Name ______________________ Date _________ |
Over the last 2 weeks, how often have you been bothered by any of the following problems? |
Not at all |
Several days |
More than half the days |
Nearly every day |
1. Little interest or pleasure in doing things |
0 |
1 |
2 |
3 |
2. Feeling down, depressed, or hopeless |
0 |
1 |
2 |
3 |
3. Trouble falling or staying asleep, or sleeping too much |
0 |
1 |
2 |
3 |
4. Feeling tired or having little energy |
0 |
1 |
2 |
3 |
5. Poor appetite or overeating |
0 |
1 |
2 |
3 |
6. Feeling bad about yourself—or that you are a failure or have let yourself or your family down |
0 |
1 |
2 |
3 |
7. Trouble concentrating on things, such as reading the newspaper or watching television |
0 |
1 |
2 |
3 |
8. Moving or speaking so slowly that other people could have noticed? Or the opposite—being so fidgety or restless that you have been moving around a lot more than usual |
0 |
1 |
2 |
3 |
9. Thoughts that you would be better off dead or of hurting yourself in some way |
0 |
1 |
2 |
3 |
(For office coding: Total Score ____ = ____ + ____ + ____) |