Dr. Stall's Office--Geriatric Depression Scale (Short Form)
                                
Date:  _______________   Name:  ________________________________
                                
                                
      Patient Assessment Tool--Geriatric Depression Scale
                                
     CHOOSE THE BEST ANSWER FOR HOW YOU FELT THIS PAST WEEK
                                                             
                                                      CIRCLE ONE

* 1.  Are you basically satisfied with your life?     yes     NO
  2.  Have you dropped many of your activities and 
       interests?                                     YES     no
  3.  Do you feel that your life is empty?            YES     no
  4.  Do you often get bored?                         YES     no
* 5.  Are you in good spirits most of the time?       yes     NO
  6.  Are you afraid that something bad is going to
       happen to you?                                 YES     no
* 7.  Do you feel happy most of the time?             yes     NO
  8.  Do you often feel helpless?                     YES     no
  9.  Do you prefer to stay at home, rather than
       going out and doing new things?                YES     no
 10.  Do you feel you have more problems with
       memory than most?                              YES     no
*11.  Do you think it is wonderful to be alive now?   yes     NO
 12.  Do you feel pretty worthless the way you are
       now?                                           YES     no
*13.  Do you feel full of energy?                     yes     NO
 14.  Do you feel that your situation is hopeless?    YES     no
 15.  Do you think that most people are better off
       than you are?                                  YES     no
                      
*Appropriate (nondepressed) answers = yes, all others= no         
 or count number of CAPITALIZED (depressed) answers

Score: _____  (Number of "depressed" answers)                     
                                                  
Norms
----------------------------
Normal              0-5
Suggests depression 6-15
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References:

1.  Yesavage JA, Brink TL, Rose TL, et al.  Development and
validation of a geriatric depression rating scale:  a preliminary
report.  J Psych Res. 1983; 17:27.

2.  Sheikh JI, Yesavage JA.  Geriatric Depression Scale:  recent
evidence and development of a shorter version.  Clin Gerontol. 
1986; 5:165-172.

The Geriatric Depression Scale may be used freely for patient
assessment according to the authors.
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