MINIDEP: A simple, self-administered depression screening tool

Depression is a debilitating illness, and many cases go unrecognized and untreated. There are several depres­sion inventories and questionnaires avail­able for practitioners’ use, but many are long or require a specially trained rater or administrator.^1-10

One well-known depression screen­ing questionnaire is the Patient Health Questionnaire (PHQ-9). This instrument is a combination of a 2-item questionnaire and, if the 2-item questionnaire is positive, a 7-item questionnaire.^2,3 Even if the PHQ-9 is used, it requires a trained healthcare professional to administer it, limiting its use.

On the other hand, the MINIDEP depres­sion screening tool that I developed can be self-administered by the patient either online or while he (she) is in the waiting room. It can be used by any health care specialist (psychi­atrist, psychologist, family practitioner, etc.) as part of the patient’s evaluation.

Unlike most conventional screening questionnaires, MINIDEP has only 7 ques­tions but covers most of the DSM-5 crite­ria for major depressive disorder. It also includes a question on unexplained pains or aches, which often is the only symptom that patients report, but is absent in the PHQ-9 and in other screening questionnaires.

Having a simple, easy-to-remember mne­monic means that this questionnaire can be used by medical students, residents, allied health and mental health professionals, and primary care physicians to screen for depres­sion in the community.¹¹

MINIDEP Categories/areas of concern addressed

Mood (lowered) and emotional lability.
Interest and desires (anhedonia).
Nutrition, poor appetite, and weight loss or gain.
Insomnia or hypersomnia.
Death or dying (thinking of), feeling worth­less or guilty, or making suicidal plans.
Energy (decreased), impaired daily activi­ties, and worsened cognitive ability.
Pains and aches (in absence of unexplained medical illnesses).

I propose rating scores for this question­naire (Figure) as follows:

0 to 3 Points: Patient is not clinically depressed. Evaluation by a mental health professional might be unnecessary.

4 to 9 Points^a: Depression is suspected. Further evaluation by a mental health pro­fessional (not necessarily a psychiatrist) is warranted.

^aThorough psychiatric evaluation also is warranted if the patient has scored 4 to 9 points, with at least 1 point from Question 5.

≥10 points: Depression is confirmed. The patient should be evaluated by a psy­chiatrist for suicidal thoughts.

Note that this proposed rating scale is based on my experience, although I believe it could be useful. To increase this screening tool’s sensitivity, in my experience, evalua­tion by a mental health professional might be necessary when a patient scores only 3 points on MINIDEP. The optimal number of points for triggering a clinical decision and this questionnaire’s sensitivity and specific­ity, however, need to be studied.
 

Disclosure
The author reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

Depression is a debilitating illness, and many cases go unrecognized and untreated. There are several depres­sion inventories and questionnaires avail­able for practitioners’ use, but many are long or require a specially trained rater or administrator.^1-10

One well-known depression screen­ing questionnaire is the Patient Health Questionnaire (PHQ-9). This instrument is a combination of a 2-item questionnaire and, if the 2-item questionnaire is positive, a 7-item questionnaire.^2,3 Even if the PHQ-9 is used, it requires a trained healthcare professional to administer it, limiting its use.

On the other hand, the MINIDEP depres­sion screening tool that I developed can be self-administered by the patient either online or while he (she) is in the waiting room. It can be used by any health care specialist (psychi­atrist, psychologist, family practitioner, etc.) as part of the patient’s evaluation.

Unlike most conventional screening questionnaires, MINIDEP has only 7 ques­tions but covers most of the DSM-5 crite­ria for major depressive disorder. It also includes a question on unexplained pains or aches, which often is the only symptom that patients report, but is absent in the PHQ-9 and in other screening questionnaires.

Having a simple, easy-to-remember mne­monic means that this questionnaire can be used by medical students, residents, allied health and mental health professionals, and primary care physicians to screen for depres­sion in the community.¹¹

MINIDEP Categories/areas of concern addressed

Mood (lowered) and emotional lability.
Interest and desires (anhedonia).
Nutrition, poor appetite, and weight loss or gain.
Insomnia or hypersomnia.
Death or dying (thinking of), feeling worth­less or guilty, or making suicidal plans.
Energy (decreased), impaired daily activi­ties, and worsened cognitive ability.
Pains and aches (in absence of unexplained medical illnesses).

I propose rating scores for this question­naire (Figure) as follows:

0 to 3 Points: Patient is not clinically depressed. Evaluation by a mental health professional might be unnecessary.

4 to 9 Points^a: Depression is suspected. Further evaluation by a mental health pro­fessional (not necessarily a psychiatrist) is warranted.

^aThorough psychiatric evaluation also is warranted if the patient has scored 4 to 9 points, with at least 1 point from Question 5.

≥10 points: Depression is confirmed. The patient should be evaluated by a psy­chiatrist for suicidal thoughts.

Note that this proposed rating scale is based on my experience, although I believe it could be useful. To increase this screening tool’s sensitivity, in my experience, evalua­tion by a mental health professional might be necessary when a patient scores only 3 points on MINIDEP. The optimal number of points for triggering a clinical decision and this questionnaire’s sensitivity and specific­ity, however, need to be studied.
 

Disclosure
The author reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.

Depression is a debilitating illness, and many cases go unrecognized and untreated. There are several depres­sion inventories and questionnaires avail­able for practitioners’ use, but many are long or require a specially trained rater or administrator.^1-10

One well-known depression screen­ing questionnaire is the Patient Health Questionnaire (PHQ-9). This instrument is a combination of a 2-item questionnaire and, if the 2-item questionnaire is positive, a 7-item questionnaire.^2,3 Even if the PHQ-9 is used, it requires a trained healthcare professional to administer it, limiting its use.

On the other hand, the MINIDEP depres­sion screening tool that I developed can be self-administered by the patient either online or while he (she) is in the waiting room. It can be used by any health care specialist (psychi­atrist, psychologist, family practitioner, etc.) as part of the patient’s evaluation.

Unlike most conventional screening questionnaires, MINIDEP has only 7 ques­tions but covers most of the DSM-5 crite­ria for major depressive disorder. It also includes a question on unexplained pains or aches, which often is the only symptom that patients report, but is absent in the PHQ-9 and in other screening questionnaires.

Having a simple, easy-to-remember mne­monic means that this questionnaire can be used by medical students, residents, allied health and mental health professionals, and primary care physicians to screen for depres­sion in the community.¹¹

MINIDEP Categories/areas of concern addressed

Mood (lowered) and emotional lability.
Interest and desires (anhedonia).
Nutrition, poor appetite, and weight loss or gain.
Insomnia or hypersomnia.
Death or dying (thinking of), feeling worth­less or guilty, or making suicidal plans.
Energy (decreased), impaired daily activi­ties, and worsened cognitive ability.
Pains and aches (in absence of unexplained medical illnesses).

I propose rating scores for this question­naire (Figure) as follows:

0 to 3 Points: Patient is not clinically depressed. Evaluation by a mental health professional might be unnecessary.

4 to 9 Points^a: Depression is suspected. Further evaluation by a mental health pro­fessional (not necessarily a psychiatrist) is warranted.

^aThorough psychiatric evaluation also is warranted if the patient has scored 4 to 9 points, with at least 1 point from Question 5.

≥10 points: Depression is confirmed. The patient should be evaluated by a psy­chiatrist for suicidal thoughts.

Note that this proposed rating scale is based on my experience, although I believe it could be useful. To increase this screening tool’s sensitivity, in my experience, evalua­tion by a mental health professional might be necessary when a patient scores only 3 points on MINIDEP. The optimal number of points for triggering a clinical decision and this questionnaire’s sensitivity and specific­ity, however, need to be studied.
 

Disclosure
The author reports no financial relationship with any company whose products are mentioned in this article or with manufacturers of competing products.