Major depressive disorder affects 17 percent of people in the United States. While some signs of depression are easier to spot than others, there is no way to truly diagnose the condition without concrete confirmation from a trained provider, such as a primary care physician or psychologist.
Because so many adults, children, and pregnant women will experience depression during their lifetime, it is important to have tests available for earlier diagnosis. This blog will highlight some of the most common screening tests that can help you stay on top of your mental health.
Who May Need a Depression Screening?
Any teen or adult (including pregnant women or women who have just given birth) over the age of 12 should be screened for depression. People who show early symptoms of depression, such as persistent sadness or loss of interest in activities they might otherwise enjoy, should also be screened.
It is important to remember that a screening test is different from a diagnosis. Screening tests are helpful in deciding if you need more help from a health care provider. For example, a high score on a screening test may prompt your primary care physician to refer you to a psychologist. However, screening tests should not replace a diagnosis.
depression criteria
By definition, a clinical diagnosis of major depression requires that you have persistent (at least two weeks) feelings of sadness and changes in your interests or activities. In addition, five of these symptoms must be present:
- Weight loss or weight gain
- Difficulty to sleep
- Fatigue
- Feeling guilty or hopeless
- Lack of concentration that becomes problematic on a day-to-day basis
- Suicidal thoughts
- delayed movements
Doctors and other mental health providers use the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) to diagnose depression. The manual is a comprehensive guide to help providers diagnose nearly 200 mental health conditions.
Types of depression screening tests
There are several types of screening tests that can alert health care providers that a patient is in a depressed state. Most assessments are self-assessments where you complete an online document or paper questionnaire that is then sent to your provider for further assessment.
Patient Health Questionnaire-9 (PHQ-9)
This nine-item questionnaire is typically the first assessment primary care providers give patients. Each question requires a score from 0 to 3, where 0 indicates that you have not experienced those feelings and 3 indicates that you experience those feelings every day. PHQ-9 is used to detect and control symptoms of depression.
While brief, the questions involve several telltale signs of depression, including sadness, low energy, poor concentration, poor appetite, and suicidal ideation. For example, the first question asks if you have experienced little interest or pleasure in doing things: a 0 indicates nothing and a 3 indicates that you do not experience any pleasure every day. A combined score of 10 to 14 indicates mild depression, 15 to 19 indicates a mild to moderate form of major depression, and anything greater than 20 represents severe depression.
beck depression inventory
Outside of PHQ-9, this 21-item screening test is one of the most common types of screening used by physicians and mental health providers. The articles cover topics such as sleep, appetite, interest in activities, feelings of failure, life satisfaction, and sadness. Responses are scored from 0 to 3, where 0 indicates no impact and 3 a sign of interference with daily activities. For example, one question refers to self-esteem. Answering with a 0 indicates that you are not disappointed in yourself, while a 3 indicates that you hate yourself.
Depression Scale of the Center for Epidemiological Studies (CES-D)
This 20-item screening test measures how often you have experienced symptoms of depression in the past week. Each response is scored on a scale of 0 to 3, where 0 indicates no symptoms and 3 indicates recurrent symptoms. For example, one item asks if you have felt sad during the last week. A score of 0 indicates rarely, while a score of 3 indicates that you have felt sad most days of the week. In general, the higher the score, the more depressed a person may be.
EQ-5D
This screening test measures your quality of life using five subtopics: mobility, self-care, usual activities, pain/discomfort, and anxiety/depression. Each section has five answers to choose from. For the anxiety/depression section, responses range from “I am not anxious or depressed” to “I am extremely anxious or depressed.”
Hamilton Depression Rating Scale (HAM-D)
This screening test contains 17 items that are measured on 5 or 3 point scales. The questions ask about various aspects of your life during the last week. Items range from mood and insomnia to suicidal thoughts and how you feel about doing work and other activities. A score below 10 indicates the absence of depression. A score between 10 and 13 can indicate mild depressive feelings, while between 13 and 17 is moderate depression. Any score above 17 indicates severe depression.
Montgomery-Åsberg Depression Rating Scale (MADRS)
This 10-item assessment measures depression in adults using a series of questions along with a 7-point scale: each item is rated on a scale of 0 to 6, where 0 is normal or no change and 6 is the most serious feelings. or symptoms. For example, one of the items involves your appetite: responding with no change in appetite would get a score of 0, while needing coaxing to eat would get a score of 6.
Social Problem Solving Inventory-Revised (SPSI-RTM)
This screening test uses a series of questions (52 in the longer form and 25 in the shorter form) to test how well you can solve problems. The ability to solve problems has a direct link to depression. In fact, problem-solving therapy is often used as a treatment for depression.
Edinburgh Postpartum Depression Scale (EPDS)
Postpartum depression affects up to 1 in 7 women. This 10-question assessment is administered to expectant mothers or mothers who have recently given birth. Mothers are asked to answer questions about how they have felt during the last seven days. There are four possible answers to check each question, and each answer is given a score of 0, 1, 2, or 3. Thirty is the maximum score. Any score above 13 indicates that you may have some form of depression. Sometimes the pediatrician will ask you to fill this out at her child’s well-child visits to make sure she doesn’t have postpartum depression.
Why screen for depression?
As much stigma as depression and other mental health conditions may carry, the reality is that mental illness is treatable, especially when found in its early stages.
As with any other disease, identify depression It can help prevent it from becoming something more serious. Often the first step in getting help is acknowledging that there is an initial problem.
Preempting depressive thoughts can also decrease the chance that they will turn into something more serious, such as suicide or substance abuse.
Think of depression screening as a mammography either colonoscopy. These tests alone will not prevent breast cancer or colon cancer from mutating and causing damage, but early detection and treatment through routine screening can dramatically increase cancer survival rates.
Contact your primary care doctor for more information about mental health screenings. They can point you in the direction of a screening test that suits your needs and, if appropriate, refer you to a mental health provider.
