Depression
is not an easy
disorder to diagnose. The chart below shows the
complexities of depression. The PHQ 9 doesn't explore in any way anything but (Depressive Episode)
The complexity of Depression
With Psychotic Features 1.a
1) Major Depressive Disorder
Without Psychotic Features 1.b
2) Major Depressive Episode
w/ Major Depressive Episode 3.a
3) Bipolar Disorder
w/ Manic Episode 3.b
w/ Schizophrenia + Major Depressive Disorder 5.a
4) Schizoaffective Disorder
w/ Schizophrenia + Manic Episode 5.b
The treatment for 1.a & 1.b are different and require diffrent drugs to treat
The treatment for 1 & 5.a and 5.b are ALL different and require diffrent drugs to treat
The treatment for 1 & 3.b are different and require diffrent drugs to treat
The treatment for 3.a & 5.b are different and require diffrent drugs to treat
The PHQ 9 is a tool who’s sole purpose is to decide if the patient has had a Depressive Episode in their lifetime. For this task the PHQ 9 is an excellent tool.
For use as a depression diagnostic it is a complete failure, why? Because it doesn’t ask a majority of the key questions needed to have an accurate diagnosis.
No questions about major depressive disorder
No questions on mania, or hypo mania
No questions about psychosis
No questions on bipolar
No questions about schizoaffective
No questions about any form of anxiety
Only one very broad question on suicide (doesn’t address ideation) i.e., are these feeling of suicide current or where they in the past.
The M.I.N.I. explores all of these areas including 23 question on suicide and other disorders that cause harm to self or others.