A rating scale to detect depression in menopause

MENO- D: A rating scale to detect depression in menopause

Professor Jayashri KULKARNI
Monash Alfred Psychiatry research centre
Subject’s name or code: …………………………….                                Date: …………………………
0    No change in energy, feel active all day
1    More tired after activity than previously
2    Decreased activity because of tiredness
3    Feel tired most of the time despite resting, decreased activity
4    Continually feeling exhausted, even small tasks such as brushing hair feel draining. “Bone weary, mind weary”
0    No Paranoid thinking
1    Increasingly worried that others think badly of you
2    Suspicious that people at work or home think badly of you
3    Convinced that others have a low opinion of you and are trying to replace you
0    No irritability
1    Mild irritability
2    Increased irritable response to minor incidents
3    Anger expressed by “snapping”, verbal outbursts over minor incidents
4    Rage, major verbal outbursts over minor incidents
0    Good self esteem or no change in self-esteem
1    Slight decrease in self–esteem
2    Poor self–esteem with no reality base
3    Very poor self-esteem in all life domains, with marked self-denigratory comments
4    No self-worth at all to the point of believing that the world would be better off without you. (NB – this rating must then lead to further questiones about suicide planning, actions and deliberate self harm)
0    Socialize normally
1    Decreased socializing
2    Disinterested in socializing
3    Social and occupational withdrawal
4    Feeling isolated, “in a bubble” even when with others
0    No new anxiety
1    Increased anxiety when performing in public
2    Highly anxious when doing new tasks
3    Heightened anxiety when doing routine and familiar tasks
4    Panic attacks, highly anxious when doing ordinary and familiar tasks
0    No physical symptoms
1    Increased muscle aches, joint pains on exercise
2    Increased leg, back and joint pains with little exertion
3    Frequent headaches, muscle and joint pains limiting activity
4    Severe aches and pains requiring pain relief and preventing activity
0    No sleep problems
1    Sleep broken by brief waking once or twice per night, but easily return to sleep
2    Sleep broken by waking several times per night, but easily return to sleep
3    Waking up three or more times per night due to hot flashes and sweating, plus difficulty returning to sleep
4    Sleeping two or less hours per night consistently. Sweating, hot flashes, feeling hot then cold, interrupting sleep all night
0    No change in weight
1    Mild weight gain (1-2kg)
2    Moderate weight gain despite no change in diet or exercise (3-6kg)
3    Continuing weight gain and abdominal fat deposition, despite dietary restriction and increasing exercise
4    Major weight gain (>6kg) with abdominal, breast, hip and thigh fat deposition
0    No change in libido
1    Mild decrease in libido
2    Diminished libido
3    Decreased libido and discomfort with sexual activity
4    Loss of interest in all sexual activity
0    No change in memory
1    Mild problems remembering names and numbers
2    Need to make lists to function at work or home
3    Impaired memory leading to dysfunction
4    Severe loss of memory leading to inability to function
0    No change in concentration
1    Mild problems with concentrating on reading
2    mild problem with concentration on reading and watching TV/films
3    Marked problems concentrating on reading and watching TV/films
4    Unable to focus on any tasks

Points are indicated as the numerical value of each possible symptom area (A-L) – then the total is added.
The minimum score is 0 and the maximum is 48 points. Between 20-24 points is considered to denote mild perimenopausal depression, needing onward monitoring.
Between 24-32 points suggests moderate perimenopausal depression needing treatment.
At 32 points and above, the woman is considered to have severe perimenopausal depression needing treatment.

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