The Vert Mooney Research Foundation, San Diego, CA, USA.
Epic Neurorehabilitation & Psychology Services, Chico, CA, USA.
Work. 2020;67(1):55-65. doi: 10.3233/WOR-203252.
Although diagnosis and treatment of depressive illness is outside the scope of practice for non-behavioral health practitioners such as occupational therapists, physical therapists, kinesiotherapists, and chiropractors, it frequently is comorbid with painful musculoskeletal disorders such as low back pain and it negatively affects outcomes, including return to work. As psychologically-informed practice becomes more widely implemented without the immediate availability of behavioral health practitioners, safe and effective methods to screen for and appropriately triage depressive illness by nonbehavioral health practitioners are necessary.
To demonstrate the efficacy and validity of a method employed by non-behavioral health practitioners to screen for and appropriately triage musculoskeletal pain patients who also are experiencing depressive illness.
As part of a previously-published psychometric research study conducted in a community-based musculoskeletal pain rehabilitation program, a method was developed for nonbehavioral health practitioners to screen for and appropriately triage patients for co-morbid depressive illness, thus providing the current opportunity to examine the effects of depressive illness on work outcomes. The first step in the two-step process involves a 22-item questionnaire, providing scores used in the second step to triage for outside consultation with behavioral health practitioners. This paper describes the screening method and its application in an observational study of the impact of depressive illness on work outcomes.
Among 156 consecutive patients who were presenting with musculoskeletal pain disorders to an outpatient rehabilitation program, 22.3% also were identified to have co-morbid clinical depression. The screening process allowed all patients to continue in the rehabilitation program. Those who were already receiving behavioral health care were encouraged to inform care providers of their participation in the program. Those who were not receiving behavioral health care were successfully triaged to care outside of the clinic. Depressive illness was found to affect success in the program, confirming the validity of the screening process for outpatient rehabilitation program participants experiencing chronic pain.
A simple and effective depression screening process that triages patients without interruption of musculoskeletal treatment can be employed by nonbehavioral health practitioners. Because return to work outcomes were found to be negatively affected by depressive illness, this approach has the potential to improve overall program efficacy.
尽管诊断和治疗抑郁症并不属于作业治疗师、物理治疗师、运动治疗师和脊医等非行为健康从业者的执业范围，但它经常与疼痛性肌肉骨骼疾病（如腰痛）共病，并对包括重返工作岗位在内的结果产生负面影响。随着心理知情实践的广泛实施，而行为健康从业者无法立即获得，因此需要非行为健康从业者安全有效地筛选和适当分诊抑郁症的方法。
展示非行为健康从业者用于筛选和适当分诊患有肌肉骨骼疼痛且同时患有抑郁症的患者的方法的疗效和有效性。
作为之前在社区肌肉骨骼疼痛康复计划中进行的一项心理计量学研究的一部分，开发了一种非行为健康从业者用于筛选和适当分诊共病抑郁症患者的方法，从而提供了目前检查抑郁症对工作结果影响的机会。两步过程的第一步涉及一个包含 22 个问题的问卷，为第二步提供分数，用于分诊需要向行为健康从业者进行外部咨询的患者。本文描述了该筛选方法及其在观察性研究中对抑郁症对工作结果影响的应用。
在向门诊康复计划就诊的 156 名连续肌肉骨骼疼痛障碍患者中，有 22.3%的患者同时被诊断出患有共病临床抑郁症。筛选过程允许所有患者继续参加康复计划。那些已经接受行为健康护理的患者被鼓励将其参与该计划告知护理提供者。那些没有接受行为健康护理的患者被成功分诊到诊所外进行护理。发现抑郁症会影响该计划的成功，从而证实了对在门诊康复计划中经历慢性疼痛的参与者进行筛选的有效性。
非行为健康从业者可以使用一种简单有效的抑郁筛选流程，在不中断肌肉骨骼治疗的情况下分诊患者。由于重返工作岗位的结果受到抑郁症的负面影响，因此这种方法有可能提高整体计划的疗效。
