Implementing Screening for Depression and Anxiety for Patients With Thyroid Disease

Date of Degree


Document Type

Doctoral Project

Degree Name

Doctor of Nursing Practice (DNP)




Diana Beckmann-Mendez


Background: Thyroid dysfunctions are the most common endocrine-specific disorders found in the clinic setting. Symptoms of hypothyroidism/hyperthyroidism overlap with anxiety/depression symptoms. Research shows a relationship between individuals with thyroid disorders and people with anxiety/depression. Mental health disorders are typically managed in the primary care setting. However, screening for depression and anxiety are low in primary care settings and often go unidentified. Purpose: To implement validated, evidence-based depression and anxiety screening tools in a Texas endocrine clinic to improve the management of patients with concomitant thyroid and mental health disorders. Objectives: The project objectives include initiating screening for anxiety/depression and referral to the patient's primary care provider (PCP). Method/Interventions: Project interventions include screening all patients diagnosed with thyroid disorders for anxiety and depression symptoms during their routine endocrinology visits. The screening was initially conducted with the ultra-brief versions of the Patient Health Questionnaire (PHQ) and Generalized Anxiety Disorder (GAD) screening tools. If positive, the full forms of each tool were completed and reviewed by the provider. Results: After 13 weeks, 106 patients were screened with the ultra-brief screeners. Of those screened, 12 patients completed the full forms of each tool, of which three patients screened positive and received referrals to follow-up with their provider. Implications: Screening for anxiety/depression with validated tools in an endocrine clinic may increase anxiety/depression disorder recognition, increase referrals to follow-up with a PCP, and improve the management of patients with concomitant endocrine and mental health disorders.

This document is currently not available here.