Have you noticed a reduced appetite and weight loss, or increased appetite and weight gain? Yes No
Have you lost interest or pleasure in activities you once enjoyed? Yes No
Do you experience persistent physical symptoms that don't respond to treatment (such as headaches, chronic pain, or constipation and other digestive disorders)? Yes No
Have you felt restless or irritable? Yes No
Have you had difficulty concentrating, remembering or making decisions? Yes No
Have you recently felt fatigue or loss of energy? Yes No
Have you felt guilty, hopeless or worthless? Yes No
Do you think about death or suicide? Yes No