[ossicones]

If you've ever taken a depression screener at a wellness visit, that's a consequence of this work. This paper describes how unreliable psychiatric diagnosis used to be. There were standards, but they ultimately came down to physician judgment. This created demand for more objective standards, which resulted in the "checklist" approach that we have now.

[dillydogg]

It's true. You wouldn't believe how many people I've SIGECAPS'd during my medical training. I didn't realize this article was the beginning of this approach, but it certainly helped get care to people who previously wouldn't have received it. Though I'm sure there are also many who may require intervention that aren't captured by a SIGECAPS exam. The double edged sword of the checklist manifesto, though I overall think it has been beneficial.

SIGECAPS is an acronym taught in US medicine for the diagnosis of major depressive disorder: Sleep disturbance, Interest loss, Guilt, Energy loss, Concentration loss, Appetite changes, Psychomotor agitation, Suicidality. And must have Depressed mood or Anhedonia (inability to enjoy things previously enjoyable).

The history of the SIG E CAPS acronym is also interesting, I've heard it was short for SIG (old shorthand for "to be prescribed") Energy CAPsules.

[post_break]

I had to look up SIGECAPS before I read the rest of your comment. Big oof when I did. Never heard of Anhedonia, but I sure have it.

[RodgerTheGreat]

Is "energy capsules" a euphemism for amphetamines?

[throwway120385]

The awful thing is that with at least some of those screeners you can still get people on the other side who make whatever you're self-reporting worse. When my spouse answered honestly on a postpartum survey about how she was feeling the social worker they sent in picked at my infant son's mismatching socks and suggested that she was so old she was "set in her ways" and that having a child might be too big of an adjustment for her. It set her back in a huge way and knowing what I know now I'd go to all of those appointments with her and never answer any of that stuff honestly.

It doesn't really matter how "objective" your standard is if you're still relying on individuals to try to "address" whatever the patient is reporting. People still form a negative opinion and label you really quickly no matter how hard the profession fights that perception.

[hickelpickle]

Related but unrelated, but we had issue with breastfeeding and the only help that was valid was being informed to go to WIC as they could provide guidance. All medical adjacent people treated it like it was a lack of effort, when it was breaking her down and making her feel worthless. I think the WIC people helped more just in their lack of judgement made it less stressful, or it was just timing.

Our child also got stuck in the canal during birth and there was a good 30 seconds where the midwife from the hospital was trying to encourage to doctor who was to step in to let here keep trying, my kid came out white and took the longest 30-60 seconds to take their first breath. Never experienced so much dunning-kurger all at once. I had read a few week before that about medical professionals talking about how ominous a quiet birth it and was just zoned out as that was exactly what happened and I could sense all the tension. Then people from children services start demanding umbilical cord because my fiance had failed for MJ on her first prenatal vist, she quit smoking as soon as we knew and never failed a test after wards. But it all felt like an extreme lack of compassion. Then I was ostracised because I didnt want to cut the cord while I just thought my kid was dead and these social workers are trying to insert themselves in the process and its all chaos for no reason. The only good thing was a nurse pretty much told them to fuck off and wait in a nice but check yourself kinda way.

But multiple times people cared about their own ego, or their perceived power than actually attempt to do a compassionate job.

[dbgrman]

I wonder what's the false negative rate for these checklists.