A rating scale to detect depression in menopause

Professor Jayashri KULKARNI

Monash Alfred Psychiatry research centre

Melbourne

 

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.