Step 1


Screening Principles (the identification of probable cases and predominant problem)


Patients may present with these symptoms which may be indicative of underlying:

  • Usually done by the GP but could be completed by a variety of appropriately trained health professionals

  • Assessment must take into account that depression and anxiety disorders:

    • Can exist independently or may be co-morbid

    • There may be symptom overlap

    • Presentation can vary in different groups e.g. young / old, men / women, ethnic groups

The main problem(s) to be treated should be identified through:

  • Discussion with the patient

  • Determining the priorities of the co- morbidities

  • Clarify sequencing of the problems by drawing up a timeline

If the patient has symptoms of both depression and anxiety then after screening treat the more predominant of the two. 



  • Vague physical symptoms - tiredness, aches and pains, poor sleep, weight or appetite change, poor concentration

  • Repeated consultation for minor physical symptoms

  • Patient whose symptom severity/disability is out of proportion to its causes

  • Social dysfunction - drug/alcohol use, relationship failure, anger, aggression, frequent absence from work

  • Interaction difficulties


  • Apprehension

  • Cued panic attacks

  • Spontaneous panic attacks

  • Irritability

  • Poor sleeping

  • Avoidance

  • Poor concentration

  • Triggers from external stimuli


Patient Information & Choice
(Information sharing regarding diagnosis and treatment options, and a preliminary decision about plans for future treatment)



to differentiate between depression & anxiety