Tests
1st tests to order
clinical diagnosis
Test
Adolescent and preadolescent 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, counselors).
Result
fulfills diagnostic criteria
Tests 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
complete blood count with differential
Test
Baseline assessment to exclude anemia or other disorders.
Infectious mononucleosis: may show anemia, reticulocytosis, lymphocytosis, atypical lymphocytes.
Iron deficiency: microcytic, hypochromic anemia; low reticulocyte count.
Hypothyroidism: occasionally mild anemia; macrocytosis.
Vitamin B12 deficiency: elevated mean corpuscular volume, low hematocrit.
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
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