Assessing Depression

Clinician Administered Assessment

Receiving a formal assessment from a medical or mental health professional is the gold standard for making a diagnosis of depression and there are several important reasons a professional evaluation may be helpful:

1. Depressive symptoms may be caused by other factors that a professional can rule out.
2. A professional is uniquely trained to assess how much the symptoms interfere with daily life in a way that is sometimes difficult for people to do on their own.
3. Because some of the very symptoms of depression are difficulty in decision making and concentration, a professional can help people to organize their experiences and keep them focused on communicating the most important information.
4. In the event someone is experiencing depressive symptoms, a professional can talk though various treatment options.
5. In some cases a person experiencing depression may wish to get insurance coverage for treatment or time off work to recover. In many of those cases, a professionally-made diagnosis is required.

Often, a professional assessment will include having a conversation in which the professional asks about symptoms, how they impact daily life and how long they have been occurring.  It is also common to complete a questionnaire report of depressive symptoms. Sometimes, a professional may ask to speak with a loved one to provide additional information or another perspective. In some cases, a professional may use a formal interview that includes specific questions to ask and instructions on how to score responses. The most common clinician interviews for adults are the Structured Clinical Interview for DSM (SCID) and the Hamilton-Rating Scale for Depression. For children, the Kiddie-Schedule for Affective Disorders (KSADS) and the Childhood Depression Rating Scale (CDRS) are common.

Self-Report

There can be barriers to meeting with a professional. For example, limited access to people with professional expertise in some rural areas, and the time and money it takes to see a professional may make it difficult to do so. In addition, sometimes people may be uncomfortable discussing depressive symptoms and may prefer to begin exploring whether they are experiencing symptoms of depression prior to speaking with a professional. In these cases, completing a free screening questionnaire may be a helpful starting point. It is quick and free of charge. Because a screening questionnaire is not a substitute for a formal diagnosis of depression, it is generally best to follow up with a visit to a medical or mental health professional if a screener indicates the presence of depressive symptoms.

The Patient Health Questionnaire-9 (PHQ-9) is a widely-used, brief questionnaire to screen for depressive symptoms in people 12 and up. The PHQ-9 asks a person to indicate how much he or she has been bothered by each of nine depressive symptoms over the past 2 weeks:

Estimated severity of symptoms is based on the sum total score using the following guidelines:

For Children:

It can sometimes be tricky or impossible to have young children report about their own depressive symptoms. In that case, parents can complete a screener about their child. The screener developed by the National Institute of Health (NIH) that inquires about depressive symptoms is called the Pediatric PROMIS – Parent Proxy Depressive Symptoms screener:

For children or teens who can complete a screener, the corresponding self-report version is the Pediatric PROMIS – Depressive Symptoms screener:

These child and teen screeners do not have defined severity guidelines like the PHQ-9. However, if parents or children are endorsing several of these symptoms, it is recommended that symptoms are discussed further with a professional, such as a child’s pediatrician or a child mental health care provider.