Over the last 2 weeks, how often have you been bothered by any of the following problems?
Not at all
Not at all
Not at all
Not at all
Little interest or pleasure in doing things
0
1
2
3
Feeling down, depreseed, or hopeless
0
1
2
3
Trouble falling or staying asleep, or sleeping too much
0
1
2
3
Feeling tired or having little energy
0
1
2
3
0
1
2
3
Feel bad about yourself – or that you are a failure or that you have let yourself of your family down
0
1
2
3
Trouble concentrating on things, such as reading the newspaper or watching television
0
1
2
3
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
Thoughts that you would be better off dead or of hurting yourself in some way
0
1
2
3
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
If you checked off on any problem on this questionnaire so far, how difficult have these problems made it for you to do your work, take care of things at home, or get along with other people?
Scoring: Count the number of boxes checked in a column.
Multiply that number by value indicated below, then add the subtotal to produce a a total score. The possible range is 0-27.
