Rate each item based on a clinical interview covering the past week. Anchors are defined at even values; use odd values for intermediate presentations.

1. 1. Apparent sadness
   ☐0No sadness

   ☐1—

   ☐2Looks dispirited but does brighten up without difficulty

   ☐3—

   ☐4Appears sad and unhappy most of the time

   ☐5—

   ☐6Looks miserable all the time; extremely despondent
2. 2. Reported sadness
   ☐0Occasional sadness in keeping with the circumstances

   ☐1—

   ☐2Sad or low but brightens up without difficulty

   ☐3—

   ☐4Pervasive feelings of sadness or gloominess; mood still influenced by external circumstances

   ☐5—

   ☐6Continuous or unvarying sadness, misery, or despondency
3. 3. Inner tension
   ☐0Placid; only fleeting inner tension

   ☐1—

   ☐2Occasional feelings of edginess and ill-defined discomfort

   ☐3—

   ☐4Continuous feelings of inner tension or intermittent panic mastered with some difficulty

   ☐5—

   ☐6Unrelenting dread or anguish; overwhelming panic
4. 4. Reduced sleep
   ☐0Sleeps as usual

   ☐1—

   ☐2Slight difficulty dropping off, or slightly reduced, light or fitful sleep

   ☐3—

   ☐4Sleep reduced or broken by at least two hours

   ☐5—

   ☐6Less than two or three hours of sleep
5. 5. Reduced appetite
   ☐0Normal or increased appetite

   ☐1—

   ☐2Slightly reduced appetite

   ☐3—

   ☐4No appetite; food is tasteless

   ☐5—

   ☐6Needs persuasion to eat at all
6. 6. Concentration difficulties
   ☐0No difficulties in concentrating

   ☐1—

   ☐2Occasional difficulties in collecting one’s thoughts

   ☐3—

   ☐4Difficulties concentrating and sustaining thought, reducing ability to read or converse

   ☐5—

   ☐6Unable to read or converse without great difficulty
7. 7. Lassitude
   ☐0Hardly any difficulty getting started; no sluggishness

   ☐1—

   ☐2Difficulties in starting activities

   ☐3—

   ☐4Difficulties starting simple routine activities, carried out with effort

   ☐5—

   ☐6Complete lassitude; unable to do anything without help
8. 8. Inability to feel
   ☐0Normal interest in surroundings and in other people

   ☐1—

   ☐2Reduced ability to enjoy usual interests

   ☐3—

   ☐4Loss of interest in surroundings; loss of feelings for friends and acquaintances

   ☐5—

   ☐6Emotionally paralysed; unable to feel anger, grief, or pleasure
9. 9. Pessimistic thoughts
   ☐0No pessimistic thoughts

   ☐1—

   ☐2Fluctuating ideas of failure, self-reproach, or self-depreciation

   ☐3—

   ☐4Persistent self-accusations or definite but rational ideas of guilt; pessimistic about the future

   ☐5—

   ☐6Delusions of ruin, remorse, or unredeemable sin; absurd, unshakable self-accusation
10. 10. Suicidal thoughts
    ☐0Enjoys life or takes it as it comes

    ☐1—

    ☐2Weary of life; only fleeting suicidal thoughts

    ☐3—

    ☐4Probably better off dead; suicidal thoughts common, suicide considered but no specific plan

    ☐5—

    ☐6Explicit plans for suicide when there is an opportunity; active preparations

Source: Montgomery SA, Åsberg M. A new depression scale designed to be sensitive to change. Br J Psychiatry. 1979;134:382–389.

For use by qualified clinicians as a decision-support aid. Scores support but do not replace clinical judgment. This is not a diagnostic instrument and no information is stored or transmitted.