What are Depression questionnaires used by Occupational health?

In this blog  we will discuss commonly used Occupational health depression questionnaires.

What are Depression questionnaires used by Occupational health?

Here are some commonly used depression questionnaires used by occupational health specialists to determine if a worker is depressed or not during well-being screening. 

Patient Health Questionnaire (PHQ-9)

The Patient Health Questionnaire (PHQ) is a 3-page self report questionnaire that is used in Occupational health clinics to determine the well being of a patient.

The questionnaire is used to assess the patient based on 8 diagnoses that correspond to the following specific DSM-IV diagnoses: major depressive disorder, panic disorder, other anxiety disorder, and bulimia nervosa.

Other disorders that the report also screens include: other depressive disorder, probable alcohol abuse/dependence, somatoform, and binge eating disorder. However for these disorders the systems will be fewer than are required for any specific DSM-IV diagnoses

Once the client or the patient has completed the questionnaire, the occupational health specialist or clinician will scan the completed questionnaire, verify positive responses, and apply diagnostic algorithms that are given in the manual of the questionnaire. 

The Patient Health Questionnaire (PHQ-9) consists of a 9-item depression module that is based off of the DSM IV Major depression criteria of symptoms that has been present for  “more than half the days” in the past 2 weeks.

When it comes to measuring the severity of the disorder, the questionnaire measures the scores in terms of 0-27 where 27 indicates high serveritu. 

The items are scored between 0 (not at all) to 3 (nearly every day) in terms of frequency that the silent experiences these depression related symotions. 

An additional item is also added to the Patient Health Questionnaire (PHQ-9)  after the or at the end of the diagnostic portion of the PHQ-9. 

This item is present to ask the client or the patients who checked off any problems on the questionnaire, how the depression impact;s their daily life and their occupation. 

The item is described as such : “How difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?”

Before making a diagnosis , the clinician present will rule out physical causes of depression, normal bereavement, and history of bipolar disorders and any other mental disorders that could explain the condition. 

You can access this Questionnaire here

Occupational Depression Inventory

Another assessment tool that is used as a depression question related to occupational health includes the Occupational Depression Inventory (ODI) that was first presented in 2020.

This particular questionnaire was designed to measure and quantify the severity of work- related depressive symptoms as well as to establish a provisional diagnosis of job-caused depression. 

The Occupational Depression Inventory ODI consists of nine items that correlates to nine symptom items and an additional item that assesses the turnover intention of the client. 

The instructions of the questionnaire include the following:

The following statements concern the impact your work could have had on you.

Please read each statement and indicate how often you experienced the problems mentioned over the PAST TWO WEEKS. 

Use the scale provided to respond:

0 = never or almost never

1 = a few days only

2 = more than half the days

3 = nearly every day

Here is an example: “I felt anxious because of my job.”

• If you did NOT feel anxious because of your job, select 0.
• If you feel anxious for reasons that you consider UNCONNECTED TO YOUR JOB (personal problems, marital problems, family problems, health problems, etc.), select 0 as well.
• If you felt anxious but don’t know why, again select 0.
• If it is clear for you that YOUR JOB caused you to feel anxious, select 1, 2 or 3 to indicate how often that happened.

When we consider the terms on the questionnaire, each item corresponds to a diagnostic criteria or symptom of depression:

• Anhedonia- “My work was so stressful that I could not enjoy the things that I usually like 

• Depressed mood-“I felt depressed because of my job.”

• Sleep alterations-“The stress of my job caused me to have sleep problems (I had difficulties falling asleep or staying asleep, or I slept much more than usual).”

• Fatigue/loss of energy-“I felt exhausted because of my work.”

• Appetite alterations-“I felt my appetite was disturbed because of the stress of my job (I lost my appetite, or the opposite, I ate too much).”

• Feelings of worthlessness-“My experience at work made me feel like a failure.”

• Cognitive impairment- “My job stressed me so much that I had trouble focusing on what I was doing (e.g., reading a newspaper article) or thinking clearly (e.g., to make decisions).”

• Psychomotor alterations-“As a result of job stress, I felt restless, or the opposite, noticeably slowed down—for example, in the way I moved or spoke.”

• Suicidal ideation-“I thought that I’d rather be dead than continue in this job.”

Finally the additional item that assesses the turnover intention of the client is presented as:

“If you have encountered at least some of the problems mentioned above, do these problems lead you to consider leaving your current job or position?:

Based on the items presented on the inventory, Occupational Depression Inventory ODI approaches depression in terms of both a  dimensional (quantitative) and a categorical (qualitative) standpoint. 

Occupational Depression Inventory ODI has been developed in two languages―English and French to be used across three countries―the U.S., New Zealand, and France. 

The Occupational Depression Inventory ODI as a tool for assessment can be used by  occupational health specialists as a tool for the following reasons:

• As a tool that allows for better identification, monitoring, and treatment of job-related depression 
• As a tool that helps to inform occupational health policies and regulations on an international scale in terms of policy making for workers health and safety. 

It must be mentioned that this particular tool has not been made public to be used as of yet considering how recent it’s publication by the authors Renzo Bianchia and Irvin Sam Schonfeld have been.

You can access the first publication of the tool here

What are Depression questionnaires used for in Occupational health?

The depression questionnaire or assessment tools for depression such as the Patient Health Questionnaire or the Occupational Depression Inventory are usually fit to be used in the following areas:

• Occupational well-being screening for new employees who are being onboarded into a new place of employment by occupational health specialists.

• For assessing an employee’s fitness to work by specialists in the case that the employee is seeking to return back to work. 

• These questions can also be used to assess employees’ health and well-being in the case that they are being relocated or when their circumstances at work are changing. 

What is occupational health?

Occupational health is one area of the public health domain that is concerned with the physical, mental and social well-being of workers in all occupations.

This area of public health involves promoting, advocating, and maintaining the highest degree of well-being for workers in the workplace across various occupations. 

The main role of occupational health within the workforce is to support management of health issues of employees within the workplace and are concerned with how their occupation impacts the health of the employee. 

It is important to mention that occupational health, while they are occeneed about how the work or the workplace might impact on the employee, it is also focused on how the employees’ health may impact on their performance at work. 

What do Occupational Health services do?

Occupational health within the workplace provides support to employees by interpreting medical information of employees in the case that they are unwell and to present it to Managers in a way that allows for employee advocacy as well as makes rooms for accommodations to support the employee in the workplace.

The support they provide includes providing advice to both the managers and supervisors as well as the employees in areas related to:

• How the medical condition impacts an employee’s ability to work and perform well on the job as well as the impact it has on their ability to carry out their responsibilities. 

• Workplace adjustments and accommodations for the employees well being such as reducing work hours or workload. 

• Time period for the return of employees to work in the case they wish to take a medical leave of absence. 

• Advice and referrals to Counselling and Psychological Services or any medical services. 

• Providing employees with information related to employees fitness to return to work and  remain at their present role.

Occupational health specialists are the professionals that employees often reach out for guidance on the issues mentioned above.

Conclusion

In this blog  we discussed commonly used Occupational health depression questionnaires.

FAQ related to Occupational health questionnaire depression

What is a PHQ-9 depression screening?

A PHQ-9 depression screening is an assessment that uses the Patient Health Questionnaire (PHQ) to determine the health of a client in term so depression and mental health. 

What is an occupational health referral?

The occupational health referral is a process that is designed to provide advice to both employees and employers for concerns that relate to the employee’s health and their ability to do their job.

The process involves consent between employee and employer with a contractual agreement for the employee to provide such consent and to partake in a medical examination process.

What power does occupational health have?

 The only power they is to make suggestions and advice to maintain the wellbeing of the employes as well as the power to:

• Determine if the employee is fit to work or not.
• Determine if the employee is ready to come back to work.
• Determine how long it will take for the employee to come back to work.
• Determine accommodations and adjustment strategies to help employees with medical conditions to maintain their well-being while being effective employees.

Can I lose my job through occupational health?

Occupational health services will not fire you because of your medical condition, instead they will most probably recommend accommodations to your employers to help you adjust to work; however, your manager or employer might make their own call to fire you or keepy you based on the occupational health report. 

References

Bianchi R, Schonfeld IS. The Occupational Depression Inventory: A new tool for clinicians and epidemiologists. J Psychosom Res. 2020 Nov;138:110249. doi: 10.1016/j.jpsychores.2020.110249. Epub 2020 Sep 15. PMID: 32977198.\

Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of general internal medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x

Newcomb, R. D., Steffen, M. W., Breeher, L. E., Sturchio, G. M., Murad, M. H., Wang, Z., & Molella, R. G. (2016). Screening for depression in the occupational health setting. Occupational medicine (Oxford, England), 66(5), 390–393. https://doi.org/10.1093/occmed/kqw043