SPECIALTY CONSULTATION FOR
PERFORMANCE ISSUES OR INJURY
REHABILITATION CONCERNS
- It is important that physicians be vigilant of symp-
toms that may warrant referral for more extensive psy-
chologic assessment and treatment (Robinson, 2001).
For example, Brewer and associates reported that in a
sample of orthopedic patients, 33% percent of injured
football players were regarded as depressed (Brewer,
Jeffers, and Petitpas, 1994). - The mnemonic IN SAD CAGES can be utilized as a
helpful tool to assess the presence of depressive
symptomology (Hendrickson, 2003a):
1.Inloss of interest in pleasurable activities
2.Ssuicidal ideation
3.Aactivity changes (e.g., decreased)
4.Ddysthymia (depressed mood)
5.Cconcentration difficulties
6.Aappetite changes (increased or decreased)
7.Gfeelings of guilt
8.Eenergy changes (usually decreased)
9.Ssleep changes (increased or decreased) - The presence of six or more of these symptoms is
indicative of a major depressive disorder. - Psychologists can assess and treat any clinical signif-
icant impairment in mood and/or function that may
be involved in the etiology, exacerbation, or mainte-
nance of the patient’s current complaints.
Psychologic referral may be indicated for refractory
cases or when patient present with comorbid mood
symptoms (e.g., anxiety, depression, grief) that sig-
nificantly impact personal, social, and/or occupa-
tional functioning (Nideffer, 1983; Miller, Vaughn,
and Miller, 1990).
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2001, Chap. 49.452 SECTION 5 • PRINCIPLES OF REHABILITATION