from the website. Family Practice Notebook Other references are listed below. Links in blue are from the website. Family Practice Notebook GERIATRIC DEPRESSION SCALE (GDS) CHOOSE
THE BEST ANSWER FOR HOW YOU FELT THIS PAST WEEK
CIRCLE ONE * 1. Are you basically satisfied with your life?
yes NO 2. Have you dropped many of your activities
YES no 3. Do you feel that your life is empty?
YES no 4. Do you often get bored?
YES no * 5. Are you hopeful about the future?
yes NO 6. Are you bothered by thoughts you can't get out
of your head?
no * 7. Are you in good spirits most of the time?
yes NO 8. Are you afraid that something bad is going to happen to you?
YES no * 9. Do you feel happy most of the time?
NO 10. Do you often feel helpless?
YES no 11.
Do you often get restless and fidgety?
no 12. Do you prefer to stay at home, rather than going out and doing new things? YES
no 13. Do you frequently worry about the future? YES no 14.
Do you feel you have more problems with
memory than most?
YES no *15. Do you think it is wonderful to be alive now? yes NO 16. Do you often feel downhearted and blue?
YES no 17. Do you feel pretty worthless the way you are now?
YES no 18. Do you worry a lot about the past? YES
no *19. Do you find life very exciting? yes
NO 20. Is it hard for you to get started on new projects?
YES no *21. Do you feel full of energy?
yes NO 22. Do you feel that your situation is hopeless? YES no 23. Do you think that most people are better off than you are?
YES no 24. Do you frequently get upset over little things? YES no 25.
Do you frequently feel like crying?
YES no 26. Do you
have trouble concentrating?
no *27. Do you enjoy getting up in the morning?
yes NO 28. Do you prefer to avoid social gatherings?
no *29. Is it easy for you to make decisions? yes NO *30. Is your mind as clear as it used to be?
*Appropriate (nondepressed) answers = yes, all others= no
or count number of CAPITALIZED (depressed) answers Score:
_____ (Number of "depressed" answers)
Norms ---------------------------- Normal 5 +/- 4 Mildly
15 +/- 6 Very depressed
23 +/- 5 ________________________________________________________________ References: 1. Yesavage JA, Brink TL, Rose TL, et al. Development
and validation of a geriatric depression rating scale: a
preliminary report. J Psych Res. 1983; 17:27 . 2. Sheikh JI, Yesavage JA. Geriatric Depression Scale: recent evidence and development of a shorter version.
Clin Gerontol. 1986; 5:165-172. The Geriatric Depression Scale may be used freely for patient assessment
according to the authors. Hamilton Depression Rating Scale (HAM-D) Background Twenty one question Survey completed by physician
Background Twenty one question Survey completed by physician
Questions Depressed mood (0 to 4)
Feelings of guilt (0 to 4)
Suicide (0 to 4)
Early (0 to 2)
Middle (0 to 2)
Late (0 to 2) Work activities (0 to 4)
Retardation to stupor (0 to 4)
Agitation (0 to 2)
Fear (0 to 4)
Anxiety (0 to 4)
Gastrointestinal symptoms (0 to 2)
Systemic somatic symptoms (0 to 2)
Decreased libido or menstrual disturbance (0 to 2)
Hypochondiasis (0 to 4)
Weight loss (0 to 2)
Diminished insight (0 to 2)
Symptom diurnal variation (1 to 2)
Feelings of unreality (0 to 4)
Paranoid symptoms (0 to 3)
Obsessive Compulsive Symptoms (0 to 2)
Resources Hamilton Scale from Glaxo (free)
Limitations: Not ideal for older patients Somatic questions positive in non-depressed older adult
Systemic somatic symptoms Consider alternative depression scales
Geriatric Depression Scale References
Geddes (2002) Am Fam Physician 65(7):1395-7
Screening for Alcohol Dependence
Ever felt you ought to cut down on your drinking?
Have people annoyed you by criticizing your drinking?
Ever felt bad or guilty about your drinking?
Ever had an eye-opener to steady nerves in the AM?
Answering Yes to 2 questions
Strong Indication for Alcoholism
Answering Yes to 3 questions
Abbreviated CAGE Questions
Used substances more than intended this year? Have you ever felt the need to cut down?
Yes to both is highly sensitive and specific
References Brown (1997) J Fam Pract 44:151-60
Brown (2001) J Am Board Fam Pract 14:95-106
Bush (1987) Am J Med 82:231-5
Mayfield (1974) Am J Psychiatry 131:1121-3 Hamilton Anxiety Scale (HAM-A)
Symptom Rating Scale (0=Not Present, 4=Disabling) Anxious
Mood Worries Anticipates
worst Tension Startles
Cries easily Restless Trembling Fears Fear of the dark Fear of strangers Fear of being alone Fear of animal Insomnia Difficulty falling asleep
or staying asleep Difficulty with Nightmare s Intellectual Poor concentration Memory
Impairment Depressed Mood Decreased interest in activities Anhedonia
Insomnia Somatic Complaints: Muscular
Muscle aches or pains Bruxism
Somatic Complaints: Sensory Tinnitus Blurred vision Cardiovascular Symptoms Tachycardia
Palpitation s Chest Pain Sensation of feeling faint Respiratory Symptoms Chest pressure
Choking sensation Shortness of Breath Gastrointestinal symptoms
Dysphagia Nausea or Vomiting Constipation Weight loss Abdominal
fullness Genitourinary symptoms Urinary
frequency or urgency Dysmenorrhea Impotence Autonomic Symptoms Dry Mouth Flushing Pallor Sweating
Behavior at Interview Fidgets
Interpretation Above 14 symptoms are graded on scale
Not present: 0
Very severe symptoms: 4 Criteria
Mild Anxiety (minimum for Anxiolytic ): 18
Moderate Anxiety: 25
Severe Anxiety: 30
Zung Self Rating Scale for Anxiety
Beck Anxiety Scale
Hamilton Anxiety Scale from Healthcare Tech. (purchase)