Assessment tool- results for anxiety depression. How accurate is it ?

[Bluebirdbrown]

Hello,

I am just curious how others feel about the reliability (or accuracy) of those online assessment tools for depression, anxiety and stress etc. How do we interpret the results? My GP tends to simply rely on the numbers scored and diagnose you. And prescribe more pills etc.

I partake in PHQ-9, K10 and SPIN and the overall results indicate that I have score high mark which representing severe symptoms or in a very high distressing range. This worries me as I don’t feel that the results reflect exactly how I feel and how bad I am. Indeed I am feeling I get better each day. Small steps but not going backwards.

I know it sounds silly to ask this question but it’s annoying me and I tend not to distort my feeling to make the results looking nicer !

[JessF]

Hello Bluebirdbrown, I think those scales can be a bit of a blunt instrument sometimes. I think they can be helpful broadly in working out whether depression and anxiety are impacting your life, and if you're improving. But ultimately these things don't come down to numbers, do they? They come down to how well you're coping with the stresses in life that have made you depressed or anxious in the first place.

I was speaking in another thread today with someone who had been asking to keep a diary at three time points a day by their psychologist, and it got me thinking about the various mood tracking apps you can download for your phone. I think these are a better gauge at how you're coping from day to day.

In terms of you feeling that the tests are making you seem worse than you actually are, it's all relative. Your own subjective experience matters most, and if you feel you're improving and can see the improvement in your life, then keep on the track you're going and don't be discouraged.

[BumbleBumble]

Hi Bluebirdbrown,

Thank you for posting the question. It is great to hear you are making positive progress. I've been asked similar questions regarding these and other scales. As JessF mentioned the PHQ-9, K10 and SPIN are screening tools and not diagnostic tools. They are wonderful at gathering information to help paint part of the picture but should not be used in isolation as they can provide a distorted picture. Similarly to what you have mentioned, "I don’t feel that the results reflect exactly how I feel and how bad I am", as the scale don't cover the whole story.

I'm glad you are seeing a GP regarding your mental health. Have you considered exploring the option of engaging with a clinical psychologist as well? They can be so helpful with managing anxiety and low mood.

Best wishes on your journey

[Bluebirdbrown]

Hi JessF and bumblebumble,

thanks so much for taking time to rely to my post. Yes I have a lot of doubts about the number scored. It’s understandably the score merely a sceeening not diagnostic tool. The problem is that my GP and even the psychologist look at my score and say “OMG your symptoms have worsen compared with the last time you did the assessment. Same sets of questions and you don’t seem to improve”! Am I to blame for not improving? I want to be honest to how I feel as reflecting on the questions !

This kind of comment/ feedback have worried me and apparently they simply just look at the number and compare the charts to diagnose me!

i admit that my mood changes from time to time but I have improved significantly since I have been on med and I do the practice etc

[Croix]

Dear Bluebirdbrown~

These tests are a very general guide, and may be the basis for seeking professional advice, they are not intended to give an accurate picture of your state, just a general indication. The text at the bottom of Beyond Blue's K10 says:

Please remember that this is not a diagnosis – only a health professional can provide that – but it can give you a better sense of how you're feeling.

The Australian Bureau of Statistics goes into depth about the different expectations for the results of the K10 when used for differing purposes, and does outline some of its strengths and shortcomings.

I would be disappointed if my GP and psych simply used scores as the basis for treatment. Even the way one rates an answer changes from person to person. As an example "About how often did you feel that everything was an effort? " I'd reply "nearly all the time", but that is due to other factors, not depression or anxiety.

Ithink Jess was right to mention that several mood gauging apps can be useful, as they take regular frequent samples and can give a relative guide provided you answer them the same way each time, thus giving you trends.

Nowadays there tends to be more emphasis on regarding the client -you - as being the expert on the client,having first hand knowledge. For this to be disregarded is unfortunate.

I guess if you can you should present your point of view more forcefully, if you feel you have improved that is important as it affects future treatment. Do you think that might be possible?

Croix

[romantic_thi3f]

Hi Bluebirdbrown,

Yes I can agree with everything that's been said - the majority of these tools are screening tools.

To get a diagnosis of anxiety and depression we really have to look at the bigger picture like some of the thoughts or feelings you might be having, your physical health (sleep, appetite, fatigue) and what's actually going on in your life. The K10 doesn't consider any of this - people who don't have depression or anxiety will naturally score so highly if they've just been through grief, divorce, loss etc.

Unfortunately though the Doctor often doesn't make that time, so it's easier for them to tally up some scores and present it to try and get a longer-term picture. The psychologist or psychiatrist will generally make the diagnosis because they can get to know you - rather than how you are for 15 minutes!

One thing that might be helpful for your psychologist is a mood chart - that way you can really see how low your mood can get and how it might change over time. You can find one here if you like - https://blackdoginstitute.org.au/docs/default-source/psychological-toolkit/19-dailymoodchart.pdf It's also not a full picture, but it is a little more reliable than the K10 in the sense it's getting a day-to-day idea.

[BumbleBumble]

Hi Bluebirdbrown,

Thanks for getting back. Your Gp and psychologist should not be using these scales in isolation to make a diagnosis however they can be used to help form a picture. Scales can also be useful in gathering a baseline to measure trends.

As these are scales they are not appropriately reflective for all individuals. If you are improving but the scales indicate a deterioration perhaps these scales are not good reflective for your mental health.

I hope this information about scales helps

[Bluebirdbrown]

Thanks for all your helpful replies and answers /suggestions. I will take this to my psych and have a chat.

Have a great day.