Around the winter holidays—for reasons as varied as weather, grieving, holiday stress, or just plain Scrooge-liness—people are more susceptible to the "holiday blues." But Timothy Lineberry, MD, psychiatric hospitalist and medical director of Mayo Psychiatric Hospital and board chair of the American Association of Suicidology, points out that depression and associated suicide risk are year-round issues.
"The holidays aren't necessarily the worst. Depression and suicide are important all year long," Dr. Lineberry says.
In fact, a 2010 Annenberg Public Policy Center study (PDF) found that the rate of suicide in the U.S. is lowest in December. Suicide actually peaks in the spring and fall, a pattern that has not changed in recent years according to the same study.
Physicians write 60% of prescriptions for anti-depressants. And because depression and other mental health issues remain a taboo topic to many Americans, many patients visit their physician instead of a mental health clinician. As such, hospitalists need to be able to accurately assess depression and suicide risk.
Dr. Lineberry suggests the following steps for hospitalists who diagnose patients with depression:
- Consider using the holidays to renew or update systems of practice to better identify depression;
- Use the PHQ-9 questionnaire with patients who display symptoms of depression; and
- Ask direct and clear questions about suicidal thoughts and behaviors. Keep substance abuse as a risk factor in mind.