Depression Tests Of The Future
While they are not yet in common use by most health care providers, in the realm of psychological research there is much interest in the potential of biomarkers to help diagnose depression and other psychiatric conditions.
There are many factors that determine whether someone develops depression in their lifetime, including genetics and environment.
Research also continues to show how the brain and the body are inextricably connected the health of one influences the health of the other.
Some studies have been looking for a potential connection between levels of inflammation in the body and depression. Others are investigating how the gut microbiome might influence mental health.
A study published in 2013 explored the possibility of a connection between elevated cortisol levels in young adults and depression. In 2015, a study at UC San Diego proposed changes in a specific gene linked to the X chromosome may contribute to mental illness in women.
One day, we may be able to screen a persons genetic information, measure the levels of inflammatory markers in their blood, and look for changes in the structure of their brain to determine their risk for depression, diagnose the condition, and find the most effective treatmentbut were not there yet.
For more mental health resources, see our National Helpline Database.
Advantages Of The Phq
- Shorter than other depression rating scales
- Can be administered in person by a clinician, by telephone, or self-administered by the patient
- Facilitates diagnosis of major depression
- Provides assessment of symptom severity
- Is well validated and documented in a variety of populations
- Can be used in adolescents as young as 12 years of age
Screening For Depression: How Depression Tests Work
There isnt a single depression test or screening that determines if someone is clinically depressed. Unlike lab tests that diagnose some illnesses, a depression test is just one tool that a professional might use when screening for and diagnosing a mental health condition like depression.
Depression tests are often in the form of a questionnaire. A physician or mental health professional may ask the questions orally or an individual may be asked to read and answer the questions on paper or on a digital device.
The answers alone aren’t enough to determine if someone has depression because a test won’t account for other possible reasons for an individual’s answers.
For example, someone experiencing acute pain may report difficulty sleeping and poor appetitebut those symptoms may be caused by pain rather than depression. A clinician would need to take their physical health condition into account after reviewing the test results.
Similarly, a treatment provider would also need to take someone’s environment into account. Someone may report difficulty sleeping not because he’s depressed, but because he has a loud neighbor who keeps him up at night.
Be aware that depression tests don’t allow for explanations. They usually ask someone to report how often certain symptoms occur during a defined time period. A treatment provider would need to probe further to gain suficient information about an individual’s symptoms.
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How Is Depression Diagnosed
Depression presents with symptoms that range from mild to severe. Feelings of sadness, difficulty sleeping or sleeping too much, feeling worthless or guilty, loss of energy or increased fatigue, and a loss of interest or pleasure in activities once enjoyed are common. Children and adolescents who are depressed may come across as irritable rather than sad.
A health care professional looks for symptoms that are interfering with the persons relationships and with their work and that represent a change in the persons previous level of functioning.1 To receive a diagnosis of depression, the person must have five depression symptoms every day, and nearly all day, for at least two weeks.2
How To Measure Depression In Low
Depression is one of the most disabling and costly illnesses worldwide. Globally, the total number of people with depression is estimated to exceed 280 million . Depression is associated with poor health and economic outcomes such as substance use disorders, HIV, educational impairments, and poverty . It is also a major risk factor for suicide, the cause of death of around 800,000 people every year .
Depression is underdiagnosed and undertreated around the world. This is particularly the case in low-income countries, where data on the prevalence of depression as well as the resources to address it are scarce .
Measuring depression in these settings is an essential starting point to understand the magnitude of the problem, develop treatment programmes, monitor progress, and inform policy. In this post, we discuss how depression is defined and which tools exist to measure it. We conclude with some best practices to follow when using these tools in research studies conducted in low-resource settings.
Depressive disorders are characterized by a combination of symptoms that affect the way that people feel, think, and behave. Depressive disorders include two main sub-categories :
There are two main classification systems for guiding the diagnosis of depression:
|Change in appetite and weight|
The appendix below includes the specific scales , as well as additional information about scoring and copyright.
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About Your Mental Health
Stressor And Stress Response Characteristics
In addition to identifying stressor type of interest, there are several key measurement considerations when choosing specific measures of stress to include in studies or analyzing existing stress measure data. These considerations include characteristics of the stressor or response as well as measurement characteristics . We briefly describe these aspects below .
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Hamilton Rating Scale For Depression
The Hamilton Rating Scale for Depression is a multiple item questionnaire used to identify depression and to evaluate recovery. Its designed for adults and is used to rate the severity of a persons depression by evaluating their mood, feelings of guilt, suicidal ideation, anxiety, insomnia, weight loss, and somatic symptoms.
Is There A Depression Scale
A depression scale is a measurement of depressive symptoms. It can be used by individuals and clinicians to determine if further involvement by mental health professionals is necessary. A depression scale is not a diagnostic tool, but simply a measurement of potential symptoms.
There are several different depression scales. Different scales are used for different groups of people, and to measure different types of depression. In order to understand what scale should be used and by whom, you must first understand how these scales are used and know the differences between them.
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How Many People Are Diagnosed With Depression
Around 17.3 million US adults have had at least one major depressive episode.2 Some 20% of women and between 10 and 12% of men will experience depression at least once in their life, says says Steven Hollon, PhD, of Brentwood, Tennessee, a professor of psychology at Vanderbilt University.
Depression is relatively rare during childhood and comparably distributed across the genders, Hollon adds. The rates just explode during adolescence and that is when gender disparities first emerge. And, he adds, Half of all the folks who are going to be diagnosed with major depression at some point will have at least one episode during adolescence.
Science Seeks A Better Way To Measure Stress Anxiety And Depression
Clinical depression and stress-related emotional disorders are responsible for high rates of suicide, the leading cause of death in young people ages 15 to 24.
Nationally, some 20% of the population will experience a mental health disorder during their lifetime, and globally these disorders cost the economy $2.5 trillion every year.
Yet there are no objective tests in use that can diagnose these disorders, says Leanne Williams, a professor of psychiatry and behavioral science at Stanford. Instead, the gold standard for psychiatric diagnosis is a verbal interview, asking patients how they feel, etc. Imagine if you were diagnosing and treating diabetes without tests, without sensors. Its really impossible to imagine, yet thats what were doing for mental health right now, says Williams, who spoke about the research at Stanfords recent Reunion Homecoming Weekend festivities.
Williams and her colleagues are working on a project called Mentaid, which aims to understand mental health by finding measurable links between brain activity and the production of certain hormones. Ultimately, the researchers aim to develop wearable devices that will measure brain activity related to emotional distress or disorder.
The science underlying that goal is complex.
The group is developing an early prototype of a wearable that would collect information on those variables and give doctors and the wearer insight into their mental health.
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Rating Scales For Depression
|Purpose||to determine the presence and severity of depression|
A depression rating scale is a psychiatric measuring instrument having descriptive words and phrases that indicate the severity of depression for a time period. When used, an observer may make judgements and rate a person at a specified scale level with respect to identified characteristics. Rather than being used to diagnose depression, a depression rating scale may be used to assign a score to a person’s behaviour where that score may be used to determine whether that person should be evaluated more thoroughly for a depressive disorder diagnosis. Several rating scales are used for this purpose.
Symptoms And Risk Factors
Classically, patients with depression present with psychological symptoms of depressed mood, loss of interest in activities, impaired concentration, feelings of worthlessness or guilt, and suicidal ideation. However, some patients may instead report nonspecific symptoms . One study found that 45 to 95 percent of patients with depression worldwide have only somatic symptoms.14
Change in weight or appetite
Change in weight or appetite
The underlying cause of depression is likely multifactorial. Risk factors should be considered when evaluating patients with possible depression.
A 2005 Cochrane review found that routine depression screening had minimal effect on the management or outcomes of depression after six or 12 months of follow-up.15 However, the U.S. Preventive Services Task Force has published more recent reviews on depression screening. This article focuses on the recommendations and findings of the USPSTF.
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Do I Need Health Insurance To Receive This Service
The referral service is free of charge. If you have no insurance or are underinsured, we will refer you to your state office, which is responsible for state-funded treatment programs. In addition, we can often refer you to facilities that charge on a sliding fee scale or accept Medicare or Medicaid. If you have health insurance, you are encouraged to contact your insurer for a list of participating health care providers and facilities.
Timescale Of The Stressor
Stressors generally take place along the following timescales: chronic stressors, life events, daily events/hassles, and acute stress. Table 1 provides definitions for each of these timescales. It is important to note that naturalistic experiences of stress rarely fall neatly into one category. For example, death of a loved one is often considered a major life event but, depending on the cause of death, may also be considered a chronic stressor, such as if the family member was sick for years or months before the death. Similarly, arguments with a spouse may be considered an acute stressor, but if they happen every day they may be considered chronic. There is a significant amount of gray area between categories. Researchers should first make a thoughtful attempt to pick the category that best aligns with the stressor and with the way that stressor type has been described in past research, and then describe the exposure with as much specificity as possible.
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How Can I Help The Doctor Make A Proper Diagnosis
Before your appointment, write down your concerns about depression and specific symptoms of depression you might have. Itâs also helpful to get an in-depth family history from relatives before meeting with your doctor. This information can help the doctor make an accurate diagnosis and ensure effective treatment. Before your visit, think about and write down:
- Your mental and physical health concerns
- Symptoms you’ve noticed
- Causes of stress in your life
- Questions you have about depression and depression medications
Compelling Evidence Linking Stress To Physical Health
The types of stress that have the most consistent and compelling relationships with disease risk and mortality are acute stress reactivity, early life stress, work or occupational stress, and social isolation/loneliness. A comprehensive review of these literatures is outside the scope of the present article however, the following section highlights foundational studies linking these stress types physical health, with a particular emphasis on cardiovascular disease and mortality. Effect sizes are included where possible, as are references to reviews and meta-analyses for further reading. Of note, we do not review the literature here on the impact of cumulative life stress . Despite initial compelling work on the impact of cumulative life stress on cardiovascular disease outcomes, this area of research is still in its infancy, with a need for measurement approaches to be unified across research studies to allow for building of a collective science .
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What Does The Doctor Look For To Make A Depression Diagnosis
A doctor can rule out other conditions that may cause depression with a physical examination, a personal interview, and lab tests. The doctor will also do a complete diagnostic evaluation, discussing any family history of depression or other mental illness.
Your doctor will evaluate your symptoms, including how long you’ve had them, when they started, and how they were treated. Theyâll ask about the way you feel, including whether you have any symptoms of depression such as:
- Sadness or depressed mood most of the day or almost every day
- Loss of enjoyment in things that were once pleasurable
- Major change in weight or appetite
- Insomnia or excessive sleep almost every day
- Physical restlessness or sense of being run-down that others can notice
- Fatigue or loss of energy almost every day
- Feelings of hopelessness or worthlessness or excessive guilt almost every day
- Problems with concentration or making decisions almost every day
- Recurring thoughts of death or suicide, suicide plan, or suicide attempt
Biological Pathways From Stress To Disease
Associations between stress and immune system functioning are especially relevant given that the major diseases of aging in the United States are mediated, in part, through the immune system. The top three leading causes of death in the United Statescardiovascular disease, cancer, and chronic lower respiratory diseaseall share the common thread of being characterized by elevated chronic inflammation . Because of this common thread, chronic systemic inflammation has become a recent focus of health research. Stress exposure has been examined extensively as a predictor of increased systemic inflammation. Indeed, elevated systemic inflammation has been found in those experiencing chronic stress like caregivers , immediately after a stressful life event like death of a loved one , historical stress like childhood adversity , daily stress , and in response to lab-based stress tasks . A short-term inflammatory response to stress is thought to be adaptive because it involves recruiting immune cells to the site of a real or potential injury in order to heal wounds resulting from stressor exposure. However, when there is no wound to heal, as is the case with psychosocial stressor exposure, repeated or exaggerated inflammatory responses may cause long-term damage and contribute to disease processes .
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Measuring Stressor Exposures Versus Stress Responses
Stress responses can be measured with self-report measures, behavioral coding, or via physiological measurements. These responses include emotions, cognitions, behaviors, and physiological responses instigated by the stressful stimuli. One of the simplest ways to measure stress responses is through self-reports of perceived stress related to a specific stressor or to ones life circumstances . For example, the Perceived Stress Scale is a 10-item self-report measure that captures an individuals perception of how overwhelmed they are by their current life circumstances. Responses to acute stressors have traditionally been studied in controlled laboratory settings in order to capture responses that unfold within minutes of stressor exposure . A commonly used acute stress paradigm is the Trier Social Stress Test , a standardized laboratory stress task in which participants give a speech and perform mental arithmetic in front of judges . The TSST reliably evokes an acute stress response for the majority of participants. Outside of the laboratory, new technology has enhanced our ability to capture real-time stress responses in daily life using mobile phones and wearables, which many researchers are now doing. Considering the impact of both stressor exposure and stress responses on health may improve the prediction of health outcomes, as many models of stress propose that the stress response mediates the effect of stress exposures on health outcomes .