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Comment & Response
June 2018

Knowledge Removes Discomfort—Reply

Author Affiliations
  • 1Faculty of Medicine, University of Ottawa, Ottawa, Canada
  • 2Department of Psychiatry and Behavioral Sciences, Central Michigan University, Mount Pleasant
JAMA Dermatol. 2018;154(6):739. doi:10.1001/jamadermatol.2018.0851

In Reply We thank Dr Nwabudike for replying to our publication on the Patient Health Questionnaire-2 (PHQ-2) in Dermatology.1 We address his inquiries in chronological order:

1. The confusion between emotional distress and depression is one of the key reasons we introduced the PHQ-2 into dermatology. The questionnaire is a brief version of psychiatry’s Diagnostic and Statistical Manual of Mental Disorders (Fifth Edition) (DSM-5) criteria for depression, translating the 2 most heavily weighted criteria into a questionnaire format.2 The complete DSM-5 depression criteria are not necessary for dermatologists to remember. Our goal is for dermatologists to recognize and screen for possible depression, detect suicidal ideation, and act on this by following our algorithm. We do not suggest that dermatologists formally diagnose or independently manage psychiatric conditions. Screening questionnaires are inadequate to make a diagnosis, and specialists should try to avoid making diagnoses outside the scope of their practice.

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