Which screening instruments may be used in the diagnosis of major depressive disorder (clinical depression)?

Updated: Aug 06, 2020
  • Author: Jerry L Halverson, MD; Chief Editor: David Bienenfeld, MD  more...
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Self-report screening instruments for depression include the following:

  • Patient Health Questionnaire-9 (PHQ-9): A 9-item depression scale; each item is scored from 0-3, providing a 0-27 severity score.

  • Beck Depression Inventory (BDI) or the Beck Depression Inventory-II (BDI-II): 21-question symptom-rating scales providing a 0-63 severity score.

  • BDI for primary care: A 7-question scale adapted from the BDI.

  • Zung Self-Rating Depression Scale: A 20-item survey.

  • Center for Epidemiologic Studies-Depression Scale (CES-D): A 20-item instrument that allows patients to evaluate their feelings, behavior, and outlook from the previous week.

In contrast to the above self-report scales, the Hamilton Depression Rating Scale (HDRS) is performed by a trained professional, not the patient. The HDRS has 17 or 21 items, scored from 0-2 or 0-4; a total score of 0-7 is considered normal, while scores of 20 or higher indicate moderately severe depression.

The Geriatric Depression Scale (GDS), although developed for older adults, has also been validated in younger adults. The GDS contains 30 items; a short-form GDS has 15 items.

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