Basic Psychology, Psychopathology

Tools for Measuring Depression

So many depression scales have been developed that a compendium of available instruments has been published. Scales vary in length, ranging from single-item measures to tools that include more than 100 statements. Some scales have been developed to measure depression in specific populations, such as postpartum women or patients with schizophrenia. Other scales have been developed to measure depression in specific age groups, such as adolescents and the elderly.  In the past 15 years, several scales assessing the DSM-IV criteria have been developed and are considered reliable, valid measures of depression severity. Two of these are briefly described, and all are recommended for clinical use.

Patient Health Questionnaire (PHQ)

The PHQ-9 is a 9-question instrument given to patients in a primary care setting to screen for the presence and severity of depression. It is the 9-question depression scale from the Patient Health Questionnaire (PHQ). The results of the PHQ-9 may be used to make a depression diagnosis according to DSM-IV criteria and takes less than 3 minutes to complete. The total of all 9 responses from the PHQ-9 aims to predict the presence and severity of depression. Primary care providers frequently use the PHQ-9 to screen for depression in patients.

Survey items

A patient may take the PHQ-9 in written form or be asked the survey items by clinic staff. The PHQ-9 questions are based on diagnostic criteria of depression from DSM-IV and ask about the patient’s experience in the last 2 weeks. Questions are about the level of interest in doing things, feeling down or depressed, difficulty with sleeping, energy levels, eating habits, self-perception, ability to concentrate, speed of functioning and thoughts of suicide. Responses range from “0” (Not at all) to “3” (nearly every day). Clinicians may ask a 10th question that asks how difficult the problems that the prior questions ask about make it to function in daily life. The 10th question is not factored into the final score and clinicians may use it to gauge the patient’s opinion of the level of impairment caused by their mental health.

PHQ-9.jpg

Interpretation of results

The total sum of the responses suggests varying levels of depression. Scores range from 0 to 27. In general, a total of 10 or above is suggestive of the presence of depression. Listed below are PHQ-9 totals, the levels of depression that they relate to, and suggested treatment for each level of depression:

PHQ-9 Score Depression severity Suggested Intervention
0-4 None-minimal None
5-9 Mild Repeat PHQ-9 at follow-up
10-14 Moderate Make treatment plan, consider counseling, follow-up, and/or prescription drugs
15-19 Moderately Severe Prescribe prescription drugs and counseling
20-27 Severe Prescribe prescription drugs. If there are poor responses to treatment, immediately refer the patient to a mental health specialist for counseling.

Clinicians may also use the PHQ-9 to evaluate treatments given for depression. A change of PHQ-9 score to less than 10 is considered a “partial response” to treatment and a change of PHQ-9 score to less than 5 is considered to be “remission.” 

You can download PHQ-9 Questions Here- PHQ-9 Questions

Beck Depression Inventory (BDI)

The Beck Depression Inventory (BDIBDI-1ABDI-II), created by Aaron T. Beck, is a 21-question multiple-choice self-report inventory, one of the most widely used psychometric tests for measuring the severity of depression. Its development marked a shift among mental health professionals, who had until then, viewed depression from a psychodynamic perspective, instead of it being rooted in the patient’s own thoughts.In its current version, the BDI-II is designed for individuals aged 13 and over, and is composed of items relating to symptoms of depression such as hopelessness and irritability, cognitions such as guilt or feelings of being punished, as well as physical symptoms such as fatigue, weight loss, and lack of interest in sex.

Interpreting The Beck Depression Inventory

Now that you have completed the questionnaire, add up the score for each of the twenty-one questions by counting the number to the right of each question you marked. The highest possible total for the whole test would be sixty-three. This would mean you circled number three on all twenty-one questions. Since the lowest possible score for each question is zero, the lowest possible score for the test would be zero. This would mean you circles zero on each question. You can evaluate your depression according to the Table below.

BDI2scoring.jpg

 

You can download Beck-Depression-Inventory Here – Beck-Depression-Inventory

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