A Regular Checkup Is Good for the Mind as Well as the Body

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EVERYONE is familiar with the concept of a periodic medical checkup – some sort of scheduled doctor’s visit to check your blood pressure, weight and other physical benchmarks.

The notion of a regular mental health checkup is less established, perhaps because of the historical stigma about mental illness. But taking periodic stock of your emotional well-being can help identify warning signs of common ailments like depression or anxiety. Such illnesses are highly treatable, especially when they are identified in their early stages, before they get so severe that they precipitate some sort of personal – and perhaps financial – crisis.

“Absolutely, people should have a mental health checkup,” said Jeffrey Borenstein, editor in chief of Psychiatric News, published by the American Psychiatric Association. “It’s just as important as having a physical checkup.”

About a quarter of American adults suffer from some type of mental health problem each year, according to the National Institute of Mental Health, and 6 percent suffer severe ailments, like schizophrenia or major depression. When left untreated, mental health illnesses are more likely to lead to hospitalization – something that could mean time lost from work.

Ideally, doctors should ask patients about their moods as part of a regular wellness visit, Dr. Borenstein said – there doesn’t necessarily need to be a special visit to gauge mental health. But if the doctor doesn’t bring it up, patients can educate themselves and start the conversation with their physicians.

Jeffrey Cain, president of the American Academy of Family Physicians, said family doctors were trained to spot symptoms of mental illness, like depression, and he encouraged patients to bring in questions or concerns for discussion. But people don’t necessarily go to their family doctor and say they are depressed, he said. Rather, they say they’re tired, or that they lack energy, that they’re having trouble concentrating or that their body aches – all of which can be symptoms of depression or anxiety.

There are some well-known screening tools that patients can use as a starting point to assess themselves, to help prompt a conversation with their doctor. Dr. Borenstein mentioned a common tool used by doctors to assess patients for depression: a “P.H.Q.,” for “patient health questionnaire” He cautioned that the idea here was not to self-diagnose using such forms – there are several versions, varying by number of questions – but rather to self-assess, and then discuss your concerns with a professional.

The P.H.Q.-9, which asks nine questions, was developed by researchers at Columbia University and Indiana University, with help from a grant from Pfizer Inc. The form is available on several Web sites. It asks about the patient’s outlook and health habits over the previous two weeks. The first question, for instance, asks patients whether they have had “little interest or pleasure” in doing things and asks them to check a box ranging from “not at all,” which scores a zero, to “nearly every day,” which scores a 3. A professional computes a total score, which gives more weight to frequent symptoms; the higher the score, the greater the likelihood of significant depression.

Another set of screening tools for depression and other mental health disorders were developed by Screening for Mental Health, a Boston-area nonprofit that creates assessment tools for use by health plans, colleges, the military and the general public. Founded by Douglas Jacobs, an associate clinical professor of psychiatry at Harvard Medical School, the organization grew out of the first National Depression Screening Day, which is held annually each October during Mental Illness Awareness Week.

Mental illnesses have specific signs and symptoms, much as a disease like diabetes does, Dr. Jacobs said, and those symptoms can be identified and treated. Take depression, again, as an example. It’s normal to be sad for a while after a personal loss or a traumatic event. But when the effects linger and begin to affect your self-esteem, or interfere with your ability to do your job or handle other responsibilities, he said, you may want to consider if you are suffering from a more serious depression that should be treated professionally – with behavioral therapy, medication or both.

A version of this article appeared in print on November 14, 2012, on page F2 of the New York edition with the headline: A Regular Checkup Is Good for the Mind As Well as the Body.

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