Depression Screening Questionnaire

COUNSELING AND THERAPY ASSOCIATES
Luciana Whipple, MA, LPC Supervisor
972-596-1805 - Plano, TX
planotherapist.com

Depression Screening Questionaire

You can print this page and answer the questions in privacy by circling the numbers beside each statement. If the results indicate that you have scored high on the depression continuum, we recommend you bring the results to your family doctor for further assessment and/or contact us if you wish to explore therapeutic options.



Not at All
Several
Days
More than
1/2 the Days
Nearly 
every Day
1
Little interest or pleasure in things you used to enjoy
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 consentrating on things, such as reading a newspaper or book or watching television
0
1
2
3
8
Moving or speaking so slowly that other people have noticed, Or: being fidgety or restless
0
1
2
3
9
Thoughts that you would be better off dead, or hurting yourself in some way
0
1
2
3

Add all columns to find total score




Interpretation of Total Score

Total Score
Depression Severity
1 - 4
Minimal depression
5 - 9
Mild depression
10-14
Moderate depression
15 - 19
Moderately severe depression
20 - 27
Severe depression


Disclaimer

The information on this page is provided for informational purposes only and does not replace in any way a formal medical or psychiatric evaluation or suggest a diagnosis. This  is  only a preliminary screening . It does not replace in any way a formal psychiatric evaluation or suggest a diagnosis. It is designed to give a preliminary idea about the presence of mild to moderate depressionsymptoms that indicate the need for an evaluation by a psychiatrist or medical practitioner. If you suspect you may be experiencing any  symptoms we would recommend you seek an evaluation by a psychiatrist or mental health professional. All therapy should begin with seeking any medical reasons for the presenting problem.


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972-596-1805 or
 

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