Practice Recommendations: Depression

Recommendations	Level of Evidence
11.0 Nurses in all practice settings should screen clients for evidence of depression, using a validated tool (such as the Stroke Aphasia Depression Questionnaire, Hospital Anxiety and Depression Scale or the Cornell Scale for Depression in Dementia – see appendix I of the Stroke Assessment Nursing BPG) prior to discharge throughout the continuum of care. In situations where evidence of depression is identified, clients should be referred to a trained healthcare professional for further assessment and management.	IV
11.1 Nurses in all practice settings should screen stroke clients for suicidal ideation and intent when a high index of suspicion for depression is present, and seek urgent medical referral.	IV

Recommendations

Level of Evidence

11.0 Nurses in all practice settings should screen clients for evidence of depression, using a validated tool (such as the Stroke Aphasia Depression Questionnaire, Hospital Anxiety and Depression Scale or the Cornell Scale for Depression in Dementia – see appendix I of the Stroke Assessment Nursing BPG) prior to discharge throughout the continuum of care.

In situations where evidence of depression is identified, clients should be referred to a trained healthcare professional for further assessment and management.

11.1 Nurses in all practice settings should screen stroke clients for suicidal ideation and intent when a high index of suspicion for depression is present, and seek urgent medical referral.

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Common symptoms of depression

Common symptoms of depression may include:

Mood related signs (anxiety, sadness, lack of reactivity to pleasant events, irritability)
Behavioural disturbances (agitation, retardation, multiple physical complaints, acute loss of interest)
Physical signs (appetite loss, weight loss, lack of energy)
Cyclic function (diurnal variation of mood, difficulty falling asleep, multiple awakenings during sleep, early morning awakenings)
Ideational disturbances (suicide, self-depreciation, pessimism, mood congruent delusions)

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