Depression Screening
Name

Name


Email Address

Email Address


On the list below check how often you have felt this way in the last week.
1.

1.

I was bothered by things that usually don’t bother me.
2.

2.

I did not feel like eating; my appetite was poor.
3.

3.

I felt that I could not shake off the blues even with help from my family.
4.

4.

I felt that I was just as good as other people.
5.

5.

I had trouble keeping my mind on what I was doing.
6.

6.

I felt depressed.
7.

7.

I felt that everything I did was an effort.
8.

8.

I felt hopeful about the future
9.

9.

I thought my life had been a failure.
10.

10.

I felt fearful.
11.

11.

My sleep was restless.
12.

12.

I was happy.
13.

13.

I talked less than usual.
14.

14.

I felt lonely.
15.

15.

People were unfriendly.
16.

16.

I enjoyed life.
17.

17.

I had crying spells.
18.

18.

I felt sad.
19.

19.

I felt that people disliked me.
20.

20.

I could not get “going.”
Possible score is 0-60. A score of 16 or more is considered depressed. Scores may reveal mild to severe depression. Discuss results with your doctor or therapist.

Radloff, L. S. (1997) The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385-401.
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