Text adapted from "The patient who is depressed" in Psychiatry in primary care by Raymond W. Lam, (CAMH, 2019).
SIGECAPS is a well-known mnemonic listing the symptoms of major depressive disorder, according to the DSM-5. SIGECAPS stands for:
- Sleep: insomnia or hypersomnia
- Interest: reduced, with loss of pleasure
- Guilt: often unrealistic
- Energy: mental and physical fatigue
- Concentration: distractibility, memory disturbance, indecisiveness
- Appetite: decreased or increased
- Psychomotor: retardation or agitation
- Suicide: thoughts, plans, behaviours.
Risk factors for major depressive disorder include:
- chronic insomnia or fatigue
- unexplained somatic symptoms
- chronic medical illness
- recent cardiovascular event (myocardial infarction, stroke)
- recent physical or psychological trauma
- other psychiatric disorder
- family history of mood disorder
- extensive use of the medical system.
Use the two-question quick screen for patients who have risk factors for major depressive disorder. Answering “yes” to either question indicates the need for a more detailed assessment.
- “In the past month, have you lost interest or pleasure in things you usually like to do?”
- “Have you felt sad, low, down, depressed or hopeless?”
A brief questionnaire such as the free, online Patient Health Questionnaire (PHQ-9) aids diagnosis and assesses severity of the depression. As a screening tool, the PHQ-9 can assist in diagnosis, and also serve as a symptom severity tracker to help assess the effectiveness of the treatment plan.
Patient Health Questionnaire
The PHQ-9 can be used to plan and monitor treatment for depression in primary care.
Screening Out Other Disorders
Use a screening questionnaire such as the free online Mood Disorder Questionnaire to rule out bipolar disorder.
Mood Disorder Questionnaire
The Mood Disorder Questionnaire (MDQ) is a screening tool for bipolar disorder.
- The Primary Care Practitioner Role
- Screening & Assessment
- Clinical Tools
- Resources & References