Depression and Its Impact in Hepatitis C Infection - Administering BDI, Page 4 of 21

Syllabus

Handout: BDI Scoring and Treatment Recommendation Overview (27k PDF)

Score	Interpretation	Action
0-5	Normal, not depressed	Monitor depressive symptoms during interferon therapy at 2 - 4 week intervals.
6-9	High normal score (These scores may predispose for depression during interferon-based treatment)	Consider prophylactic antidepressant treatment prior to initiating interferon therapy. Patient preference, clinician judgment, and possible major depressive disorder (MDD) risk factors should be considered. Discuss risks/benefits of antidepressant treatment with patient. Monitor depressive symptoms during interferon therapy at 2 - 4 week intervals.
10-18	Mild to moderate depression	If the patient meets DSM-IV criteria for MDD, start antidepressants after evaluating for medical contributions and history of bipolar disorder. Refer to mental health if depressive symptoms do not improve. If patient does not meet criteria for MDD, continue to monitor every 2 - 4 weeks and consider referral to mental health practitioner.
19-29	Moderate to severe depression	Any patient scoring higher than 18 who is not currently being seen in psychiatry should be referred to psychiatry and a follow-up appointment should be scheduled. Patients with serious suicide ideation should be urgently referred to psychiatry. Follow legal mandates concerning involuntary treatment if applicable.
30-63	Severe depression	Urgent referral to mental health is needed. Assess for suicide risk and proceed accordingly. Follow legal mandates concerning involuntary treatment if applicable.