| How do I know if I am at risk? |
These tools are designed to assess your risk of stress and depression. Scales are based on the symptom criteria that health care professionals use to help identify these conditions. The answers to these questions cannot be used alone to make a diagnosis. These tools are intended to indicate whether or not you may benefit from further evaluation and treatment.
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| PHQ-2 |
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During the past month, have you often been bothered by feeling down, depressed, or hopeless?
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(0)
Not at all
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(1)
Several days
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(2)
More than half the days
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(3)
Nearly everyday
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During the past month, have you often been bothered by little interest or pleasure in doing things?
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(0)
Not at all
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(1)
Several days
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(2)
More than half the days
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(3)
Nearly everyday
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| Score Range 0-6 |
Score > 3 = Depressive Disorder
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| Reference: Kroenke K, Spitzer RL, and Williams JBW. Medical care 41 (11): 1284-1292. |
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| INTERHEART Stress Screener |
| For the following question, stress is defined as feeling irritable or filled with anxiety, or as having sleeping difficulties as a result of conditions at work or at home. |
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Never
Experienced
Stress
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Some Period
of Stress
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Several Periods
of Stress
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Permanent
Stress
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How often have you felt stress at work in the past year?
(Mark here if not applicable: i.e. no longer working  )
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How often have you felt stress at home in the past year?
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What level of financial stress do you feel?
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Little/None
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Moderate
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High/Severe
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Result and Recommendation: If you marked any boxes with several periods of stress or permanent stress or high/severe, it is recommended that you consider stress management.
The INTERHEART Study found that experiencing several periods of stress at home or work in the preceding year was associated with a 45% increased odds of having a heart attack and permanent stress increase the risk by 117%.
Financial stress was associated with a 33% increased risk of heart attack in this study.
Reference: Adapted from: The INTERHEART Study, Yusuf S, Hawken S. Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries, case-control study. Lancet 2004; 364:937-52.
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| Adaptation of the short DSM-IV CIDI Questionnaire |
| During the past twelve months, was there ever a time when you felt sad, blue, or depressed for two weeks or more in a row? |
| No Yes |
| If Yes, during those times, did you: |
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Lose interest in most things like hobbies, work or activities that usually give you pleasure?
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No
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Yes
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Feel tired or low on energy?
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No
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Yes
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Gain or lose weight?
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No
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Yes
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Have more trouble falling asleep than you usually do?
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No
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Yes
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Have more trouble concentrating than usual?
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No
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Yes
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Think a lot about death (either your own, someone else’s, or death in general)
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No
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Yes
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Feel down on yourself, no good or worthless?
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No
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Yes
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Result and Recommendation: If you checked “Yes” to five or more boxes on the right, a referral for evaluation and management of depression is recommended.
Reference: Adapted from the short DSM-IV CIDI Questionnaire for the: INTERHEART Study, Yusuf S, Hawken S. Ounpuu S, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries, case-control study. Lancet 2004; 364:937-52.
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|
Social Readjustment Rating Scale
(Holmes & Rahe, 1967) |
| Put a checkmark next to the life events you have experienced during the past year: |
| Event |
Value (Life Change Units) |
| Death of spouse |
100
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| Divorce |
73
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| Marital separation from mate |
65
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| Detention in jail, other institution |
63
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| Death of a close family member |
63
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| Major personal injury or illness |
53
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| Marriage |
50
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| Fired from work |
47
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| Marital reconciliation |
45
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| Retirement |
45
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| Major change in the health or behavior of a family member |
44
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| Pregnancy |
40
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| Sexual difficulties |
39
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| Gaining a new family member (e.g., through birth, adoption, oldster moving, etc.) |
39
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| Major business re-adjustment (e.g., merger, reorganization, bankruptcy) |
39
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| Major change in financial status |
38
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| Death of close friend |
37
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| Change to different line of work |
36
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| Major change in the number of arguments with spouse |
35
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| Taking out a mortgage or loan for a major purchase |
31
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| Foreclosure on a mortgage or loan |
30
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| Major change in responsibilities at work |
29
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| Son or daughter leaving home (e.g., marriage, attending college) |
29
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| Trouble with In-laws |
29
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| Outstanding personal achievement |
28
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| Spouse beginning or ceasing to work outside the home |
26
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| Beginning or ceasing formal schooling |
26
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| Major change in living conditions |
25
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| Revision of personal habits (dress, manners, associations, etc.) |
24
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| Trouble with boss |
23
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| Major change in working hours or conditions |
20
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| Change in residence |
20
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| Change to a new school |
20
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| Major change in usual type and/or amount of recreation |
19
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| Major change in church activities (a lot more or less than usual) |
19
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| Major change in social activities (clubs, dancing, movies, visiting) |
18
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| Taking out a mortgage or loan for a lesser purchase (e.g., for a car, TV, freezer, etc.) |
17
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| Major change in sleeping habits |
16
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| Major change in the number of family get-togethers |
15
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| Major change in eating habits |
15
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| Vacation |
13
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| Christmas season |
12
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| Minor violations of the law (e.g., traffic tickets, etc. ) |
11
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| Total Score: |
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Social Readjustment Rating Scale Scoring:
Under 150 Life Crisis Units: 30% chance of developing a stress-related illness in the near future
150-299 Life Crisis Units: 50% chance of developing an illness
Over 300 Life Crisis Units: 80% chance of developing an illness
Reference: Holmes, T.H. & Rahe, RH, The Social Readjustment Rating Scale. Journal of Psychosomatic Research. 1967 August; 11 (2): 213-8.
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