Clinical Scales from Psychiatric Times

Clinical Scales: iOS (free); Android (free)

One of the things that I often find myself reminding my students is that people can or will often tell a piece of paper something that they can’t or won’t tell another person. (can’t, because they don’t have the language; won’t, because they might be embarrassed or unsure where to begin). This is one reason that I am a fan of short symptom batteries such as the BDI – something that can give me a more objective representation of a client’s symptoms, and which can often be useful in marking their progress over time.

As an example, a few years ago I saw a woman who presented as very depressed. We immediately started some behavioral activation exercises, laid the groundwork for some cognitive work, and referred her for medication. She showed promising response after the first few weeks – she was regularly completing her behavioral homework and her physical and interpersonal presentation was less depressed. It was clear, though, that she didn’t believe my feedback about her improvement until I compared her PHQ-9 score that week to her score the first day that she came in.

Because of this, I’m pretty consistently on the lookout for validated, low-cost (or free) instruments. The idea of being able to do it paper-free appeals to me on a couple of levels as well. I was happy to come across this app, which offers short, checklist-style screeners for:

Keep one thing in mind as I continue: none of these are standalone diagnostic tools. This goes double for the ADHD and Autism checklists, which are too limited in scope and too face-valid to give a reliable diagnosis of either disorder (Not that the CHAT identifies itself as a diagnostic  tool). Not all of these are great, or even good, measures. I performed a cursory lit search on these scales, and (for example) the material that I found on the Hamilton Anxiety Scale was not particularly promising. (If you’re interested and you follow the link, you will find that that the Geriatric Depression Scale has its own standalone Android and iOS apps). I have tried to include links to research or at least a bibliography on these instruments so that you can review them and make your own choice as to their use. I typically did not include links to resources that are not freely available.

The app is pretty straightforward to use.  Run the app, pick your measure, and go. You can navigate backwards and forwards among test items. At the end, it gives you a score and a possible interpretation (see screenshot). This app does not keep records locally. If you want a paper trail, you have to email the results to copy and paste into a chart. A sample email result from the CHAT is shown in the screenshot gallery. There is no identifying information in the email, minimizing the risk of sending results in this fashion. Just don’t get confused if you do a lot of these in a row.

There are no specific issues regarding personal data for this app, as it keeps none and the emailed results have no identifying information other than an email address of your choice.

The UI is  clean and straightforward. On my Android phone (a Galaxy S2 running 4.0.4), there was a weird bug which prevented me from using the home screen button on the top right. I actually had to get out of the app, force-close it, and re-run the app to get back to the home screen. This is enough to keep me from using the app on Android (my regular phone). I did not have similar issues with the iOS app. However, it’s worth trying as this bug may not be replicated on other Android devices.

Content – 4/5 – Measures are of varying utility, but cover the basics. Many of you may already have preferred measures of depression, anxiety, etc. that are not included.

UI – 2/5 (Android) 5/5 (iOS)  – Intuitive to use, with the irritating Android bug noted.

** Disclaimer: While some of these apps may be helpful to you, NOTHING  that I review is a replacement for therapy services from a qualified, licensed psychotherapist. If you are reading this because you or someone you care for needs it for mental health reasons, get them live help ASAP. Also, if you haven’t yet, read A Few Words on Security, which contains tips on keeping your and your client’s smartphone data safe from unwanted eyes.