0 = No sadness – 2 = Looks dispirited but brightens up without difficulty – 4 = Appears sad and unhappy most of the time – 6 = Looks miserable all the time; extremely despondent

0 = Occasional sadness in keeping with circumstances – 2 = Sad or low but brightens up without difficulty – 4 = Pervasive feelings of sadness; mood still influenced by external circumstances – 6 = Continuous or unvarying sadness, misery, or despondency

0 = Placid; only fleeting inner tension – 2 = Occasional feelings of edginess and ill-defined discomfort – 4 = Continuous inner tension or intermittent panic, manageable with difficulty – 6 = Unrelenting dread or anguish; overwhelming panic

0 = Sleeps as usual – 2 = Slight difficulty dropping off or slightly reduced, light, or fitful sleep – 4 = Sleep reduced or broken by at least 2 hours – 6 = Less than 2–3 hours sleep

0 = Normal or increased appetite – 2 = Slightly reduced appetite – 4 = No appetite; food is tasteless – 6 = Needs persuasion to eat at all

0 = No difficulties concentrating – 2 = Occasional difficulties collecting thoughts – 4 = Difficulty concentrating reduces ability to read or hold a conversation – 6 = Unable to read or converse without great difficulty

0 = Hardly any difficulty getting started; no sluggishness – 2 = Difficulties starting activities – 4 = Difficulties starting simple routine activities, carried out with effort – 6 = Complete lassitude; unable to do anything without help

0 = Normal interest in surroundings and other people – 2 = Reduced ability to enjoy usual interests – 4 = Loss of interest in surroundings; loss of feelings for friends and acquaintances – 6 = Emotionally paralyzed; inability to feel anger, grief, or pleasure

0 = No pessimistic thoughts – 2 = Fluctuating ideas of failure, self-reproach, or self-depreciation – 4 = Persistent self-accusations; increasingly pessimistic about the future – 6 = Delusions of ruin or unredeemable sin; absurd and unshakable self-accusations

0 = Enjoys life or takes it as it comes – 2 = Weary of life; only fleeting suicidal thoughts – 4 = Probably better off dead; suicidal thoughts common but no specific plans – 6 = Explicit plans for suicide; active preparations