how important it is to identify serious mental health issues associated with postconcussion patients. In each case, the Patient Health Questionnaire–9 (PHQ-9) was used by the family physician to engage the patient in a fruitful dialogue, enabling a thorough exploration of the patient’s concerns and a speedy and successful clinical outcome. However, this tool could be used at the earliest stage of concussion diagnosis and during follow-up. It can be implemented concurrently with the Sport Concussion Assessment Tool, 5th edition (SCAT5), to better predict and prevent future serious mental health events. These cases demonstrate important lessons for family physicians when screening patients with concussion. The US Preventive Services Task Force recommends screening children and adolescents 12 to 18 years of age for major depressive disorder.1 Kroenke et al found that the PHQ-9 is a reliable and valid measure of depression severity.2 The SCAT5 is recognized as a current best-practice assessment tool.3 These cases have prompted implementation of regular postconcussion PHQ-9 screening in addition to SCAT5 screening in a family physician’s clinical practice, as anticipating and preventing bad sport-related concussion (SRC) outcomes is of paramount importance.