Over the last 2 weeks, how often have you been bothered by 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 orhave let yourself or your family down
0
1
2
3
7. Trouble concentrating on things, such as reading thenewspaper 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 hurtingyourself in some way
0
1
2
3
Total
0
Not difficult at all
Somewhat difficult
Very difficult
Extremely difficult
10. If you checked off any problems, 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?
O
O
O
O
1-4 ----- Minimal Depression
5-9 ----- Mild Depression
10-14 ----- Moderate Depression
15-19 ----- Moderately Severe Depression
20-27 ----- Severe Depression
Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc. No permission required to reproduce, translate, display or distribute.