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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Age

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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!

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1. He/ she has problems with concentration.

2. He/ she lost appetite.

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

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

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

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 become indifferent to the needs of the next.

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

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

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

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

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 often doesn't get up and doesn't do anything all days long.

12. He/ she eats definitely more than ever.

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

14. He/ she avoids contacts with other people.

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

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 assigns the blame for the bad things that happen.

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

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

19. He/ she significantly put on weight.

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

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 believes that the world is a hopeless and that nothing will change.

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

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

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

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 He she is withdrawn and not willing to answer the questions.

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 ceased to engage in household duties.

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

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

29. His/ her behaviour has changed significantly.

30. 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!

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

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

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

34. He/ she lost interest in family life.

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

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

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

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

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

40. 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!

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

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

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

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

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

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 is silent and withdrawn.

47. He/ she preferably spends time alone.

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

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

50. 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!

51. He/ she has problems with coordination.

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

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

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

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

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

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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