| RPT |
|.|.|Cornell Scale for Depression in Dementia - Response Sheet (CSDD-RS) |
Scores above 18 indicate a definite major depression.|
Scores above 10 indicate a probable major depression.|
Scores below 6 as a rule are associated with absence of significant depressive symptoms.| |
Questions and Answers:|
|
1. MOOD-RELATED SIGNS: Anxiety; anxious expression, rumination, worrying|
<*Answer_8358*>| |
2. MOOD-RELATED SIGNS: Sadness; sad expression, sad voice, tearfulness|
<*Answer_8359*>| |
| Date Given: <.Date_Given.>| Clinician: <.Staff_Ordered_By.>|
3. MOOD-RELATED SIGNS: Lack of reaction to pleasant events|
<*Answer_8360*>| |
4. MOOD-RELATED SIGNS: Irritability; annoyed, short tempered|
<*Answer_8361*>| |
5. BEHAVIORAL DISTURBANCE: Agitation; restlessness, hand wringing, hair pulling|
<*Answer_8362*>| |
6. BEHAVIORAL DISTURBANCE: Retardation; slow movements, slow speech,
slow reactions|
<*Answer_8363*>| |
7. BEHAVIORAL DISTURBANCE: Multiple physical complaints
Location: <.Location.>| | Veteran: <.Patient_Name_Last_First.>|
(score 0 if gastrointestinal symptoms only)|
<*Answer_8364*>| |
8. BEHAVIORAL DISTURBANCE: Loss of interest; less involved in usual activities
(score 0 only if change occurred acutely, i.e., in less than one month)|
<*Answer_8365*>| |
9. PHYSICAL SIGNS: Appetite loss; eating less than usual|
<*Answer_8366*>| |
10. PHYSICAL SIGNS: Weight loss (score 2 if greater than 5 pounds in one month)|
<*Answer_8367*>| |
11. PHYSICAL SIGNS: Lack of energy; fatigues easily, unable to sustain
SSN: <.Patient_SSN.>| DOB: <.Patient_Date_Of_Birth.> (<.Patient_Age.>)
activities|
<*Answer_8368*>| |
12. CYCLIC FUNCTIONS: Diurnal variation of mood; symptoms worse in the morning|
<*Answer_8369*>| |
13. CYCLIC FUNCTIONS: Difficulty falling asleep; later than usual for this
individual|
<*Answer_8370*>| |
14. CYCLIC FUNCTIONS: Multiple awakenings during sleep|
<*Answer_8371*>| |
15. CYCLIC FUNCTIONS: Early morning awakening; earlier than usual for this
| Gender: <.Patient_Gender.>||
individual|
<*Answer_8372*>| |
16. IDEATIONAL DISTURBANCE: Suicidal; feels life is not worth living|
<*Answer_8373*>| |
17. IDEATIONAL DISTURBANCE: Poor self-esteem; self-blame, self-depreciation,
feelings of failure|
<*Answer_8374*>| |
18. IDEATIONAL DISTURBANCE: Pessimism; anticipation of the worst|
<*Answer_8375*>| |
19. IDEATIONAL DISTURBANCE: Mood congruent delusions; delusions of poverty,
illness or loss|
<*Answer_8376*>| |
NOTES/CURRENT MEDICATIONS: <*Answer_8377*> | |
Information contained in this note is based on a self-report assessment and is not sufficient to use alone for
diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other
diagnostic activities.| |
$~
CSDD-RS Total Score = <*Answer_7771*>| |
|
