Depression Cases: Assessment

Use the following 2 Mnemonics for assessment in any case of suspected depression and/or Suicidal attempt. Widely applicable and used in most EDs, and is often tested in the MCEM OSCE Part C.

SIGMECAPS

1. Sleep
2. Interest
3. Guilt Feelings
4. Mood lately/Memory
5. Energy Level (Tired or fatigued)
6. Concentration
7. Appetite loss (Weight Loss/Gain)
8. Psychomotor symptoms
9. Suicidal ideations

5 out of 9 indicates depression

SADPERSONS

1. S – Sex:  1 if male; 0 if female; (more females attempt, more males succeed)
2. A – Age: 1 if < 20 or > 44 (Remember 1945)
3. D – Depression: 1 if depression is present
4. P – Previous attempt: 1 if present
5. E –Ethanol abuse: 1 if present
6. R – Rational thinking loss: 1 if present
7. S – Social Supports Lacking: 1 if present
8. O – Organized Plan: 1 if plan is made and lethal
9. N – No Spouse: 1 if divorced, widowed, separated, or single
10. S – Sickness: 1 if chronic, debilitating, and severe

0 - 2   Discharge with follow up
3 - 4   Discharge with close monitoring
5 - 6   Consider Admission
7 +    Definite admission (Can hold the patient under mental health act, even if Normal Capacity)

(Source: Univ of North Carolina, 2013)