Investigations
1st investigations to order
clinical diagnosis
Test
Adolescent and pre-adolescent depressive disorders are clinical diagnoses, based on a comprehensive diagnostic evaluation of history and presenting symptoms. It is crucial to make an accurate diagnosis, with input from multiple sources including, but not limited to, the child, parents, and school (teachers, counsellors).
Result
fulfils diagnostic criteria
Investigations to consider
serum thyroid-stimulating hormone (TSH) and free thyroxine (T4)
Test
Baseline assessment to exclude thyroid dysfunction.
Primary hypothyroidism: elevated TSH; free T4 may be low.
Hyperthyroidism: suppressed TSH; elevated free T4.
Result
normal; excludes thyroid dysfunction
full blood count with differential
Test
Baseline assessment to exclude anaemia or other disorders.
Infectious mononucleosis: may show anaemia, reticulocytosis, lymphocytosis, atypical lymphocytes.
Iron deficiency: microcytic, hypochromic anaemia; low reticulocyte count.
Hypothyroidism: occasionally mild anaemia; macrocytosis.
Vitamin B12 deficiency: elevated mean corpuscular volume, low haematocrit.
Result
normal
urine drug screen
Test
Baseline assessment test.
Result
negative or positive for substance
urine pregnancy test
Test
Screen for pregnancy in females should also be completed.
Result
variable
serum B12 and folate
Test
Helpful in excluding medical causes of depression. With increasing rates of juvenile obesity, which in itself can be comorbid with depression, there is an increase of micronutrient deficiency.
Result
normal
vitamin D level
Test
Helpful in excluding medical causes of depression. With increasing rates of juvenile obesity, which in itself can be comorbid with depression, there is an increase of micronutrient deficiency.
Result
normal
Use of this content is subject to our disclaimer