Burns Depression Checklist

Instructions: Choose a number to indicate how much you have experienced each symptom during the past week, including today.

The results of this checklist are not a substitute for clinical evaluation. If you have suicidal thoughts, please get professional help immediately. Please answer all 25 items honestly and objectively.

This test is private and the results are not transmitted or in any way saved.

Thoughts and Feelings

• Feeling sad or down in the dumps 01234
• Feeling unhappy or blue 01234
• Crying spells or tearfulness 01234
• Feeling discouraged 01234
• Feeling hopeless 01234
• Low self-esteem 01234
• Feeling worthless or inadequate 01234
• Guilt or shame 01234
• Criticizing yourself or blaming others 01234
• Difficulty making decisions 01234

Activities and Personal Relationships

• Loss of interest in family, friends or colleagues 01234
• Loneliness 01234
• Spending less time with family or friends 01234
• Loss of motivation 01234
• Loss of interest in work or other activities 01234
• Avoiding work or other activities 01234
• Loss of pleasure or satisfaction in life 01234

Physical Symptoms

• Feeling tired 01234
• Difficulty sleeping or sleeping too much 01234
• Decreased or increased appetite 01234
• Loss of interest in sex 01234
• Worrying about your health 01234

Suicidal Urges

• Do you have any suicidal thoughts? 01234
• Would you like to end your life? 01234
• Do you have a plan for harming yourself? 01234