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

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? *

N/A

Not at all difficult

Somewhat difficult

Very difficult

Extremely difficult