For neurological patients

Each statement has 4 possible answers. Choose the answer that matches your condition.

HEALTH QUESTIONNAIRE FOR DEPRESSION (PHQ-9)

In the past two weeks, have you experienced:

Lack of interest in current events?

Not every day

A few days

More than half a day

Almost every day

Indifference, depression?

Not every day

A few days

More than half a day

Almost every day

Trouble falling asleep, insomnia, sleeping too much?

Not every day

A few days

More than half a day

Almost every day

Feeling tired or lack of energy?

Not every day

A few days

More than half a day

Almost every day

Lack of appetite or overeating?

Not every day

A few days

More than half a day

Almost every day

Do you feel like a failure, blame for burdening your family?

Not every day

A few days

More than half a day

Almost every day

Difficulty concentrating on reading or watching TV?

Not every day

A few days

More than half a day

Almost every day

Are you moving or speaking unusually slowly (slowness), or are you agitated, moving more than usual?

Not every day

A few days

More than half a day

Almost every day

Thoughts of suicide or self-harm?

Not every day

A few days

More than half a day

Almost every day

Name

E-mail

The usual calculation corresponds to 4 possible answers. Choose the answer that best fits the current state of affairs.

Hospital School of Anxiety and Depression (HADS)

Evaluation of the ALARM level

Part I (assessment of the level of ANXIETY). Im feeling stressed, Im not feeling well

all time

often

from time to time, sometimes

I dont feel at all

I feel fear, it seems that something terrible is about to happen

definitely it is, and the fear is very great

yes, it is, but the fear is not very great

sometimes but it doesnt bother me

I dont feel at all

Restless thoughts swirling in my head

constantly

most part of time

from time to time and not so often

only sometimes

I can easily sit down and relax

definitely it is

probably it is

only occasionally, it is

I cant at all

I experience inner tension or trembling

I dont feel at all

sometimes

often

Often

I feel restless, I constantly need to move

definitely it is

probably it is

only to some extent, it is

I dont feel at all

I have a sudden feeling of panic

Often

often

not so often

does not happen at all

Part II (assessment of the level of DEPRESSION) What brought me great pleasure, and now makes me feel the same way

definitely it is

probably it is

only to a very small extent, it is

its not like that at all

I am able to laugh and see something funny in this or that event.

definitely it is

probably it is

only to a very small extent, it is

not at all able

I feel energized

I dont feel at all

rarely

sometimes

almost all the time

It seems to me that I began to do everything very slowly

almost all the time

often

sometimes

not at all

I dont care about my appearance

definitely it is

I dont spend as much time on it as I need to

maybe Ive started to devote less time to this

I take care of myself just like before

I believe that my activities (occupations, hobbies) can bring me a sense of satisfaction

just like usual

yes, but not to the same extent as before

much less than usual

I dont think so at al

Я могу получить удовольствие от хорошей книги, радио- или телепрограммы YA mogu poluchit udovolstviye ot khoroshey knigi, radio- ili teleprogrammy I can enjoy a good book, radio or TV program

often

sometimes

seldom

rarely

Name

E-mail

“In this poll the most popular groups. Read each meeting group carefully. Then comes the one statement specific to each group that best fits how you found yourself THIS WEEK AND TODAY. Check the box next to the selected values. If several criminals from the same group are equally well suited to you, then check the boxes next to each of them. Before making your choice, make sure you read all the marks in each group."

Text of the Beck Depression Scale

How did you feel THIS WEEK AND TODAY

I dont feel upset, sad.

Im sad.

Im frustrated all the time and cant get out of it.

Im so upset and unhappy that I cant stand it.

I dont worry about my future.

I feel puzzled by the future.

I feel like there is nothing in store for me in the future.

My future is hopeless and nothing can change for the better.

I dont feel like a failure.

I feel like Ive failed more than other people.

When I look back at my life, I see many failures in it.

I feel like Im a complete failure as a person.

I get as much satisfaction from life as before.

I dont get as much satisfaction from life as I used to.

I no longer get satisfaction from anything.

I am completely dissatisfied with life, and Im tired of everything.

I dont feel guilty about anything.

Quite often I feel guilty.

Most of the time I feel guilty.

I constantly feel guilty.

I dont feel like I can be punished for anything.

I feel that I can be punished.

I expect that I can be punished.

I feel already punished.

I am not disappointed in myself.

I was disappointed in myself.

I hate myself.

I know that I am not worse than others.

I criticize myself for mistakes and weaknesses.

I blame myself all the time for my actions.

I blame myself for everything bad that happens.

I never thought about killing myself.

Thoughts of suicide come to me, but I will not carry them out.

I would like to end my life.

I would kill myself if the opportunity presented itself.

10.

I dont cry more than usual.

Now I cry more than before.

Now I cry all the time.

I used to be able to cry, but now I cant, even if I feel like it.

11.

Now Im no more irritable than usual.

I get irritated more easily than before.

Now I constantly feel irritated.

I became indifferent to things that irritated me before.

12.

I have not lost interest in other people.

I am less interested in other people than before.

I almost lost interest in other people.

I completely lost interest in other people.

13.

I put off making a decision sometimes, just like before.

More often than before, I put off making a decision.

Its harder for me to make decisions than before.

I can no longer make decisions.

14.

I dont feel like I look worse than usual.

It worries me that I look old and unattractive.

I know that there have been significant changes in my appearance that make me unattractive.

I know I look ugly.

15.

I can work just as well as before.

I need to make an extra effort to start doing something.

I can hardly force myself to do anything.

I cant do any work at all.

16.

I sleep just as well as before.

Now I sleep worse than before.

I wake up 1-2 hours earlier and find it hard to get back to sleep.

I wake up a few hours earlier than usual and cant get back to sleep

17.

I am no more tired than usual.

Now I get tired faster than before.

I get tired of almost everything I do.

I cant do anything because Im tired.

18.

My appetite is no worse than usual.

My appetite became worse than before.

My appetite is much worse now.

I have no appetite at all.

19.

Lately I have not lost weight or the weight loss has been negligible.

Lately I have lost over 2 kg.

I have lost over 5 kg.

I have lost over 7 cr.

19. I deliberately try to lose weight and eat less

YES

20.

I am no more worried about my health than usual.

I am concerned about my physical health problems such as pain, indigestion, constipation, etc.

I am very concerned about my physical condition and find it hard to think of anything else.

Im so concerned about my physical condition that I cant think of anything else.

21.

Recently, I have not noticed a change in my interest in sex.

I am less interested in the problems of sex than before.

Now I am much less interested in sexual problems than before.

I completely lost my sexual interest.

10.

I dont cry more than usual.

Now I cry more than before.

Now I cry all the time.

I used to be able to cry, but now I cant, even if I feel like it.

Name

E-mail

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