Columbia DISC Depression Scale (Ages 11 and over) – Parent (rev 20220822) Columbia DISC Depression Scale (Ages 11 and over) Present State (last 4 weeks) TO BE COMPLETED BY PARENT Child & Adolescent Psychiatry at Columbia University & NYSPI Client name* First Last Client date of birth MM slash DD slash YYYY Program* Psychiatry only CGC School-based Health Center FFT MDFT IICAPS Is the client 11 years old, or older?* Yes No Columbia – to be completed by ParentPlease answer the following questions as honestly as possible. In the last four weeks … 1. Has your child often seemed sad or depressed?* No Yes 2. Has it seemed like nothing was fun for [him/her] and [he/she] just wasn't interested in anything?* No Yes 3. Has [he/she] often felt grouchy or irritable and often in a bad mood, when even little things would make you mad?* No Yes 4. Has [he/she] lost weight, more than just a few pounds?* No Yes 5. Has it seemed like your child lost [his/her] appetite or ate a lot less than usual?* No Yes 6. Has [he/she] gained a lot of weight, more than a few pounds?* No Yes 7. Has it seemed like [he/she] felt much hungrier than usual or ate a lot more than usual?* No Yes 8. Has [he/she] had trouble sleeping – that is, trouble falling asleep, staying asleep, or waking up too early?* No Yes 9. Has [he/she] slept more during the day than [he/she] usually does?* No Yes 10. Has your child seemed to do things like walking or talking much more slowly than usual?* No Yes 11. Has [he/she] often seemed restless … like [he/she] just had to keep walking around?* No Yes 12. Has [he/she] seemed to have less energy than [he/she] usually do?* No Yes 13. Has doing even little things seemed to make [he/she] feel really tired?* No Yes 14. Has your child often blamed [himself/herself] for bad things that happened?* No Yes 15. Has [he/she] said [he/she] couldn't do anything well or that [he/she] wasn't as good looking or as smart as other people?* No Yes 16. Has it seemed like [he/she] couldn't think as clearly or as fast as usual?* No Yes 17. Has [he/she] often seemed to have trouble keeping [his/her] mind on [his/her] [schoolwork/work] or other things?* No Yes 18. Has it often been hard for [him/her] mind or to make decisions?* No Yes 19. Has your child said [he/she] often thought about death or about people who died or about being dead [himself/herself]?* No Yes 20. Has [he/she] talked seriously about killing [himself/herself]?* No Yes 21. Has [he/she] tried to kill [himself/herself] in the last four weeks?* No Yes 22. Has [he/she] EVER, in [his/her] WHOLE LIFE, tried to kill [himself/herself] or made a suicide attempt?* No Yes Columbia Teen Score – ParentAutomatically calculated – do not edit Score Chance of Depression How often is this seen? 0-6 Very unlikely in 2/3 of teens 7-11 Moderately likely in 1/4 of teens 12-15 Likely in 1/10 of teens 16 and above Highly likely in 1/50 of teens
