Columbia DISC Depression Scale (Ages 11 and over) – Teen (rev 20220822) Columbia DISC Depression Scale (Ages 11 and over) Present State (last 4 weeks) TO BE COMPLETED BY TEEN Child & Adolescent Psychiatry at Columbia University & NYSPI Client name* First Last 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 FormPlease answer the following questions as honestly as possible. In the last four weeks … 1. Have you often felt sad or depressed?* No Yes 2. Have you felt like nothing is fun for you and you just aren't interested in anything?* No Yes 3. Have you often felt grouchy or irritable and often in a bad mood, when even little things would make you mad?* No Yes 4. Have you lost weight, more than just a few pounds?* No Yes 5. Have you lost your appetite or often felt less like eating?* No Yes 6. Have you gained a lot of weight, more than just a few pounds?* No Yes 7. Have you felt much hungrier than usual or eaten a lot more than usual?* No Yes 8. Have you had trouble sleeping – that is, trouble falling asleep, staying asleep, or waking up too early?* No Yes 9. Have you slept more during the day than you usually do?* No Yes 10. Have you often felt slowed down … like you walked or talked much slower than you usually do?* No Yes 11. Have you often felt restless … like you just had to keep walking around?* No Yes 12. Have you had less energy than you usually do?* No Yes 13. Has doing even little things made you feel really tired?* No Yes 14. Have you often blamed yourself for bad things that happened?* No Yes 15. Have you felt you couldn't do anything well or that you weren't as good looking or as smart as other people?* No Yes 16. Has it seemed like you couldn't think as clearly or as fast as usual?* No Yes 17. Have you often had trouble keeping your mind on your [schoolwork/work] or other things?* No Yes 18. Has it often been hard for you to make up your mind or to make decisions?* No Yes 19. Have you often thought about death or about people who had died or about being dead yourself?* No Yes 20. Have you thought seriously about killing yourself?* No Yes 21. Have you tried to kill yourself in the last four weeks?* No Yes 22. Have you EVER, in your WHOLE LIFE, tried to kill yourself or made a suicide attempt?* No Yes Columbia Teen ScoreAutomatically 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
