Alexandre Mitellus

Tag: French

  • Burn Depression Checklist

    Burn's Depression Checklist

    Please answer all questions based on how you have been feeling over the past 30 days. Select one option per question. All answers are required.

    Please enter your name. Please enter a valid email address.
    GDPR consent is required.
    Mental health consent is required.

    Thoughts and Feelings

    1. Feeling sad or down in the dumps

    2. Feeling unhappy or blue

    3. Crying spells or tearfulness

    4. Feeling discouraged

    5. Feeling hopeless

    6. Low Self-Esteem

    7. Feeling worthless or inadequate

    8. Guilt or shame

    9. Criticising yourself or blaming others

    10. Difficulty in making decisions

    Activities and Personal Relationships

    11. Loss of interest in family, friends or colleagues

    12. Loneliness

    13. Spending less time with family or friends

    14. Loss of motivation

    15. Loss of interest in work or other activities

    16. Avoiding work or other activities

    17. Loss of pleasure or satisfaction in life

    Physical Symptoms

    18. Feeling tired

    19. Difficulty sleeping or sleeping too much

    20. Decrease or increases appetite

    21. Loss of interest in sex

    22. Worrying about your health

    Suicidal Urges

    23. Do you have any suicidal thoughts?

    24. Would you like to end your life?

    25. Do you have a plan for harming yourself?

    Please answer all questions.