Eliciting Depression Symptoms

Question 1

What areas should be covered when eliciting symptoms of depression?

Answer 1

1. Core Symptoms of depression (low mood, anhedonia, fatigueability)
2. Biological symptoms
3. Cognitive and emotional symptoms
4. Ideas of guilt and unworthiness
5. Depressive cognition (negative thoughts) and suicidal ideation
6. Rule out co-morbidity

Question 2

What questions help elicit the core symptom of low mood in depression?

Answer 2

1. How are you feeling in yourself?
2. How has your mood been lately?
3. How bad has it been? Have you cried at all?
4. If I were to ask you to rate your mood, on a scale of ‘1’ to ‘10’ where ‘ten is normal and one is as depressed as you have ever felt, how would you rate your mood now?

Question 3

What questions help elicit the core symptom of anhedonia in depression?

Answer 3

1. Can you still enjoy the things you used to enjoy? (Or)
2. Have you lost enjoyment in things you used to enjoy?
3. Is the level of enjoyment the same as before?
4. What are the things that you find enjoyable/interesting?

Question 4

What questions help elicit the core symptom of reduced energy level and decreased activity in depression?

Answer 4

1. How have you been in your energy levels these days?
2. Have you been feeling drained of energy lately?
3. How do you spend your day?
4. Have you wanted to stay away from other people?

Question 5

What questions help elicit biological symptoms of depression?

Answer 5

1. How has your sleep been recently?
2. Do you need less sleep than usual?
3. Have you had any trouble getting off to sleep?
4. Do you wake early in the morning?
5. Does your mood vary over the course of the day?
6. Is your depression/mood worse at any particular time of day?
7. What is the best time/worst time of the day for you?
8. What has your appetite been like recently?
9. Have you lost any weight lately?
10. Has there been any change in your interest in sex?

Question 6

What questions help elicit cognitive symptoms of depression?

Answer 6

1. How has your concentration been lately?
2. What is your memory like at the moment?

Question 7

What questions help elicit emotional symptoms of depression?

Answer 7

1. How confident do you feel in yourself?
2. How do you describe your self-esteem to be?

Question 8

What questions help elicit ideas of guilt in depression?

Answer 8

1. Do you feel that you’ve done something wrong?
2. Do you feel guilty about anything at the moment?
3. Do you tend to blame yourself at all?
4. Do you tend to blame anyone else for your problems?
5. Do you have any regrets?
6. Do you feel that you’ve committed a crime, or sinned greatly, or deserve punishment?

Question 9

What questions help elicit suicidal intent and negative thoughts in depression?

Answer 9

1. Do you have any worries on your mind at the moment?
2. Have you ever felt that life wasn’t worth living?
3. How do you see the future?
4. Do you feel inferior to others or even worthless?
5. Do you feel hopeless about yourself? Or has life seemed quite hopeless?
6. Do you feel helpless?
7. Do you feel that life is a burden?
8. Do you wish yourself dead? Why do you feel this way?
9. Have you had thoughts of ending your life?
10. Have you thought about how you would do it?
11. Did you actually try?
12. Would you do anything to harm yourself or to hurt yourself?
13. Have you got any plans to end your life? What plans?

Question 10

What questions help understand the duration, course, effects and coping with depression?

Answer 10

1. How long have you been feeling this way?
2. What do you think might have caused this?
3. How is it affecting your life?
4. How do you manage to cope?
5. Do you get any help?

Question 11

What comorbidities should be ruled out during the assessment of depression?

Answer 11

1. Anxiety, obsessions
2. Psychosis/Hypomania or mania
3. Coping strategies like alcohol and illicit drug