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.

Gender

Age

City size

Education

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!

The report from this test costs 5.00 PLN Net (6.15 with VAT). Credit card, PayPal, Fast transfer, SMS payment.

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

2. He/ she preferably spends time alone.

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

4. He/ she lost interest in family life.

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

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

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

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

9. He/ she avoids contacts with other people.

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

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 expresses negative opinions about his/ her look.

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

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

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

15. He/ she lost appetite.

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

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

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

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

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

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 cries, seemingly for no reason.

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

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

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

25. He/ she claims that he/ she deserves his/ her hopeless 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!

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

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

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

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

30. He/ she is silent and withdrawn.

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 has problems with coordination.

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

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

34. He/ she suffers from insomia.

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

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 has stopped his/ her sexual activity.

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

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

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

40. 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!

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

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

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

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

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

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

47. He/ she has problems with concentration.

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

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

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 significantly put on weight.

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

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

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

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

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 complains about tiredness and lack of willingness to act.

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.

Thank you for completing the test.