Depression doesn’t have a uniform presentation, but teenage depression assessments can help differentiate between typical adolescent “growing pains” and serious mental health challenges.
It’s difficult to be a teenager, even under the best circumstances. You’re figuring out life, who you are, who the people around you are, and how it’s all connected. Adversity is a natural part of this process.
As a result, some teens may develop depression. According to the latest national data, 17% of youth between 12 and 17 years have experienced a major depressive episode in the past 12 months.
There’s no one-size-fits-all test for depression. Different frameworks include customized criteria, each designed to assess depression in the most thorough way possible.
Dr. Caroline Fenkel, a doctor of social work and chief clinical officer of Charlie Health, from Malvern, Pennsylvania, indicates some of the most common depression assessments used for teenagers include:
- Patient Health Questionnaire-9 for Adolescents (PHQ-9A)
- Beck Depression Inventory (BDI)
- Center for Epidemiological Studies Depression for Children (CESD-DC) scale
“Of these, PHQ-9 and BDI are more commonly used tests and have the highest sensitivity and specificity,” Fenkel explains.
Patient Health Questionnaire-9 for Adolescents (PHQ-9A)
The PHQ-9 is a 9-item questionnaire that incorporates common symptoms and criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR).
It has an 88% sensitivity and specificity for major depressive disorder (MDD), meaning it can detect MDD (or the absence of MDD) 88% of the time without many false positives.
“The PHQ-9A (Patient Health Questionnaire-9 Modified for Adolescents) is a modified version of the PHQ-9 that is specifically designed to screen for depression in adolescents,” explains Fenkel, who adds that the modified version:
- uses age-appropriate language and format
- incorporates symptoms unique to teens
- screens for suicide ideation
- is easily administered and interpreted
Help is out there
If you or someone you know is in crisis and considering suicide or self-harm, please seek support:
- Call the 988 Suicide and Crisis Lifeline at 988.
- Text HOME to the Crisis Textline at 741741.
- Not in the United States? Find a helpline in your country with Befrienders Worldwide.
- Call 911 or your local emergency services number if you feel safe to do so.
If you’re calling on behalf of someone else, stay with them until help arrives. You may remove weapons or substances that can cause harm if you can do so safely.
If you are not in the same household, stay on the phone with them until help arrives.
Beck Depression Inventory (BDI)
The BDI is a multi-format, 21-item self-reported depression questionnaire for adults and adolescents 13 and older. A more concise version exists, called the BDI-II, which uses a 13-item format.
The BDI evaluates real-time symptoms across cognitive, affective, physical, and vegetative, or altered consciousness, categories.
It has a reliability range of up to 92%.
Like the PHQ-9, a youth version also exists, called the Beck Youth Inventory (BYI), which can be used for young people ages 7–18.
Becca Smith, a licensed professional counselor and chief clinical officer at Basepoint Academy, Arlington, Texas, explains, “The BDI can help diagnose depression, track its progress over time, and assess the effectiveness of treatment.”
Center for Epidemiological Studies Depression for Children (CESD-DC) scale
The CESD was developed in 1977 as a way to evaluate depression levels in caregivers. Since that time, it’s been found to be effective for detecting depression in a variety of age groups, including teenagers.
The CESD-DC is the adolescent version. It’s a 20-item self-reported questionnaire that looks at symptoms as well as their intensity and frequency. Smith indicates it takes about 10 minutes to complete and can be used for youth between the ages of 6–17 years of age.
Other teenage depression assessments
Teenage depression assessments are not limited to four options. Many others exist, and when and why they’re used often depends on a teen’s symptoms, circumstances, and specific needs.
Other assessments include:
- Pediatric Symptom Checklist (PSC)
- Strengths and Difficulties Questionnaire (SDQ)
- Clinical Interview Schedule (CIS)
- Hamilton Rating Scale for Depression (HRSD)
- Zung Self-Rating Depression Scale
- Behavior Assessment System for Children (BASC)
- Composite International Diagnostic Interview (CIDI)
Screening tools aren’t definitive. They can be very accurate, but there’s more to MDD and other depressive diagnoses than scoring high on an evaluation.
A formal diagnosis usually involves ruling out other conditions or causes first. After other concerns are eliminated from the equation, a mental health professional thoroughly assesses your teen for various types of depressive disorders.
This will involve in-depth consultations, a review of current circumstances and symptoms, as well as the results from any depression instruments.
Ultimately, teens, just like adults, will need to meet certain diagnostic criteria to receive a formal diagnosis.
MDD can look differently in teens because their world isn’t the same as an adult’s. They experience different challenges, situations, and environments.
Teenage depression symptoms can include:
- changes in their friend group
- lack of motivation or energy
- low self-esteem
- appetite changes
- sleeping too much or too little
- substance misuse
- acting out against authority
- decline in academic performance
- avoidance of peer activities
- extreme emotional reactions
- memory loss
- suicide ideation
Should you conduct a teenage depression test at home?
Many of the teenage depression assessments out there are readily available with an Internet search. This doesn’t mean using them without professional guidance is recommended.
Additionally, many depression assessments are developed with strict administration guidelines for a psychiatrist or trained evaluator. Most parents will not have the training for this type of instrument.
Remember, depression screening tests don’t diagnose depression. They can offer insight into psychological distress, but only a professional can truly assess the presence of mental health disorders.
According to Smith, the best way you can support your teen is to listen to them.
“Many teens with depression may be hesitant to open up about their feelings, so it’s important that you create a safe, nonjudgmental space for them to talk and express themselves,” she says.
This starts to build trust and empathy and can lay the foundation for other supportive efforts.
You can also:
- Encourage them to engage with professional help.
- Help them establish healthy lifestyle habits.
- Show interest and support for their hobbies and friendships.
- Promote family activities.
- Regularly check in and be involved in their lives.
Teens benefit from many of the same treatments as adults. This includes a combination of medication, psychotherapy, and practical lifestyle changes, says Smith.
Common forms of psychotherapy for MDD include:
- cognitive behavioral therapy (CBT)
- interpersonal therapy (IPT)
- dialectical behavior therapy (DBT)
- mindfulness therapy
- group therapy
- family therapy
Fenkel prefers an integrative approach, which pulls tools from a variety of therapies, custom-tailored to a teen’s individual needs.
Teenage depression assessments are tools used to help identify if your teen is experiencing MDD.
While they’re not 100% accurate and are not a sole indication of a diagnosis, they can be an important part of the diagnostic process.
If your teen is experiencing depressive symptoms, taking them to a mental health professional can help you better understand what’s going on and what treatment they need.