Pediatric Depression Workup

Updated: Apr 19, 2023
  • Author: Spencer E Black, MD; Chief Editor: Caroly Pataki, MD  more...
  • Print

Approach Considerations

There are no specific laboratory evaluations that identify depression. However, other potential etiologies must be ruled out, guided by clinical presentation. Workup includes laboratory evaluation along with additional, selected tests. Include a complete blood count (CBC) with differential in the initial laboratory evaluation to rule out infection and anemia. Assay electrolytes, blood urea nitrogen, creatinine clearance, creatinine, and urine osmolality to exclude renal disorders. 

When using tricyclic antidepressants (TCAs) or lithium carbonate, monitor plasma levels to measure compliance and to avoid toxicity. Evaluate urine osmolality, creatinine clearance, and thyroid function periodically during lithium treatment. 

Other tests that may be indicated or helpful include the following: 

  • Electroencephalography - For patients with a history or presentation that is suggestive of seizure disorder 

  • Electrocardiography - For patients who will be treated with a TCA 

  • Liver function tests and thyroid function tests (triiodothyronine [T3], thyroxine [T4], and thyroid-stimulating hormone [TSH]) to rule out thyroid disease 

  • Children’s Depression Inventory or Patient Health Questionnaire 9 for Adolescents - Simple self-report surveys that may assist in determining the severity of childhood depression