SHIFT WORK DISORDER - myCME.com

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SLEEP/WAKE LOGName:Use these symbolsLights out or inbed trying to sleepExample:PM Midnight AM Noon PMCAsleepLights on or out ofbed for the night6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6CCCaffeinated coffeeor sodaSleeping aid,Day How much alcohol, medications? Sleep Awake-timeDate sleep? Time, type, amount quality? fatigue?Fri 6 hours 6:30 PM 1 beer06/11 + 1 hour nap 10 PM Ambien 10 mg Hi Mod Lo Hi Mod LoPM Midnight AM Noon PM6 7 8 9 10 11 12 1 2 3 4 5 6 7 8 9 10 11 12 1 2 3 4 5 6Fill out in the morningFill out inthe eveningSleeping aid,Day How much alcohol, medications? Sleep Awake-timeDate sleep? Time, type, amount quality? fatigue?Hi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoHi Mod LoAdapted from Spielman & Glovinsky, NY, 1991.
PHQ-9 QUICK DEPRESSION ASSESSMENTFor initial diagnosis:Fold back this page before administering this questionnaireINSTRUCTIONS FOR USEfor doctor or healthcare professional use only1. Patient completes PHQ-9 Quick Depression Assessment on accompanying tear-off pad.2. If there are at least 4 s in the blue highlighted section (including Questions #1 and #2), consider a depressive disorder.Add score to determine severity.3. Consider Major Depressive Disorder— if there are at least 5 s in the blue highlighted section (one of which corresponds to Question #1 or #2)Consider Other Depressive Disorder— if there are 2 to 4 s in the blue highlighted section (one of which corresponds to Question #1 or #2)Note: Since the questionnaire relies on patient self-report, all responses should be verified by the clinician and a definitive diagnosis made on clinical grounds,taking into account how well the patient understood the questionnaire, as well as other relevant information from the patient. Diagnoses of Major DepressiveDisorder or Other Depressive Disorder also require impairment of social, occupational, or other important areas of functioning (Question #10) and ruling outnormal bereavement, a history of a Manic Episode (Bipolar Disorder), and a physical disorder, medication, or other drug as the biological cause of the depressivesymptoms.To monitor severity over time for newly diagnosed patients orpatients in current treatment for depression:1. Patients may complete questionnaires at baseline and at regular intervals (eg, every 2 weeks) at home and bring them in attheir next appointment for scoring or they may complete the questionnaire during each scheduled appointment.2. Add up s by column. For every : Several days = 1 More than half the days = 2 Nearly every day = 33. Add together column scores to get a TOTAL score.4. Refer to the accompanying PHQ-9 Scoring Card to interpret the TOTAL score.5. Results may be included in patients’ files to assist you in setting up a treatment goal, determining degree of response, as well asguiding treatment intervention.PHQ-9 SCORING CARD FOR SEVERITY DETERMINATIONfor healthcare professional use onlyScoring—add up all checked boxes on PHQ-9For every : Not at all = 0; Several days = 1;More than half the days = 2; Nearly every day = 3Interpretation of Total ScoreTotal Score Depression Severity0-4 None5-9 Mild depression10-14 Moderate depression15-19 Moderately severe depression20-27 Severe depressionSpitzer RL, et al. JAMA. 1999;282:1737-1744.
Page 1 and 2: Practice Management Tips ForSHIFT W
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Recognition of shift-workdisorder i
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Shift-work disorderThe timing of sh
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Managing the patient withshift-work
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Shift-work disorderFigure 3 Optimal
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Shift-work disorderfor a motor vehi
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Shift-work disordermoderate caffein
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Supplement toAvailable at jfponline
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Armodafinil for Treatment of Excess
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The Epidemiology and Diagnosis of I
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CIRCADIAN RHYTHM SLEEP DISORDERSPra
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Table 2— AASM Levels of Recommend
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3.2.1.1 Both the Morningness-Evenin
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Five studies used one of the newer
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4.4 Advanced Sleep Phase DisorderBe
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Table 1—Subject Demographicsn M:F
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Scale. 28 The simple reaction time
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Median RT (msec)1600A14001200100080
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10Mentally AExhaustedSharpScore8642
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Current Treatment Options in Neurol
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398 Sleep Disordersand sleep loss,
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400 Sleep DisordersTable 1. Treatme
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402 Sleep DisordersStandard dosageC
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404 Sleep DisordersStandard procedu
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406 Sleep DisordersCaffeineMelatoni
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408 Sleep DisordersWake-promoting a
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