Depression affects more than 350 million people worldwide, according to the WHO. The reality is likely much worse, given the difficulties in diagnosing and treating this disorder. However, there are several tests and methods available to measure the severity of a depressive state. Do these depression tests help in accurately diagnosing this illness? We will attempt to answer this question in this dossier.
WHAT IS DEPRESSION?
Depression is a significant public health issue. Clinically and psychologically, it is different from a simple bout of sadness. Recognized as a disease in many countries, it comes with several more or less severe symptoms:
- A depressive mood and constant sadness that occurs almost every day;
- A loss of pleasure and interest in daily activities;
- Significant weight gain or loss;
- Psychomotor retardation;
- Sleep disturbances;
- Reduced ability to concentrate, memory issues, and indecisiveness;
- Constant pessimism often leads to thoughts about death and suicide;
- Abnormal fatigue, even after a night’s sleep.
The symptoms of depression last for two weeks or more and affect professional and personal activities. The person affected may not be aware of their condition, hence the need for a medical diagnosis through a depression test and confirmation by a professional.
WHY DO I FEEL THE NEED TO GET TESTED?
The symptoms mentioned above are not exhaustive. A depressive episode can also lead to sexual disturbances (loss of libido, hyperactivity, aggressiveness, etc.), muscle pain, ongoing migraines, and a general slowdown in activity.
If you recognize one of these signs in a loved one or yourself, it is expected to feel the need to take a depression test. Diagnosis is the best way to identify this disorder as soon as the first signals appear and take appropriate measures.
ONLINE TESTS
Once unknown, depression is now the focus of many awareness campaigns. These operations aim to shed light on this disorder, inform the public of its impact on the community, and encourage individuals to get diagnosed immediately.
Many organizations and professionals, including psychologists and psychosocial experts, now offer online depression tests to facilitate the diagnosis of a depressive state. These depression tests, in the form of questionnaires, are freely accessible on specialized websites. Several Canadian sites offer these tests, including HereToHelp, MDCalc, and The Centre for Addiction and Mental Health.
Through these evaluations, getting an initial opinion on your psychological and emotional state in just a few clicks is possible. Although these tests are designed with the best intentions, they do not replace the diagnosis and opinion of a medical professional. If you need the help of a certified psychologist or psychiatrist, visit the Canadian Mental Health Association website or the Order of Psychologists of Quebec website to find the nearest professional.
You can also evaluate and treat your depressive state at one of the Neurofeedback clinics in the Neuroperforma network.
PROFESSIONAL-RECOGNIZED TESTS
Professionals rely on a rational analysis of symptoms and other psycho-emotional factors to diagnose the existence of a depressive state. In some cases, they also use tests recognized by other psychologists and doctors working with depressive patients. Here are a few:
HAMILTON DEPRESSION SCALE
Published in 1960 by psychiatrist Max Hamilton, this depression test remains one of the most used by health professionals to measure the severity of major or characterized depression. The Hamilton scale is designed for professional use. It is a 17-point questionnaire that rates a depressive state on a scale of 10 to 18.
- If the patient scores above 18, their depressive state is considered moderate to severe;
- Between 14 and 17: the depression is mild to moderate;
- Between 10 and 13: it is considered mild depression.
MAJOR DEPRESSION INVENTORY (MDI) DEVELOPED FOR WHO BY PER BECH
Developed by Danish psychiatrist Per Bech, this depression test allows individuals to self-assess the severity of a depressive state or mood disorder. This self-assessment includes ten questions that rate how the patient has felt during the two weeks preceding the test.
The questions address personal aspects such as sadness, interest in daily activities, energy levels, self-confidence, guilt, appreciation of life, concentration levels, vigour, sleep state, and appetite.
The MDI result can be interpreted according to the test’s scoring, the criteria of the ICD-10, or the DSM-IV criteria. Due to its complexity and the different possible scoring systems, the MDI test is mainly used by clinicians.
BECK DEPRESSION INVENTORY (BDI)
The Beck Inventory is another depression test recognized by professionals and is often used in psychological analysis. It is a self-assessment questionnaire containing 13 items listed alphabetically (from A to M). Each item includes four statements corresponding to 4 increasing levels of symptom intensity.
The Beck depression test evaluates psycho-emotional aspects such as sadness, outlook on the future, appreciation of life, satisfaction, guilt, disappointment, suicidal thoughts, interest in others, decision-making ability, attractiveness, work effort, fatigue, and appetite.
SYMPTOM CHECKLIST (SCL-90) BY ETTEMA AND ARRINDELL
The SCL-90 is a self-inventory seeking to provide an overview of the physical and psycho-emotional functioning of the respondent. The questionnaire thus measures the severity of a depressive state with varying degrees of precision.
The SCL-90 also reveals indices that help identify other disorders such as somatic issues, agoraphobia, sleep problems, anxiety, and interpersonal sensitivity and distrust.
PATIENT HEALTH QUESTIONNAIRE – 9 ITEMS (PHQ-9)
Shorter than other questionnaires, PHQ-9 is a self-assessment tool for depression that professionals also use. As the name suggests, this depression test focuses on the nine main criteria of a depressive state listed in the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders – 4th Edition).
These symptoms include:
- Lack of interest in daily activities;
- Feelings of sadness, depression, or hopelessness;
- Difficulties falling asleep or excessive sleeping;
- Persistent fatigue;
- Loss of appetite or tendency to overeat;
- Poor self-perception;
- Difficulty concentrating on simple tasks like reading a book or watching TV;
- Lack of energy or extreme agitation;
- Suicidal thoughts or self-harm desires.
The PHQ-9 depression test operates on a scoring system based on responses to each item. For each question, the PHQ-9 assigns a score from 0 to 3 depending on the frequency of symptoms over the past two weeks.
- 0 if the symptom did not appear at all during this period;
- 1 if the symptom occurred a few days;
- 2 if the symptoms persisted for a week;
- 3 if they appeared every day for two weeks.
The questionnaire results in a score ranging from 0 to 27, which then allows evaluation of the severity of the depression:
- 1 to 4: minimal depressive state;
- 5 to 9: mild depression;
- 10 to 14: moderate depression;
- 15 to 19: moderately severe depression;
- 20 to 27: severe depression.
CENTER FOR EPIDEMIOLOGIC STUDIES – DEPRESSION SCALE (CES-D)
Developed from recognized assessment instruments like the Beck scale, the CES-D evaluates the subject’s mood based on the frequency of depressive symptoms during the week preceding the test.
This depression test allows self-assessment based on 20 items covering symptomatic factors such as:
- Feelings of guilt;
- Sleep disturbances;
- Loss of appetite;
- Psychomotor retardation;
- Depressive mood, etc.
Symptom frequency is measured on a scale from 0 to 3 points, with 0 corresponding to infrequent occurrence (less than one day) and 3 to widespread occurrence (between 5 and 7 days). The CES-D results in a score that does not exceed 60 points. The higher the score, the more severe the depressive state.
MINI INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW (MINI)
The MINI test is another self-assessment of the depressive state that can be done online in less than 5 minutes. The questionnaire includes ten items related to the respondent’s emotional and psychological state during the previous month.
The MINI depression test offers an initial opinion based on a factor analysis of symptoms associated with depression, including prolonged sadness for two weeks, loss of interest in life, lack of appetite, sleep disturbances, daily lack of vigour, loss of self-confidence, and suicidal or self-harm thoughts.
HOW TO GET A PROPER DIAGNOSIS
Do you recognize one or more of the symptoms mentioned in the tests discussed in this article? Or, have you used one of these tests, and the results seem to indicate a more or less advanced depressive state? In that case, we recommend getting adequately diagnosed by a professional.
SEEING A PSYCHOLOGIST
A psychologist is THE priority person to consult to confirm or refute the results of an online depression test. This professional is precisely qualified to handle moderate psychological disorders such as depression.
Their expertise is limited to depressive states that do not pose a direct and immediate threat to your health or that of those around you.
SEEING A DOCTOR
If your malaise is deeper and affects your physical health, consider consulting a specialized doctor, such as a psychiatrist. This professional offers personalized support and, if necessary, medication to alleviate your depressive state.
This doctor is better suited if you have suicidal thoughts all day, suffer from severe eating disorders, or live with severe anxiety daily.
CONCLUSION
Online depression tests, although entirely accurate, do not replace a professional diagnosis established by a clinician. If you present one or more symptoms of depression, we advise you to consult a professional as soon as possible.
To start a neurofeedback process at Neuroperforma, we invite you to take a free consultation with one of our advisors.
Please note that Neuroperforma does not offer diagnostic services.