Center for Epidemiologic Studies Depression Scale – Caregiver (CESD-Revised) 20210419 Client Name* First Last Client Date of Birth* MM slash DD slash YYYY Today's Date* MM slash DD slash YYYY 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 Please click SUBMIT when complete
