How Depression Tests Work

How Depression Tests Work Depression Diagnosis Print Depression Tests That Can Help Determine If You Have a Mood Disorder By Amy Morin, LCSW facebook twitter instagram Amy Morin, LCSW, is a psychotherapist, author of the bestselling book 13 Things Mentally Strong People Dont Do, and a highly sought-after speaker. Learn about our editorial policy Amy Morin, LCSW Medically reviewed by Medically reviewed by Steven Gans, MD on September 18, 2018 Steven Gans, MD is board-certified in psychiatry and is an active supervisor, teacher, and mentor at Massachusetts General Hospital. Learn about our Medical Review Board Steven Gans, MD Updated on April 08, 2019 Depression Overview Types Symptoms Causes & Risk Factors Diagnosis Treatment Coping ADA & Your Rights Depression in Kids In This Article Table of Contents Expand Purpose and Uses Screenings Tests Limitations Diagnosis View All There isn’t a single depression test that determines if someone is clinically depressed. Unlike lab tests that diagnose some illnesses, a depression test is just one tool that a professional might use when diagnosing a mental health condition like depression.   Depression tests are often in the form of a questionnaire. A physician or mental health professional may ask the questions orally or an individual may be asked to read and answer the questions on paper or on a digital device.   The answers alone arent enough to determine if someone has depression because a test wont account for other possible reasons for an individuals answers. For example, someone experiencing acute pain may report difficulty sleeping and poor appetiteâ€"but those symptoms may be caused by pain rather than depression. A  clinician would need to take their physical health condition into account after reviewing the test results. Similarly, a treatment provider would also need to take someones environment into account. Someone may report difficulty sleeping not because hes depressed, but because he has a loud neighbor who keeps him up at night. Be aware that depression tests dont allow for explanations. They usually ask someone to report how often certain symptoms occur during a defined time period. A treatment provider would need to probe further to gain suficient information about an individuals symptoms. Purpose and Uses A depression screening doesn’t diagnose depression. It only indicates if symptoms of depression are present and may warrant further evaluation. Depression screenings are often used as a first step in determining whether a physician should inquire more about an individual’s mental health. A patient may be given the screening to complete before seeing the physician or the physician may ask the questions during an exam.   In 2016, the US Preventative Task Force recommended that physicians administer depression screenings to everyone over the age of 18. By asking a few simple questions about a person’s mood, symptoms, and behavior, a physician can determine whether further evaluation is needed. This recommendation was made because depression often goes undetected. Some studies estimate its only recognized about 50 percent of the time. Most physicians are making depression screenings a routine part of an office visit.   But, you dont have to wait until your next doctors appointment to take a depression screening. Depression screenings are also available online. Some websites offer free screening tests that allow individuals to complete in the privacy of their own homes. What Kind of Doctor Should You See for Your Depression? Common Screenings The most common depression screening tool is the Patient Health Questionnaire-9 (PHQ-9). It indicates whether an individual has symptoms of depression that may require professional intervention. Through a series of nine questions, symptoms are assessed. Some of the areas that are evaluated include appetite changes, fatigue, thoughts of suicide or self-harm, and loss of interest and pleasure in doing things.   If a physician conducts the screening and the score indicates possible depression, you may be interviewed more about your symptoms. Your physician may also assess your physical health to rule out any underlying medical conditions contributing to your symptoms and you may be referred to a mental health professional for further evaluation.   You can also take the PHQ-9 online any time for free.  The Anxiety and Depression Association of America offers the questions. You aren’t given a score, but your answers appear on a printable form. Printing out that form and taking it into your appointment with your physician can be a good way to start the conversation about your mood. Mental Health America offers the PHQ-9 as well. After answering the questions you’ll receive a score and an interpretation of that score as well as recommendations about next steps you might take in getting help. Mental Health America also offers other screenings, such as a bipolar screening test. When a depression screening indicates possible depression, it can be important to take a bipolar screening test too because depression can be part of bipolar disorder. The PHQ-9 offers a modified version for teens. The adolescent PHQ-9 asks the same type of questions as the adult version, but the language is easier to understand. It also asks about school-related difficulties as opposed to occupational issues. If you take a depression screening and it indicates possible depression, schedule an appointment with your physician to talk about it. Your physician may want to do another screening or may refer you to a mental health professional. Common Symptoms of Clinical Depression Depression Discussion Guide Get our printable guide to help you ask the right questions at your next doctors appointment. Download PDF Common Tests Physicians, psychiatrists, psychotherapists, and other mental health professionals may use depression tests as part of their evaluation or treatment. Sometimes tests are administered to gain a better understanding of the severity of someones depression, while at other times, an individual may take the same test several times throughout treatment to track their progress. Most depression tests result in a numerical score. That score provides a mental health treatment provider data about a persons depression. There are many tests that may be used to assess depression. Here are some of the most commonly used. Beck Depression Inventory (BDI-II) The Beck Depression Inventory was created by Aaron Beck, a psychiatrist who is considered to ?be the father of cognitive therapy. The current version of the test, the BDI-II, is appropriate for individuals 13 and over. It contains 21 questions, with each being scored on a scale of 0 to 3. Higher total scores indicate more severe symptoms of depression. Zung Self-Rating Depression Scales (SDS) The Zung Self-Rating Depression Scale assesses the severity of a person’s depression. It consists of 20 items that explore the psychological, somatic, and affective aspects of depression. It’s a quick and simple tool. Major Depression Inventory (MDI) The Major Depression Inventory consists of 10 items and individuals rank how often they’ve experienced certain symptoms over the past two weeks (ranging from never to all the time on a Likert scale). The items are then scored and the score indicates the severity of depression (from no depression to severe). Rome Depression Inventory (RDI) The Rome Depression Inventory consists of a series of 25 items that use the phrases most commonly used by depressed individuals to describe their discomfort. Plutchik-Van Praag Self-Report Depression Scale (PVP) The Plutchik-Van Pragg self-report depression scale uses 34 items to cover the diagnostic criteria for depression. Although it was developed for an earlier edition of the Diagnostic and Statistical Manual (the DSM-III), it remains relevant today as clinicians use the DSM-5. Hamilton Rating Scale for Depression (HRSD) The Hamilton Rating Scale for Depression is a multiple item questionnaire used to identify depression and to evaluate recovery. It’s designed for adults and is used to rate the severity of a person’s depression by evaluating their mood, feelings of guilt, suicidal ideation, anxiety, insomnia, weight loss, and somatic symptoms. Carroll Rating Scale (CRS) The Carroll Rating Scale is a self-report version of the Hamilton Rating Scale for Depression (HAMD). It consists of 52 dichotomous items. Center for Epidemiological Studies Depression (CES-D) The Center for Epidemiological Studies Depression has been used since the 1970s. It consists of 20 items and the self-report version remains widely used. Children’s Depression Inventory (CDI) The Children’s Depression Inventory measures the affective, cognitive, and behavioral signs of depression in children between the ages of 7 and 17. Potential Drawbacks While these tests can be very helpful to the diagnosis and treatment of depression, they do have some potential drawbacks as well.   Self-report inventories are based on someones answers to the questions. The scores can be easily exaggerated or minimized by the person completing the questionnaire.   A person wanting to impress their physician or one who is embarrassed by their symptoms may minimize their symptoms. Similarly, a person who wants to ensure a clinician doesn’t underestimate their suffering may exaggerate how much difficulty they’re experiencing. If a test is administered orally, hearing difficulties or processing disorders may affect a person’s answers. Similarly, a person with poor reading comprehension may not be able to complete a questionnaire accurately. The place in which the test is administered can also impact the answers. If a patient is given a questionnaire to complete in a crowded waiting room or is asked to hand the form to a receptionist, the answers may be different than if the test were given in private or in the presence of a physician only. Additionally, depression impacts the way people think, so individuals who are feeling depressed may not be accurate reporters of their symptoms or they may have poor insight into their symptoms.   What Happens After? If you take a depression test and the scores indicate you may be depressed, a mental health professional is likely going to interview you about your answers and ask more questions to arrive at a clear diagnosis. If you are diagnosed with depression, a mental health professional will discuss treatment options with you. Depending on the type of depression you have, therapy, medication, or a combination of the two may be necessary to treat your symptoms. Find Help With the 7 Best Online Help Resources for Depression