What tests are used to diagnose MDD and how do they differ?

Dori, one of the things that people often ask is: “How do you test for major depressive disorder?” What do you tell your patients? Well, as a psychiatrist I depend on my clinical interview and my clinical exam. There are no litmus tests to test for major depressive disorder, it’s not just a blood test that you can take. Certainly, in some primary care offices, or pediatric offices, doctors and nurse practitioners will give screening exams, just nine item questionnaires that sort of try to screen for depressed mood, suicidal thinking, feelings of hopelessness and helplessness. But that in itself isn’t sufficient to make a diagnosis of major depressive disorder. Those are tools that are used to screen people who might be suffering with major depressive disorder but they really need to be referred on to a psychiatrist at that point for a full clinical interview, for a good history, an evaluation as to, you know, their current functioning. Right. And there are even public depression screening days. I work with the Mental Health Association and we have fairs at malls, and places like that, and advertise it, so people can come in and have that kind of screening to determine whether they have a depression that’s worth evaluating more and warranting treatment. And that is an important issue because of the stigma associated with depression in our society. People tend to be inhibited about thinking of themselves as having a depressive problem and we know as we talked about before that it’s such a serious issue in terms of the risks, short-term and long-term. The other thing I want to emphasize is what you said, some patients come in and they heard advertisements, or they’ve seen news articles and such, about this and that biological test for depression. And the really important message that I give my patients is: there are no biological tests. There is a lot of theory about it, and there are some abnormalities that you can get with biological factors, such as endocrine function and that sort of thing, but there’s no test that tells somebody they have a major depressive disorder. Right.

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