Do you often get bored? Yes No
Do you often get restless or fidgety? Yes No
Do you feel in good spirits? Yes No
Do you feel you have more problems with memory than most people? Yes No
Can you concentrate easily when reading the paper? Yes No
Do you prefer to avoid social gatherings? Yes No
Do you often feel downhearted and blue? Yes No
Do you feel happy most of the time? Yes No
Do you often feel helpless? Yes No
Do you feel worthless and ashamed about yourself? Yes No
Do you often wish you were dead? Yes No
