How to consult with your iPhone if you have depression?

This year, Ezvid Inc. has released the "Do I Have Depression?" application. This application is
a psychological questionnaire and basic analysis system for non-medical use
only. "Do I Have Depression?" addresses concerns many people may have
of themselves and their friends and loved ones. The app will help to
distinguish if the medical condition can be determined as clinical depression,
or it can be considered as normal mood fluctuations.

Please be sure not to perceive this application as
replacement for professional care. It is definitely NOT. If you feel that your
personal, or your loved one medical condition is somehow out of the ordinary,
please consult with professional therapist. And this app might just help you to
make up your mind and turn to the doctor for psychological assistance.

The application asks the user a set of 34 questions based on
a rubric developed by clinical professionals, on topics ranging from sleep
disturbance, mood destabilization and interpersonal relationships, to eating
habits, work productivity, and more.

The questions are the same as those commonly found on
accepted psychological questionnaires based on research and used by mental
health professionals. As the website suggests, it can be useful to take the
test once a week for a while to establish consistency, but it’s worth repeating
that if you believe you are suffering from depression, it’s best to walk away
from this app and seek help from professional resources.

You cannot imagine of how many people suffer symptoms of depression, but yet
they are often unaware of the implications of their symptoms. Sometimes, the
cultural, gender, or religious considerations prevent them from accepting that,
and consequently, the medical treatment comes too late to make the substantial
improvement to the health and wellbeing. Years and years are lost in blues,
while the normal life is passing by.

Usage of this application on a sustained basis for at least 6 weeks, when
paired with proper note-taking, will shed light on self-diagnosed feelings of
sadness, sorrow, worry, guilt, and hopelessness. This is a comprehensive
self-test application, however it is not a medical device, so do not rely
solely on the outcomes for making decision to seek medical assistance.

Device Requirements:

* Compatible with iPhone, iPod touch, and iPad

* Requires iOS 3.0 or later

* Available for $.99 from the iTunes
Store.

Sources and Additional
Information:

http://prmac.com/release-id-31297.htm

http://www.chipchick.com/2011/09/depression-iphone.html

Quick inventory of depressive symptomatology (self-report) (QIDS-SR 16)

Instructions: Please circle the one response to each item that best describes you for the past seven days.

1. Falling asleep:

0 I never take longer than 30 minutes to fall asleep.

1 I take at least 30 minutes to fall asleep, less than half the time.

2 I take at least 30 minutes to fall asleep, more than half the time.

3 I take more than 60 minutes to fall asleep, more than half the time.

2. Sleep during the night:

0 I do not wake up at night.

1 I have a restless, light sleep with a few brief awakenings each night.

2 I wake up at least once a night, but I go back to sleep easily.

3 I awaken more than once a night and stay awake for 20 minutes or more, more than half the time.

3. Waking up too early:

0 Most of the time, I awaken no more than 30 minutes before I need to get up.

1 More than half the time, I awaken more than 30 minutes before I need to get up.

2 I almost always awaken at least one hour or so before I need to, but I go back to sleep eventually.

3 I awaken at least one hour before I need to, and can’t go back to sleep.

4. Sleeping too much:

0 I sleep no longer than 7–8 hours/night, without napping during the day.

1 I sleep no longer than 10 hours in a 24-hour period including naps.

2 I sleep no longer than 12 hours in a 24-hour period including naps.

3 I sleep longer than 12 hours in a 24-hour period including naps.

5. Feeling sad:

0 I do not feel sad.

1 I feel sad less than half the time.

2 I feel sad more than half the time.

3 I feel sad nearly all of the time.

6. Decreased appetite:

0 There is no change in my usual appetite.

1 I eat somewhat less often or lesser amounts of food than usual.

2 I eat much less than usual and only with personal effort.

3 I rarely eat within a 24-hour period, and only with extreme personal effort or when others persuade me to eat.

7. Increased appetite:

0 There is no change from my usual appetite.

1 I feel a need to eat more frequently than usual.

2 I regularly eat more often and/or greater amounts of food than usual.

3 I feel driven to overeat both at mealtime and between meals.

8. Decreased weight (within the last two weeks):

0 I have not had a change in my weight.

1 I feel as if I’ve had a slight weight loss.

2 I have lost 2 pounds or more.

3 I have lost 5 pounds or more.

9. Increased weight (within the last two weeks):

0 I have not had a change in my weight.

1 I feel as if I’ve had a slight weight gain.

2 I have gained 2 pounds or more.

3 I have gained 5 pounds or more.

10. Concentration/Decision making:

0 There is no change in my usual capacity to concentrate or make decisions.

1 I occasionally feel indecisive or find that my attention wanders.

2 Most of the time, I struggle to focus my attention or to make decisions.

3 I cannot concentrate well enough to read or cannot make even minor decisions.

11. View of myself:

0 I see myself as equally worthwhile and deserving as other people.

1 I am more self-blaming than usual.

2 I largely believe that I cause problems for others.

3 I think almost constantly about major and minor defects in myself.

12. Thoughts of death or suicide:

0 I do not think of suicide or death.

1 I feel that life is empty or wonder if it’s worth living.

2 I think of suicide or death several times a week for several minutes.

3 I think of suicide or death several times a day in some detail, or I have made specific plans for suicide or have actually tried to take my life.

13. General interest:

0 There is no change from usual in how interested I am in other people or activities.

1 I notice that I am less interested in people or activities.

2 I find I have interest in only one or two of my formerly pursued activities.

3 I have virtually no interest in formerly pursued activities.

14. Energy level:

0 There is no change in my usual level of energy.

1 I get tired more easily than usual.

2 I have to make a big effort to start or finish my usual daily activities (for example, shopping, homework, cooking or going to work).

3 I really cannot carry out most of my usual daily activities because I just don’t have the energy.

15. Feeling slowed down:

0 I think, speak, and move at my usual rate of speed.

1 I find that my thinking is slowed down or my voice sounds dull or flat.

2 It takes me several seconds to respond to most questions and I’m sure my thinking is slowed.

3 I am often unable to respond to questions without extreme effort.

16. Feeling restless:

0 I do not feel restless.

1 I’m often fidgety, wringing my hands, or need to shift how I am sitting.

2 I have impulses to move about and am quite restless.

3 At times, I am unable to stay seated and need to pace around.

Scoring the QID-SR-16

_____ Enter the highest score on any of the 1 of the 4 sleep items (#1, 2, 3 or 4)

_____ Item 5

_____ Enter the highest score on any ONE appetite item (#6, 7, 8 or 9)

_____ Item 10

_____ Item 11

_____ Item 12

_____ Item 13

_____ Item 14

_____ Enter the highest score on either of the psychomotor items (#15 or 16)

_____ TOTAL

Interpretation of Depression Severity Thresholds (QID-SR-16):

0 – 5 No Depression; 6 – 10 Mild; 11 – 15 Moderate; 16 – 20 Severe; 21 – 27 Very Severe

The QIDS-C16 and the QIDS-SR16 total scores range from 0 to 27. The total score is obtained by adding the scores for each of the nine symptom domains of the DSM-IV MDD criteria: depressed mood, loss of interest or pleasure, concentration/decision making, self-outlook, suicidal ideation, energy/fatigability, sleep, weight/appetite change, and psychomotor changes. Sixteen items are used to rate the nine criterion domains of major depression: 4 items are used to rate sleep disturbance (early, middle, and late insomnia plus hypersomnia); 2 items are used to rate psychomotor disturbance (agitation and retardation); 4 items are used to rate appetite/weight disturbance (appetite increase or decrease and weight increase or decrease). Only one item is used to rate the remaining 6 domains (depressed mood, decreased interest, decreased energy, worthlessness/guilt, concentration/decision making, and suicidal ideation). Each item is rated 0-3. For symptom domains that require more than one item, the highest score of the item relevant for each domain is taken. For example, if early insomnia is 0, middle insomnia is 1, late insomnia is 3, and hypersomnia is 0, the sleep disturbance domain is rated 3. The total score ranges from 0-27.

Source: http://www.martincbt.com/depressiveinventory.html

Zung Self-Rating Depression Scale

Background

Zung’s model for depression, the Zung Self-Rating Depression scale, measures psychological and somatic symptoms linked to depression.  In addition, the scale can be used as a screening tool, monitor for changes, and clinical research purposes.

   

The questionnaire includes 20-items testing four common characteristic of depression – the pervasive effect, the physiological equivalents, other disturbances, and psychomotor activities. Respondents are given a 4-point scale to react to positive or negative statements. Approximately 10 minutes is required to complete the test.



Author: Dr. William W.K. Zung

Structure

1. Twenty question survey completed by patient


2. Likert Scale Format


3. Asks half of questions positively and half negatively



1. Negative Example: "I notice that I am losing weight"


2. Positive Example: "I eat as much as I used to"




4. Answers scored on 1 to 4 scale



1. Minimal: None or a little of the time


2. Severe: Most or all of the time

Zung Self-Rating Depression Rating Scale

Questions and Scoring

Please read each statement and decide how much of the time the statement describes how you’ve been feeling during the past 2 weeks. Respond to all statements.

1. I fell down-hearted and blue.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

2. Morning is when I feel the best.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

3. I have crying spells or feel like it.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

4. I have trouble sleeping at night.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

5. I eat as much as I used to.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

6. I still enjoy sex.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

7. I notice that I am losing weight.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

8. I have trouble with constipation.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

9. My heart beats faster than usual.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

10. I get tired for no reason.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

11. My mind is as clear as it used to be.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

12. I find it easy to do the things I used to.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

13. I am restless and can't keep still.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

14. I feel hopeful about the future.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

15. I am more irritable than usual.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

16. I find it easy to make decisions.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

17. I feel that I am useful and needed.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

18. My life is pretty full.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

19. I feel that others would be better off if I were dead.



• A little of the time (1)


• Some of the time (2)


• Good part of the time (3)


• Most of the time (4)

20. I still enjoy the things I used to do.



• A little of the time (4)


• Some of the time (3)


• Good part of the time (2)


• Most of the time (1)

Scores Interpretation

Scores on the test range from 25 through 100. The scores fall into four ranges:

• Score <50: Normal


• Score <60: Mild depression


• Score <70: Moderate or Marked Major Depression


• Score >70: Severe or Extreme Major Depression

Zung Self-Rating Depression Rating Scale

Sources and Additional Information:

http://www.fpnotebook.com/Psych/Exam/ZngSlfRtngDprsnScl.htm

http://www.statisticssolutions.com/zsds

http://en.wikipedia.org/wiki/Zung_Self-Rating_Depression_Scale

http://healthnet.umassmed.edu/mhealth/ZungSelfRatedDepressionScale.pdf

Geriatric Depression Scale - Self-report Assessment for Elderly

The Geriatric Depression Scale (GDS) is a 30-item self-report assessment designed specifically to identify depression in the elderly. The items may be answered yes or no, which is thought to be simpler than scales that use a five-category response set. It is generally recommended as a routine part of a comprehensive geriatric assessment. One point is assigned to each answer and corresponds to a scoring grid. A score of 10 or 11 or lower is the usual threshold to separate depressed from non-depressed patients. However, a diagnosis of clinical depression should not be made on the GDS results alone. Although the test has well-established reliability and validity, responses should be considered in conjunction with other results from a comprehensive diagnostic work-up. A short version of the GDS containing 15 questions has been developed. The GDS is also available in a number of languages other than English.

Purpose

Depression is widespread among elderly persons, affecting one in six patients treated in general medical practice and an even higher percentage of those in hospitals and nursing homes. Older people have the highest suicide rate of any group, and many medical problems common to older people may be related to, or intensified by, a depressive disorder. Recognition of the prevalence of depression among older people prompted the development of the geriatric depression scale in 1982-83. Yes/no responses are thought to be more easily used than the graduated responses found on other standard assessment scales such as the Beck Depression Inventory, the Hamilton rating scale for depression, or the Zung self-rating depression scale.

While it is not found in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR ) produced by the American Psychiatric Association, the GDS is widely recommended for clinical use and is included as a routine part of a comprehensive geriatric assessment. It is also increasingly being used in research on depression in the elderly.

Geriatric Depression Scale

Precautions

Depression scales are either interviewer-administered or by self-report means. The GDS is a self-report assessment developed in 1982 by J. A. Yesavitch and colleagues. A self-report assessment is easier and quicker to administer, though an interviewer-administered test is generally more sensitive and specific—another reason for using more than one tool to obtain an accurate diagnosis.

There is some controversy over whether the GDS is reliable for depression screening in individuals with mild or moderate dementia. Several studies have shown good agreement with observer ratings of depression, whether or not the patient had dementia. However, persons with dementia may deny symptoms of depression. It also appears that less educated people are more likely to score in the depressed range on the GDS 15-item short form. These caveats notwithstanding, the GDS can be usefully applied in general medical settings in combination with other clinical assessments, observation, and interviews with elder patient and their families.

Both symptom pattern and symptom severity must be considered when trying to identify depression. These dimensions are taken into account in the development of symptom scales and, while clinical judgment takes priority, a scale such as the GDS can help in identifying persons with depression, whether they are making satisfactory progress with treatment, or when they may need further assessment or referral.

Description

Yesavitch and his coworkers chose 100 statements that they determined were related to seven common characteristics of depression in later life. These included:

• somatic concern


• lowered affect (affect is the outward expression of emotion)


• cognitive impairment


• feelings of discrimination


• impaired motivation


• lack of future orientation


• lack of self-esteem

The best 30 items were selected after administration of the 100 items to 46 depressed and normal elders. Those items were then administered to 20 elders without depression and 51 who were in treatment for depression. The test was 84% sensitive and 95% specific for a depression diagnosis. Repeated studies have demonstrated the value of GDS.

Geriatric Depression Scale

Long Mood Assessment Scale

1. Are you basically satisfied with your life?

2. Have you dropped many of your activities and interests?

3. Do you feel that your life is empty?

4. Do you often get bored?

5. Are you hopeful about the future?

6. Are you bothered by thoughts you can t get out of your head?

7. Are you in good spirits most of the time?

8. Are you afraid that something bad is going to happen to you?

9. Do you feel happy most of the time?

10. Do you often feel helpless?

11. Do you often get restless and fidgety?

12. Do you prefer to stay at home, rather than going out and doing new things?

13. Do you frequently worry about the future?

14. Do you feel you have more problems with memory than most?

15 Do you think it is wonderful to be alive now?

16 Do you often feel downhearted and blue?

17 Do you feel pretty worthless the way you are now?

18 Do you worry a lot about the past?

19 Do you find life very exciting?

20 Is it hard for you to get started on new projects?

21 Do you feel full of energy?

22 Do you feel that your situation is hopeless?

23 Do you think that most people are better off than you are?

24 Do you frequently get upset over little things?

25 Do you frequently feel like crying?

26 Do you have trouble concentrating?

27 Do you enjoy getting up in the morning?

28 Do you prefer to avoid social gatherings?

29 Is it easy for you to make decisions?

30 Is your mind as clear as it used to be?

Scoring

A scoring grid accompanies the GDS. One point is given for each respondent's answer that matches those on the grid. For example, the grid response to "Are you basically satisfied with your life?" is "no." If the elderly person responds in the negative one point is scored; if the response is "yes," then no point is scored.

1. no 6. yes 11. yes 16. yes 21. no 26. yes

2. yes 7. no 12. yes 17. yes 22. yes 27. no

3. yes 8. yes 13. yes 18. yes 23. yes 28. yes

4. yes 9. no 14. yes 19. no 24. yes 29. no

5. no 10. yes 15. no 20. yes 25. yes 30. no

Results

For the 30-item assessment, a score of 0–9 is considered normal; 10–19 indicates mild depression, and a score over 20 is suggestive of severe depression. The maximum number of points that can be scored is 30.

Geriatric Depression Scale

Short Mood Assessment Scale

1. Are you basically satisfied with your life?

2. Have you dropped many of your activities and interests?

3. Do you feel that your life is empty?

4. Do you often get bored?

5. Are you in good spirits most of the time?

6. Are you afraid that something bad is going to happen to you?

7. Do you feel happy most of the time?

8. Do you often feel helpless?

9. Do you prefer to stay at home, rather than going out and doing new things?

10. Do you feel you have more problems with memory than most?

11 Do you think it is wonderful to be alive now?

12 Do you feel pretty worthless the way you are now?

13 Do you feel full of energy?

14 Do you feel that your situation is hopeless?

15 Do you think that most people are better off than you are?

Scoring

1. no   6. yes   11. no

2. yes  7. no    12. yes

3. yes  8. yes   13. no

4. yes  9. yes   14. yes

5. no   10. yes  15. yes



Results

For the 15-item assessment, a score of 0–4 is considered normal; 5-8 indicates mild depression, 8-11 indicates moderate depression, and a score over 12 is suggestive of severe depression. The maximum number of points that can be scored is 15.

Sources and Additional Information:

http://www.minddisorders.com/Flu-Inv/Geriatric-Depression-Scale.html

http://www.stanford.edu/~yesavage/GDS.html

http://www.mhsfopcls.com/downloads/ger_dep_scl.pdf

http://en.wikipedia.org/wiki/Geriatric_Depression_Scale