D0600: Total Severity Score

D0600: Total Severity Score

Item Rationale

Health-related Quality of Life

• Review Item Rationale for D0160, Total Severity Score.

• The PHQ-9-OV© is adapted to allow the assessor to interview staff and identify a Total Severity Score for potential depressive symptoms.

Planning for Care

• The score can be communicated among health care providers and used to track symptoms and how they are changing over time.

• The score is useful for knowing when to request additional assessment by providers or mental health specialists for underlying depression.

Steps for Assessment

After completing the Staff Assessment of Resident Mood:

1. Add the numeric scores across all frequency items for Staff Assessment of Mood, Symptom Frequency (D0500) Column 2.

2. Maximum score is 30 (3 × 10).

Coding Instructions

The interview is successfully completed if the staff members were able to answer the frequency responses of at least 8 out of 10 items on the PHQ-9-OV©.

• The software will calculate the Total Severity Score. For detailed instructions on manual calculations and examples, see Appendix E: PHQ-9-OV© Total Severity Score Scoring Rules.

Coding Tips and Special Populations

• Responses to PHQ-9-OV© can indicate possible depression. Responses can be interpreted as follows:

— Major Depressive Syndrome is suggested if—of the 10 items, 5 or more items are identified at a frequency of half or more of the days (7-11 days) during the look-backperiod and at least one of these, (1) little interest or pleasure in doing things, or (2) feeling down, depressed, or hopeless is identified at a frequency of half or more of the days (7-11 days) during the look-back period.

— Minor Depressive Syndrome is suggested if—of the 10 items, (1) feeling down, depressed or hopeless, (2) trouble falling or staying asleep, or sleeping too much, or (3) feeling tired or having little energy are identified at a frequency of half or more of the days (7-11 days) during the look-back period and at least one of these, (1) little interest or pleasure in doing things, or (2) feeling down, depressed, or hopeless is identified at a frequency of half or more of the days (7-11 days).

— In addition, PHQ-9-OV© Total Severity Score can be used to track changes inseverity over time. Total Severity Score can be interpreted as follows:

1-4: minimal depression

5-9: mild depression

10-14: moderate depression

15-19: moderately severe depression

20-30: severe depression