Assessment tools for depression need to address the key components of the condition, including depressed mood, hopelessness, decreased interest in activities, psychomotor retardation, sleep disruption, fatigue or loss of energy, diminished ability to think or concentrate, low self-esteem and suicidal ideation. Some assessment tools can be self-administered, while others are administered by a psychologist.
Self-Administered Tools
According to the Family Practice Notebook and the Resource Centers for Minority Aging Research (RCMAR), self-administered assessment tools include the BDI-II, the CES-D and the PHQ.
The BDI takes about 10 to 15 minutes to complete. Some patients may take longer depending on the severity of their depression. This test gives practitioners a single score that determines the intensity of symptoms. The BDI contains 21 questions in a self-report format, including items intending to measure symptoms of severe depression, which would require hospitalization. The BDI has been used for 35 years and is reported as being highly reliable regardless of the population.
The CES-D contains 20 items that are completed in about five to 10 minutes. This test was developed for studying the development and characteristics of depression symptoms in the general population. This test is reported to have excellent consistency based on test-re-test ratings.
Two versions of the PHQ (Patient Health Questionnaire) are used together to assess the existence and severity of depression symptoms. The PHQ-2 contains two "yes or no" questions. If a there is a positive result, then the PHQ-9 is administered regarding symptoms, level of impairment and severity of depression. The PHQ-9 (see Resources) contains nine questions based on criteria in the Diagnostic and Statistical Manual Fourth Edition (DSM-IV).
Interviewer-Administered Tool
Cornell Scale for Depression in Dementia (CSDD) is a 19-item clinician-administered tool that incorporates information from the patient and caregivers. It takes 10 to 20 minutes based on involvement of caregiver during testing. The CSDD is more appropriate for older adults, especially those suffering from dementia or other cognitive difficulties, according to the RCMAR.
The Children's Depression Inventory (CDI) contains either 10 or 27 questions, short or long form. This test if for children ages seven through 17 and is written at a first-grade reading level.
There is also a version of the Beck Depression Inventory for children, according to MindDisorders.com.
Mnemonic Devices
According to the Family Practice Notebook, some mnemonic devices are useful in determining depression symptoms.
SALSA screens for the presence of major depression with two of four symptoms present every day for two or more weeks: sleep disturbance, anhedonia (decreased interest in activities), low self-esteem and decreased appetite.
SIG-E-CAPS also screens for major depression with five of nine positive answers every day over a two-week or more period. The first symptom, depressed mood, must exist in addition to sleep decreased (insomnia with 2 to 4 a.m. awakening), anhedonia, feelings of guilt or worthlessness (not a major criteria), decreased energy, concentration difficulties, appetite disturbance or weight loss, psychomotor retardation/agitation and suicidal thoughts.
