Mental health issues are not matters of opinion. They are medical conditions that arise due to a complex mix of chemistry, environment, and genetics. In other words, mental health conditions are much like physical health conditions. Both come about due to issues that may or may not be under a person’s control. Both can be addressed, to some degree, with the proper treatment program.
Tests for Diagnosing Mental Illness
- Patient Health Questionnaire-9 (PHQ-9)
- Beck Depression Inventory (BDI)
- Zung Self-Rating Depression Scale
- Center for Epidemiological Studies—Depression (CES-D)
- Hamilton Anxiety Scale (HAM-A)
- Penn State Worry Questionnaire
- Yale-Brown Obsessive Compulsive Scale
- Schizophrenia Test and Early Psychosis Indicator (STEP)
- Goldberg Bipolar Spectrum Screening Questionnaire
- Dissociative Experiences Scale
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The right treatment program begins with the right diagnosis. When teams know exactly what is causing a mental health issue, they can know what to do to help ease symptoms. There are a variety of tested and proven tests doctors can use to help their clients when they seem to be struggling with mental health concerns. These are 10 of the mental health tests doctors have at their disposal:
- Patient Health Questionnaire-9 (PHQ-9): This is a screening test clinicians can use for people who might be struggling with depression. According to an overview article in the Journal of General Internal Medicine, the test consists of nine different questions, and each question is based on a manual called the Diagnostic and Statistical Manual of Mental Disorders. This is the manual doctors use when they are actively diagnosing someone with a mental illness. The PHQ-9 simply allows people to answer questions that can uncover whether or not they are facing the symptoms they would need to have to get a depression diagnosis per the DSM. People taking this test are asked a series of questions about how they feel, how they have been reacting to the world, and what they think about the future. They can answer each question with a “0,” which indicates that they do not agree with the statement. Or, they can answer with a “3,” which indicates that they would agree with the statement every day. Answers of “2,” which are in the middle, are also acceptable.
- Beck Depression Inventory (BDI): This test contains 21 questions, according to the American Psychological Association (APA), and it is designed to help clinicians spot symptoms of depression in the people who visit them for care. The test can be administered in a number of different formats. Doctors can read questions aloud; they can ask people to type answers into a computer; or they can hold up a series of flash cards and ask clients to respond to those cards. There are also versions of this test that contain fewer questions, for those who cannot tolerate a longer interview. The APA says that consistency levels for the BDI are in the 0.86 range, which indicates that this test is quite good at uncovering depression issues.
- Zung Self-Rating Depression Scale: This is yet another test for depression, and according to the World Health Organization (WHO), it is widely used. There are 20 questions on the test, all relating to how someone feels and the depression symptoms the person might be experiencing. There are many questions to answer, and they can seem a little repetitive, but the test only takes about 10 minutes to complete. Each question demands a graded response, on a scale of 1 to 4, with higher numbers associated with a greater level of agreement. WHO says most people who have depression score between 50 and 69 on this test, but people who have severe depression might get scores of 70 or even higher.
- Center for Epidemiological Studies—Depression (CES-D): Depression is a common mental health condition that could impact almost anyone. That is why, in part, there are so many different tests for depression. Since it strikes so often, doctors need a number of different tools to spot the changes and deliver relief. But sometimes, depression hits a specific type of person, and that person might benefit from a test made just for them and their unique needs. This is one such test. The CES-D is designed to help people who work as caregivers. There are 20 questions on this test, APA says, and it was designed with caregivers in mind. Questions revolve around depression symptoms, such as loss of appetite or feeling lonely, and answers can run on a scale from 1 to 3. Higher numbers indicate a higher affinity with the statement.
- Hamilton Anxiety Scale (HAM-A): People who have anxiety disorders may struggle with attacks, in which they are plagued by severe symptoms for a short period of time. But these people may also feel low levels of anxiety throughout the day at different periods of time. The HAM-A test is designed to uncover all of those symptoms, both acute and chronic. According to an analysis in Psychiatric Times, this is a highly sensitive test that could deliver great results. The test is performed as an interview, and it measures a person’s anxiety based on 14 different set points, including feelings of anxiousness, tension, nervousness, and sleeplessness. The person’s behavior during the test is also recorded. It takes about 20 minutes to complete and score the test.
- Penn State Worry Questionnaire: This test is designed to help doctors spot patients with anxiety. These people might not seem anxious or concerned on the outside, but their internal thoughts might be consumed with worry and fear. They might be convinced that the worst is always about to happen, or they might be concerned about the way they have handled something that has already happened. This test has 16 questions. In an overview in Behavior Research and Therapy, researchers say that the test is very specific concerning worry. It does not measure another illness like depression, and it does not measure anxiety overall. Instead, this is a sensitive test that has to do with overwhelming feelings of worry and concern. It could be useful for people with a specialized anxiety disorder that has to do with worry.
- Yale-Brown Obsessive Compulsive Scale: Back in 1991, an article in the Archives of General Psychiatry explained that this test was made to help refine diagnosis of obsessive-compulsive disorder. Past tests could be influenced by the types of phobias people had or the compulsions they felt. That could mean that some people did not get the right diagnosis and the right help. This test is different, as it cannot be influenced by obsession or compulsion presence or type. People answer a series of 10 questions, giving answers ranging from 0 to 4. The results can help clinicians to understand how serious the mental health issue is, and the results can help doctors to understand how many problems people deal with on an average day.
- Schizophrenia Test and Early Psychosis Indicator (STEP): This test is designed to help doctors find early signs of schizophrenia in people who may not have the full-blown version of this mental illness quite yet. People like this might have schizophrenia, but they may not have become fully psychotic at any point in time. With the right help and medications, they might avoid future psychosis. This test could help doctors to provide those needed therapies. The website Counseling Resource suggests that this test contains 17 questions, and all of those questions concern feelings or experiences people may have dealt with at some point during their daily life. It is a self-administered test, which means the doctor provides the materials and the person takes the test without assistance. All answers should home in on symptoms and changes felt within the prior six months.
- Goldberg Bipolar Spectrum Screening Questionnaire: This is a screening test for bipolar disorder, and Counseling Resource states that it was developed by a doctor named Ivan Goldberg, who gave the test its name. It is designed to screen for symptoms of bipolar disorder in people with are 18 or older. It is a test that should only be given to people who have already had one episode of depression. Those who might have bipolar disorder but who have not yet had an episode that qualifies as depression might benefit from a different type of test that is more sensitive to their symptoms and needs. This is another self-administered test, and it takes just a few moments to complete.
- Dissociative Experiences Scale: This test provides a measure of the number and severity of episodes in which a person felt apart or separate from their body or the world around them. This is a test that could be vital in the diagnosis of both schizophrenia and bipolar disorder. Back in 1993, the validity of this test was examined for an article in the American Journal of Psychiatry, and the researchers found that the scale was about 76 percent specific. That means the results are more often right than they are wrong. To take the study, people answer a series of questions about the symptoms they have experienced within the recent past, along with their opinions about the future yet to come.
It might seem unusual or even a little unfair that a doctor could perform a few multiple-choice tests and come up with a diagnosis of mental illness. It does not seem rigorous or scientific somehow. It is important to remember that the questions on these tests have been developed over a very long period of time, and the benefits and drawbacks of these tests have been studied as well. These are not tests that were just designed. These are tests that have been tested themselves, and they remain the best way to diagnose a mental illness along with clinical observation.
In most cases, clinicians use several different tests to help their patients. They might use different screening tests for different illnesses, or they might use different tests to screen for the same illness. Every test takes just a few minutes to perform, but when all of the results are in, the picture of mental health that emerges could be quite complete. People who take these tests have an opportunity to review the results, and most doctors take the time to explain what they have found and what those results will mean in terms of therapies and treatment. The tests can work as a teaching tool, allowing people to understand fully what is happening in their minds. The tests can be performed again when therapy is in full swing, which allows doctors to record a change or improvement in mental health over time. That could help to guide future treatment, especially if a person does not improve at the level a doctor might expect.
If you’ve been asked to participate in mental health testing, do your part to answer questions honestly and completely. Remember that this is part of your healing. Your doctor wants to help.