Questionnaires we administer in the clinic — and the ones you take between visits on your own — can be helpful in tracking your progress and planning your treatments.
questionnaires Can Help with treatment
We ask patients to complete medical questionnaires at the beginning of each visit to Wells Medicine. These questionnaires, and any completed between visits, help inform your care and contribute to research.
We use questionnaires for several reasons:
- We use them to track how you’re doing – while imperfect, the scores can provide useful feedback
- You may also use the scores to see how you’re doing
- We use the data (anonymously) with our research partners for retrospective review and analysis
One-Time Questionnaires
CTQ
When a new patient first comes to Wells Medicine, one of the first questionnaires that we ask most people to complete is the Childhood Trauma Questionnaire (CTQ). The CTQ is a very well-validated and long-researched questionnaire that looks at events in a person’s childhood and assigns a score based on the answers that characterizes how traumatic it was. This can include factors such as parental divorce, sexual abuse, malnutrition, or parental abandonment. We administer the CTQ only once, at a patient’s first appointment.
There is some good data showing that a high CTQ score often makes it difficult for patients doing treatment with typical medications such as Prozac, Paxil, Wellbutrin, and others to attain good results. Inversely, the data seem to show that a high CTQ score may suggest greater opportunity for success for patients receiving treatments such as ketamine or a stellate ganglion block.
In our clinic, it is not a bad thing for patients to have a high CTQ. It can actually mean that that there is more opportunity for success and the treatment may have a higher likelihood of being successful.
Questionnaires at each appointment
QIDS
For patients seeing us for depression, with treatments such as ketamine infusions or TMS, we typically ask that they complete a Quick Inventory of Depressive Symptomatology (QIDS) at each appointment.
QIDS is a blunt scoring tool with 16 questions. It asks how the patient has been feeling over the last 7 days, which can be difficult to answer, especially when one is coming in every few days for an initial series of six ketamine treatments and when mood may be changing very rapidly. There be some questionnaires that are better suited of interventional treatments, however there are good reasons to use it.
QIDS is a very well-studied and well-validated tool that has been used commonly in many psychiatric intervention studies. There are other questionnaires that have also been well-researched, but they are much longer and more extensive. QIDS fits our needs of being both very well-researched and studied, while also not taking an extensive amount of time to complete.
GAD-7
Patients who see us to treat anxiety, especially for nitrous oxide treatments or TMS, may be asked to complete the General Anxiety Disorder questionnaire (GAD-7) with 7 questions , which looks very specifically at anxiety.
PCL
For patients seeing us for PTSD, for Stellate Ganglion Treatments for instance, we use the Post-Traumatic Stress Disorder Checklist (PCL) screening tool, which has 20 questions.
Y-BOCS
For patients treating OCD, including those using TMS, we typically use the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) with 10 questions.
We encourage mood-tracking at home
Because we in-office questionnaires are only completed on the day of treatment, we are hampered in our data analysis. In particular, we don’t capture a detailed arc of symptom changes.
If a patient comes in for ketamine treatment only when they feel the benefit of their last treatment wearing off, we will see that reflected by higher QIDS scores at the time of treatment.
When a patient has recently had treatment and is doing much better, we may see some dramatic changes in a reduction of QIDS scores.
We don’t get to see all these changes in periodic questionnaires completed at the office. However, also tracking your mood at home at home can help you to take notice of when your symptoms change and when you might benefit by returning for additional treatments or maintenance treatments.
The Value in Questionnaire Scores
Questionnaires provide a useful way of understanding how we’re doing in addition to more subjective feedback we may feel or get from those around us.
Subjective measures
Subjectively, we are often the last ones to know when something is going wrong with ourselves. Patients’ families and social circles often see changes, both positive and negative, before patients will notice those changes in themselves.
Things that families might take notice of positively may looks like — “Oh, you called Aunt Bertha, you went out to lunch, you wanted to go to Sephora, you cleaned your room, you washed your car, you picked up a book, you picked up your guitar…” There’s a sense of movement. Families may notice that a patient is sleeping better, or eating better.
When patients begin to notice the effects fading, what families or the people around them might say is — “Oh, you didn’t want to go out with your friends last night, you seem so irritable, you’re much flatter than you were, you’re not doing as much…”
The people around us can be a good subjective tool for understanding and noticing what is going on for us.
Objective measures
It can very useful to complement more subjective measures of our mental health with slightly more objective measures – those that come from questionnaire scores.
For patients who are interested in a very clinical measure of how they are doing, each of the questionnaires listed above is freely available online alongside scoring rubrics. There are also mood-tracking apps that can send a notification during each day to complete a questionnaire — whether it is a short series of questions, open-ended short-answers, or simply a choice between smiley and frowny faces. Another common questionnaire is the PHQ-9, or Patient Health Questionnaire, which is a brief set of 9 questions.
Sometimes objective measures can reveal good changes before patients are even noticing the benefits of treatment. We frequently see patients who feel like they haven’t really seen any noticeable changes from treatment, but their QIDS score decrease dramatically over the course of those first three infusions. Often, changes in what a patient notices subjectively can be much more evident later on, while changes in their objective scoring can reveal dramatic changes much sooner.
results from All this Data
We share anonymized data with our research partners, including at Baylor College of Medicine and Texas A&M, for study and analysis. Some of the results of that work has been published in conference posters and scientific articles, which a selection available on our research page.
Across our population of patients, from varied backgrounds and of all manner of ethnic and political background and of diverse ages and with all kinds of symptom presentation, we’ve shown strong results with ketamine treatments, for instance. This kind of analysis and conclusion show just how valuable these questionnaires can be, and how there can be surprisingly helpful information in them even if they are imperfect.
We’re very glad to have information from these questionnaires for research and to help track progress with individual patients.
About Us
Wells Medicine is a Houston-based practice designed to provide meaningful care for mental health. Providing targeted interventional treatments for Depression, Anxiety, OCD, PTSD and other conditions, with Ketamine Treatments, Stellate Ganglion Blocks, TMS, and Nitrous-Oxide Treatments. Focused on comprehensive care and integration with Psychiatry, Psychology, and Support Services. We are evidence-based, patient-focused and mission-driven.
The content here is for informational purposes and should not be relied upon for medical decisions. For the details of your specific medical conditions and treatments consult your doctors or other qualified healthcare professionals.
