Pb Psychiatric Services

Depressed mood

1. Gloomy attitude, pessimism about the future, feeling of sadness, tendency to weep

Absent 0 Sadness +1 Occasional weeping days +2 Frequent weeping +3 Extreme symptoms +4

2. Feelings of guilt

Absent 0 Self-reproach, feels he/she has let people down +1 Ideas of guilt +2 Present illness is a punishment, delusions of guilt +3 Present illness is a punishment, delusions of guilt +4

3. Suicide

Absent 0 Feels life is not worth living +1 Wishes he/she were dead +2 Sucidal ideas or gestures +3 Attempts at sucide +4

Initial insomnia

4. Difficulty falling asleep

Absent 0 Occasional +1 Frequent days +2

Insomnia during the night

5. Restless, disturbed, waking at night

Absent 0 Occasional +1 Frequent days +2

Delayed insomnia

6. Exaggerated self-opinion and unrealistic convictions of Waking in early hours of the morning and unable to fall asleep again

Absent 0 Occasional +1 Frequent +2

Work and interests

7. Absence from work after treatment or recovery may rate ≤4

Not Difficulty 0 Feeling Incapacity, listlessness. +1 Hobbies lost, less socializing. +2 Productivity decreased +3 Unable to work, stopped working due to illness +4

Retardation

8. Slowness of thought, speech, and activity; apathy; stupor

Absent 0 Slight retardation at interview +1 Obvious retardation at interview days +2 Interview difficult +3 Complete stupor +4

Agitation

9. Restlessness associated with anxiety

Absent 0 Mild days +1 Severe +2

10. Psychiatric anxiety

Absent 0 Tension and irritability +1 Worrying about minor matters +2 Apprehensive attitude +3 Fears +4

Somatic anxiety

11. Gastrointestinal, indigestion, cardiovascular, palpitations, headaches, respiratory, genitourinary, etc.

Absent 0 Mild +1 Moderate +2 Severe +3 Severe +4

Gastrointestinal somatic symptoms

12. Loss of appetite, heavy feeling in abdomen, constipation

Absent 0 Mild +1 Severe days +2

General somatic symptoms

13. Heaviness in limbs, back, or head; diffuse backache; loss of energy and fatigability

Absent 0 Mild +1 Severe +2

Genital symptoms

14. Loss of libido, menstrual disturbances

Absent 0 Mild +1 Severe +2

15. Hypochondriasis

Not present 0 Bodily self-absorption +1 Preoccupation with health days +2 Querulous attitude +3 Hypochondriacal delusions +4

16. Weight loss

None 0 Slight days +1 Obvious or severe +2

Insight

17. Must be interpreted in terms of patient’s understanding and backgroun

No loss 0 Partial or doubtful loss +1 Loss of insight days +2

18. Diurnal Variation

No Variation 0 Wose in the A.M +1 Wose in the P.M +2

19. Depersonalization and Derealization Feelings of unreality, nihilistic ideas

Absent 0 Mild +1 Moderate +2 Severe +3 Incapacitating +4

20. Paranoid Symptoms

None 0 Suspicious +1 Ideas of reference +2 Delusions of persecution +3

21. Obsessional and Compulsive Symptoms

Absent 0 Mild +1 Severe +2

HAM-D Score	Grade
0-7	Normal
8-13	Mild depression
14-18	Moderate depression
19-22	Severe depression
≥23	Very severe depression

(HAM-D)

0