Depression Evaluation

Introduction: This Depression Evaluation Form is designed to assess and evaluate various aspects related to depression. Depression is a common mental health disorder characterized by persistent feelings of sadness, hopelessness, and a lack of interest in activities. This evaluation aims to gather information to better understand and assess an individual's symptoms and severity of depression.

Background: Depression is a significant public health concern globally, affecting individuals of all ages and backgrounds. It can have a profound impact on an individual's quality of life, relationships, and overall well-being. Early detection and intervention are crucial in effectively managing depression and preventing potential complications.

Participant Information:

• Name: __________________________

• Age: ____________________________

• Gender: _________________________

• Date of Evaluation: _______________

Instructions: Please read each statement carefully and select the response that best reflects your experiences over the past two weeks. If you are unsure about a statement, select the option that seems most appropriate to you.

Criteria	Never	Occasionaly	Frequently	Almost constantly
1.Persistent feelings of sadness or emptiness
2. Loss of interest or pleasure in activities
3. Changes in appetite or weight
4. Insomnia or excessive sleeping
5. Fatigue or loss of energy
6. Feelings of worthlessness or excessive guilt
7. Difficulty concentrating or making decisions
8. Thoughts of death or suicide
9. Irritability or restlessness
10. Physical symptoms without a clear cause

Scoring:

• Not at all: 0 points

• Several days: 1 point

• More than half the days: 2 points

• Nearly every day: 3 points

Total Score: ___________

Interpretation:

• 0-4: Minimal to no depression symptoms

• 5-9: Mild depression symptoms

• 10-14: Moderate depression symptoms

• 15-19: Moderately severe depression symptoms

• 20-27: Severe depression symptoms

Comment/Feedback:

Please use the space below to provide any additional comments or feedback regarding this evaluation form. Your input is valuable in improving our assessment process.

Comments/Feedback: ________________________________________

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Thank you for completing the Depression Evaluation Form. Your responses will be kept confidential and used solely for evaluation purposes. Please return the form to the designated healthcare professional.

Comments	Notes

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