The informations which we request from you on the first page SHOULD APPLY TO PERSON, ABOUT WHICH YOU FILL UP THE TEST. These informations are used exclusively for statistical purposes and are not in any way identified.

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Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

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1. He/ she often says he is afraid of doing something.

2. He/ she makes animpression of being frightened when he/ she has to contact other people.

3. He/ she often says that he/ she cannot control his/ her thoughts.

4. He/ she often doesn't get up and doesn't do anything all days long.

5. He/ she lost interest in family life.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

6. He/ she has weakened or even stopped contacts with his/ her friends.

7. He/ she formulates the opinion that his/ her death or disappearance would be the best solution of the problems.

8. He/ she is silent and withdrawn.

9. He/ she often accuses the others of staring or even watching him/ her.

10. His/ her behaviour has changed significantly.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

11. He/ she never says he/ she is happy or enjoys anything.

12. He/ she has become indifferent to the needs of the next.

13. He/ she has begun to use stimulants or increased their amount.

14. He/ she has problems with concentration.

15. He/ she significantly lost his/ her weight.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

16. He/ she gives the impression of a person detached from reality.

17. He/ she assigns the blame for the bad things that happen.

18. He she is withdrawn and not willing to answer the questions.

19. He/ she avoids contacts with other people.

20. He/ she started to sleep a lot more.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

21. He/ she often agonises him/ herself over his/ her state of health.

22. He/ she often cries, seemingly for no reason.

23. He/ she has problems with coordination.

24. He/ she significantly put on weight.

25. He/ she often doesn't change his/ her clothes.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

26. He/ she is apathetic and it is difficult to change it.

27. He/ she is sad, makes the impression of being unhappy and depressed.

28. He/ she often ignores the requests coming in and expresses the need for peace of mind.

29. He/ she often claims that he/ she has not achieved anything and that this will not change.

30. He/ she expresses negative opinions about his/ her look.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

31. He/ she claims that he/ she deserves his/ her hopeless life.

32. Even beset he/ she does not undertake any activities.

33. He/ she often says that he/ she cannot do anything and that nothing goes off well.

34. He/ she believes that the world is a hopeless and that nothing will change.

35. He/ she suffers from insomia.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

36. He/ she states that he/ she can get no satisfaction from his/ her activities.

37. He/ she often claims that all the others wish him bad and only wait for his/ her mistake.

38. He/ she is not able to make the simplest decisions.

39. He/ she is indifferent to the environment, He/ she even accepts things that irritated him/ her before.

40. He/ she pays no attention to a personal hygiene.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

41. He/ she has the opinion that his environmant has changed, became strange.

42. All of the sudden he/ she is fascinated by death/ suicide people

43. He/ she has lost interest in things that he/ she enjoyed before.

44. He/ she often states that his / her life is worth nothing.

45. He/ she often says that he/ she had nightmares.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

46. He/ she ceased to engage in household duties.

47. He/ she has stopped his/ her sexual activity.

48. He/ she takes no action in problematic situations.

49. He/ she lost appetite.

50. He/ she eats definitely more than ever.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

51. He/ she often has problems with sleep, wakes too early or cannot sleep.

52. It is difficult to persuade him/ her to any activity.

53. Most willingly he/ she spends time at home saying tah only there he/ she feels safe.

54. He/ she complains about tiredness and lack of willingness to act.

55. He/ she preferably spends time alone.

Read statements given below carefully. There is a scale of the answers (from -3 to 3) under each statement. (-3) means that it does not refer to you and (3) means that it fully refers to you. Tick the right answer (according to your knowledge about yourself).
Remember there are no wrong or good answers!

56. He/ she gives negative opinions about him/ herself

Has the person in question ever been cured of depression? If yes, how long ago?

This test used for depression examination was developed using Beck's scale, PHQ-9 test (authors: Drs. Robert L. Spitzer, Janet B. W. Williams, Kurt Kroenke), Burns scale, and our own research.

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