HRS-DS Welcome to your HRS-DS Depressed moodSad, hopeless, helpless, worthless Absent Gloomy attitude, pessimism, hopelessness Occasional weeping Frequent weeping Patient reports highlight these feelings states in his/her spontaneous verbal and non-verbal communication. None Feelings of guilt Absent Self-reproach, feels he/she has let people down Ideas of guilt or rumination over past errors or sinful deeds Present illness is punishment Hears accusatory or denunciatory voices and/or experiences threatening visual hallucinations. Delusions of guilt None Suicide Absent Feels life is not worth living Wishes he/she were dead, or any thoughts of possible death to self Suicide, ideas or half-hearted attempt Attempts at suicide (any serious attempt rates 4) None Insomnia, early No difficulty falling asleep Complaints of occasional difficulty in falling asleep i.e. more than half-hour Complaints of nightly difficulty falling asleep None Insomnia, middle No difficulty Patient complains of being restless and disturbed during the night Walking during the night – any getting out of bed rates 2 (except voiding bladder) None Insomnia, late No difficulty Waking in the early hours of the morning but goes back to sleep Unable to fall asleep again if he/she gets out of bed None Work and activities No difficulty Thoughts and feelings of incapacity related to activities: work or hobbies Loss of interest in activity – hobbies or work – either directly reported by patient or indirectly seen in listlessness, in decisions and vacillation (feels he/she has to push self to work or activities) Decrease in actual time spent in activities or decrease in productivity. In hospital, rate 3 if patient does not spend at leas three hours a day in activities Stopped working because of present illness. In hospital rate 4 if patient engages in no activities except supervised ward chores None Retardation Normal speech and thought Slight retardation at interview Obvious retardation at interview Interview difficult Interview impossible None Agitation None Fidgetiness Playing with hands, hair, obvious restlessness Moving about; can’t sit still Hand wringing, nail biting, hair pulling, biting of lips, patient is on the run None Anxiety, psychicSubjective tension and irritability, loss of concentration Absent Mild Moderate Severe Incapacitating None Anxiety, psychicWorrying about minor matters Absent Mild Moderate Severe Incapacitating None Anxiety, psychicApprehension Absent Mild Moderate Severe Incapacitating None Anxiety, psychicFears expressed without questioning Absent Mild Moderate Severe Incapacitating None Anxiety, psychicFeelings of panic Absent Mild Moderate Severe Incapacitating None Anxiety, psychicFeeling jumpy Absent Mild Moderate Severe Incapacitating None Anxiety, somaticGastrointestinal: dry mouth, wind, indigestion, diarrhea, cramps, belching Absent Mild Moderate Severe Incapacitating None Anxiety, somaticCardiovascular: palpations, headaches Absent Mild Moderate Severe Incapacitating None Anxiety, somaticRespiratory: hyperventilation, sighing Absent Mild Moderate Severe Incapacitating None Anxiety, somaticUrinary frequency Absent Mild Moderate Severe Incapacitating None Anxiety, somaticSweating Absent Mild Moderate Severe Incapacitating None Anxiety, somaticGiddiness, blurred vision Absent Mild Moderate Severe Incapacitating None Anxiety, somaticTinnitus Absent Mild Moderate Severe Incapacitating None Somatic symptoms: gastrointestinal None Loss of appetite but eating without encouragement Difficulty eating without urging. Requests or requires laxatives or medication for GI symptoms None Somatic symptoms: general None Heaviness in limbs, back or head; backaches, headaches, muscle aches, loss of energy, fatigability Any clear-cut symptom rates 2 None General SymptomsSymptoms such as: loss of libido, menstrual disturbances Absent Mild Severe None Hypochondriasis Not present Self-absorption (bodily) Preoccupation with health Strong conviction of some bodily illness Hypochondrial delusions None Insight Acknowledges being depressed and ill Acknowledges illness but attributes cause to bad food, overwork, virus, need for rest, etc. Denies being ill at all None Loss of Weight Less than 1 lb (0.5 kg) weigh loss in one week 1-2 lb (0.5 kg-1.0 kg) weight loss in week Greater than 2 lb (1 kg) weight loss in week Not assessed None Time's up
