center for epidemiologic studies depression scale revised (CESD-R)

Client Name*

First Last

Client Date of Birth*

Today's Date*

Below is a list of ways you might have felt or behaved. Please select the answer that best represents how often you have felt this way in the past week or so.

In the last week…

1. My appetite was poor.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

2. I could not shake off the blues.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

3. I had trouble keeping my mind on what I was doing.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

4. I felt depressed.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

5. My sleep was restless.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

6. I felt sad.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

7. I could not get going.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

8. Nothing made me happy.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

9. I felt like a bad person.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

10. I lost interest in my usual activities.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

11. I slept much more than usual.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

12. I felt like I was moving too slowly.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

13. I felt fidgety.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

14. I wished I were dead.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

15. I wanted to hurt myself.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

16. I was tired all the time.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

17. I did not like myself.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

18. I lost a lot of weight without trying to.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

19. I had a lot of trouble getting to sleep.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

20. I could not focus on the important things.*

Not at all or less than 1 day
1-2 days
3-4 days
5-7 days
Nearly every day for 2 weeks

center for epidemiologic studies depression scale revised (CESD-R)

Center for Epidemiologic Studies Depression Scale – Caregiver (CESD-Revised)

Below is a list of ways you might have felt or behaved. Please select the answer that best represents how often you have felt this way in the past week or so.

In the last week…

Please click SUBMIT when complete