{"id":3940,"date":"2025-03-01T18:07:47","date_gmt":"2025-03-01T18:07:47","guid":{"rendered":"https:\/\/mitellus.fr\/?p=3940"},"modified":"2025-03-02T01:00:08","modified_gmt":"2025-03-02T01:00:08","slug":"burns-depression-checklist","status":"publish","type":"post","link":"https:\/\/mitellus.fr\/?p=3940","title":{"rendered":"Burn&#8217;s Depression Checklist"},"content":{"rendered":"<div style=\"max-width: 800px; margin: 20px auto;\"><form method=\"POST\" action=\"https:\/\/mitellus.fr\/wp-admin\/admin-post.php?action=burns_all_submit\"><input type=\"hidden\" id=\"security\" name=\"security\" value=\"81f3034a4d\" \/><input type=\"hidden\" name=\"_wp_http_referer\" value=\"\/index.php?rest_route=%2Fwp%2Fv2%2Fposts%2F3940\" \/><input type=\"hidden\" name=\"submit_survey\" value=\"1\"><input type=\"hidden\" name=\"redirect_to\" value=\"https:\/\/mitellus.fr\/?p=3940\"><div style=\"margin-bottom: 20px;\"><label for=\"progress\">Progress:<\/label><progress id=\"progress\" value=\"0\" max=\"25\" style=\"width: 100%; height: 20px;\"><\/progress><span id=\"progress-text\">0\/25 (0%)<\/span><\/div><div style=\"padding: 20px; border: 1px solid #ddd; border-radius: 10px; background-color: #f9f9f9; margin-bottom: 20px;\"><label for=\"name\">How should I call you? <span style=\"color:red;\">*<\/span><\/label><br><input type=\"text\" name=\"name\" id=\"name\" required style=\"width: 100%; max-width: 600px; margin: 10px 0; padding: 10px; box-sizing: border-box;\"><br><br><label for=\"email\">Email <span style=\"color:red;\">*<\/span><\/label><br><input type=\"email\" name=\"email\" id=\"email\" required style=\"width: 100%; max-width: 600px; margin: 10px 0; padding: 10px; box-sizing: border-box;\"><br><br><label for=\"comment\">Comment<\/label><br><textarea name=\"comment\" id=\"comment\" rows=\"4\" cols=\"50\" style=\"width: 100%; max-width: 600px; margin: 10px 0; padding: 10px; box-sizing: border-box;\"><\/textarea><br><br><label><input type=\"checkbox\" name=\"gdpr_consent\" id=\"gdpr-consent\" required> I consent to the processing of my personal data in accordance with GDPR for the purpose of this survey.<\/label><br><br><label><input type=\"checkbox\" name=\"health_consent\" id=\"health-consent\" required> I consent to my data being used to evaluate my mental health state as part of this survey.<\/label><br><br><\/div><style>.radio-btn { display: inline-block; margin: 5px; }.radio-btn input[type=\"radio\"] { display: none; }.radio-btn label { padding: 8px 12px; background-color: #f0f0f0; border: 1px solid #ccc; border-radius: 5px; cursor: pointer; }.radio-btn input[type=\"radio\"]:checked + label { background-color: #0073aa; color: white; border-color: #005177; }form label { font-weight: bold; display: block; margin-bottom: 5px; }.section-button { text-align: center; margin: 20px 0; }.section-button input[type=\"submit\"] { background-color: #0073aa; color: white; border: none; padding: 10px 20px; cursor: pointer; font-size: 16px; border-radius: 5px; transition: background-color 0.3s; }.section-button input[type=\"submit\"]:hover { background-color: #005177; }.question { margin-bottom: 30px; transition: background-color 0.5s; }<\/style><script>document.addEventListener(\"DOMContentLoaded\", function() {const form = document.querySelector(\"form\");const questions = document.getElementsByClassName(\"question\");const progressBar = document.getElementById(\"progress\");const progressText = document.getElementById(\"progress-text\");let answeredCount = 0;const radioButtons = document.querySelectorAll(\".radio-btn input[type='radio']\");radioButtons.forEach((radio) => {radio.addEventListener(\"change\", function() {const currentQuestionIndex = Array.from(questions).indexOf(this.closest(\".question\"));const nextQuestionIndex = currentQuestionIndex + 1;answeredCount++;updateProgress();if (nextQuestionIndex < questions.length) {const nextQuestion = questions[nextQuestionIndex];nextQuestion.scrollIntoView({ behavior: \"smooth\", block: \"start\" });nextQuestion.style.backgroundColor = \"#e0f7fa\";setTimeout(() => nextQuestion.style.backgroundColor = \"\", 1000);} else {form.querySelector(\".section-button input[type='submit']\").scrollIntoView({ behavior: \"smooth\", block: \"start\" });}});});function updateProgress() {progressBar.value = answeredCount;const percentage = Math.round((answeredCount \/ 25) * 100);progressText.textContent = `${answeredCount}\/25 (${percentage}%)`;}form.addEventListener(\"submit\", function(event) {const gdprConsent = document.getElementById(\"gdpr-consent\").checked;const healthConsent = document.getElementById(\"health-consent\").checked;if (!gdprConsent || !healthConsent) {event.preventDefault();alert(\"Please provide both GDPR and health consents.\");} else if (answeredCount < 25) {event.preventDefault();alert(\"Please answer all 25 questions.\");}});});<\/script><div style=\"padding: 20px; border: 1px solid #ddd; border-radius: 10px; background-color: #f9f9f9; margin-bottom: 20px;\" id=\"tf\"><h2>Thoughts and Feelings<\/h2><p>Select the most relevant answer for each symptom (Questions 1-10).<\/p><div class=\"question\"><label>1. Feeling sad or down in the dumps <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q1_0\" name=\"responses[1]\" value=\"0\" required><label for=\"q1_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q1_1\" name=\"responses[1]\" value=\"1\" required><label for=\"q1_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q1_2\" name=\"responses[1]\" value=\"2\" required><label for=\"q1_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q1_3\" name=\"responses[1]\" value=\"3\" required><label for=\"q1_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q1_4\" name=\"responses[1]\" value=\"4\" required><label for=\"q1_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>2. Feeling unhappy or blue <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q2_0\" name=\"responses[2]\" value=\"0\" required><label for=\"q2_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q2_1\" name=\"responses[2]\" value=\"1\" required><label for=\"q2_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q2_2\" name=\"responses[2]\" value=\"2\" required><label for=\"q2_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q2_3\" name=\"responses[2]\" value=\"3\" required><label for=\"q2_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q2_4\" name=\"responses[2]\" value=\"4\" required><label for=\"q2_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>3. Crying spells or tearfulness <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q3_0\" name=\"responses[3]\" value=\"0\" required><label for=\"q3_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q3_1\" name=\"responses[3]\" value=\"1\" required><label for=\"q3_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q3_2\" name=\"responses[3]\" value=\"2\" required><label for=\"q3_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q3_3\" name=\"responses[3]\" value=\"3\" required><label for=\"q3_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q3_4\" name=\"responses[3]\" value=\"4\" required><label for=\"q3_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>4. Feeling discouraged <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q4_0\" name=\"responses[4]\" value=\"0\" required><label for=\"q4_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q4_1\" name=\"responses[4]\" value=\"1\" required><label for=\"q4_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q4_2\" name=\"responses[4]\" value=\"2\" required><label for=\"q4_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q4_3\" name=\"responses[4]\" value=\"3\" required><label for=\"q4_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q4_4\" name=\"responses[4]\" value=\"4\" required><label for=\"q4_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>5. Feeling hopeless <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q5_0\" name=\"responses[5]\" value=\"0\" required><label for=\"q5_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q5_1\" name=\"responses[5]\" value=\"1\" required><label for=\"q5_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q5_2\" name=\"responses[5]\" value=\"2\" required><label for=\"q5_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q5_3\" name=\"responses[5]\" value=\"3\" required><label for=\"q5_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q5_4\" name=\"responses[5]\" value=\"4\" required><label for=\"q5_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>6. Low Self-Esteem <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q6_0\" name=\"responses[6]\" value=\"0\" required><label for=\"q6_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q6_1\" name=\"responses[6]\" value=\"1\" required><label for=\"q6_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q6_2\" name=\"responses[6]\" value=\"2\" required><label for=\"q6_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q6_3\" name=\"responses[6]\" value=\"3\" required><label for=\"q6_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q6_4\" name=\"responses[6]\" value=\"4\" required><label for=\"q6_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>7. Feeling worthless or inadequate <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q7_0\" name=\"responses[7]\" value=\"0\" required><label for=\"q7_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q7_1\" name=\"responses[7]\" value=\"1\" required><label for=\"q7_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q7_2\" name=\"responses[7]\" value=\"2\" required><label for=\"q7_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q7_3\" name=\"responses[7]\" value=\"3\" required><label for=\"q7_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q7_4\" name=\"responses[7]\" value=\"4\" required><label for=\"q7_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>8. Guilt or shame <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q8_0\" name=\"responses[8]\" value=\"0\" required><label for=\"q8_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q8_1\" name=\"responses[8]\" value=\"1\" required><label for=\"q8_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q8_2\" name=\"responses[8]\" value=\"2\" required><label for=\"q8_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q8_3\" name=\"responses[8]\" value=\"3\" required><label for=\"q8_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q8_4\" name=\"responses[8]\" value=\"4\" required><label for=\"q8_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>9. Criticising yourself or blaming others <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q9_0\" name=\"responses[9]\" value=\"0\" required><label for=\"q9_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q9_1\" name=\"responses[9]\" value=\"1\" required><label for=\"q9_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q9_2\" name=\"responses[9]\" value=\"2\" required><label for=\"q9_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q9_3\" name=\"responses[9]\" value=\"3\" required><label for=\"q9_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q9_4\" name=\"responses[9]\" value=\"4\" required><label for=\"q9_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>10. Difficulty in making decisions <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q10_0\" name=\"responses[10]\" value=\"0\" required><label for=\"q10_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q10_1\" name=\"responses[10]\" value=\"1\" required><label for=\"q10_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q10_2\" name=\"responses[10]\" value=\"2\" required><label for=\"q10_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q10_3\" name=\"responses[10]\" value=\"3\" required><label for=\"q10_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q10_4\" name=\"responses[10]\" value=\"4\" required><label for=\"q10_4\">4 - Extremely<\/label><\/div><\/div><\/div><div style=\"padding: 20px; border: 1px solid #ddd; border-radius: 10px; background-color: #f9f9f9; margin-bottom: 20px;\" id=\"ar\"><h2>Activities and Personal Relationships<\/h2><p>Select the most relevant answer for each symptom (Questions 11-17).<\/p><div class=\"question\"><label>11. Loss of interest in family, friends or colleagues <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q11_0\" name=\"responses[11]\" value=\"0\" required><label for=\"q11_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q11_1\" name=\"responses[11]\" value=\"1\" required><label for=\"q11_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q11_2\" name=\"responses[11]\" value=\"2\" required><label for=\"q11_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q11_3\" name=\"responses[11]\" value=\"3\" required><label for=\"q11_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q11_4\" name=\"responses[11]\" value=\"4\" required><label for=\"q11_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>12. Loneliness <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q12_0\" name=\"responses[12]\" value=\"0\" required><label for=\"q12_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q12_1\" name=\"responses[12]\" value=\"1\" required><label for=\"q12_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q12_2\" name=\"responses[12]\" value=\"2\" required><label for=\"q12_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q12_3\" name=\"responses[12]\" value=\"3\" required><label for=\"q12_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q12_4\" name=\"responses[12]\" value=\"4\" required><label for=\"q12_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>13. Spending less time with family or friends <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q13_0\" name=\"responses[13]\" value=\"0\" required><label for=\"q13_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q13_1\" name=\"responses[13]\" value=\"1\" required><label for=\"q13_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q13_2\" name=\"responses[13]\" value=\"2\" required><label for=\"q13_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q13_3\" name=\"responses[13]\" value=\"3\" required><label for=\"q13_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q13_4\" name=\"responses[13]\" value=\"4\" required><label for=\"q13_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>14. Loss of motivation <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q14_0\" name=\"responses[14]\" value=\"0\" required><label for=\"q14_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q14_1\" name=\"responses[14]\" value=\"1\" required><label for=\"q14_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q14_2\" name=\"responses[14]\" value=\"2\" required><label for=\"q14_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q14_3\" name=\"responses[14]\" value=\"3\" required><label for=\"q14_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q14_4\" name=\"responses[14]\" value=\"4\" required><label for=\"q14_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>15. Loss of interest in work or other activities <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q15_0\" name=\"responses[15]\" value=\"0\" required><label for=\"q15_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q15_1\" name=\"responses[15]\" value=\"1\" required><label for=\"q15_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q15_2\" name=\"responses[15]\" value=\"2\" required><label for=\"q15_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q15_3\" name=\"responses[15]\" value=\"3\" required><label for=\"q15_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q15_4\" name=\"responses[15]\" value=\"4\" required><label for=\"q15_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>16. Avoiding work or other activities <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q16_0\" name=\"responses[16]\" value=\"0\" required><label for=\"q16_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q16_1\" name=\"responses[16]\" value=\"1\" required><label for=\"q16_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q16_2\" name=\"responses[16]\" value=\"2\" required><label for=\"q16_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q16_3\" name=\"responses[16]\" value=\"3\" required><label for=\"q16_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q16_4\" name=\"responses[16]\" value=\"4\" required><label for=\"q16_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>17. Loss of pleasure or satisfaction in life <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q17_0\" name=\"responses[17]\" value=\"0\" required><label for=\"q17_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q17_1\" name=\"responses[17]\" value=\"1\" required><label for=\"q17_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q17_2\" name=\"responses[17]\" value=\"2\" required><label for=\"q17_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q17_3\" name=\"responses[17]\" value=\"3\" required><label for=\"q17_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q17_4\" name=\"responses[17]\" value=\"4\" required><label for=\"q17_4\">4 - Extremely<\/label><\/div><\/div><\/div><div style=\"padding: 20px; border: 1px solid #ddd; border-radius: 10px; background-color: #f9f9f9; margin-bottom: 20px;\" id=\"ps\"><h2>Physical Symptoms<\/h2><p>Select the most relevant answer for each symptom (Questions 18-22).<\/p><div class=\"question\"><label>18. Feeling tired <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q18_0\" name=\"responses[18]\" value=\"0\" required><label for=\"q18_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q18_1\" name=\"responses[18]\" value=\"1\" required><label for=\"q18_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q18_2\" name=\"responses[18]\" value=\"2\" required><label for=\"q18_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q18_3\" name=\"responses[18]\" value=\"3\" required><label for=\"q18_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q18_4\" name=\"responses[18]\" value=\"4\" required><label for=\"q18_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>19. Difficulty sleeping or sleeping too much <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q19_0\" name=\"responses[19]\" value=\"0\" required><label for=\"q19_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q19_1\" name=\"responses[19]\" value=\"1\" required><label for=\"q19_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q19_2\" name=\"responses[19]\" value=\"2\" required><label for=\"q19_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q19_3\" name=\"responses[19]\" value=\"3\" required><label for=\"q19_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q19_4\" name=\"responses[19]\" value=\"4\" required><label for=\"q19_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>20. Decrease or increases appetite <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q20_0\" name=\"responses[20]\" value=\"0\" required><label for=\"q20_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q20_1\" name=\"responses[20]\" value=\"1\" required><label for=\"q20_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q20_2\" name=\"responses[20]\" value=\"2\" required><label for=\"q20_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q20_3\" name=\"responses[20]\" value=\"3\" required><label for=\"q20_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q20_4\" name=\"responses[20]\" value=\"4\" required><label for=\"q20_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>21. Loss of interest in sex <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q21_0\" name=\"responses[21]\" value=\"0\" required><label for=\"q21_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q21_1\" name=\"responses[21]\" value=\"1\" required><label for=\"q21_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q21_2\" name=\"responses[21]\" value=\"2\" required><label for=\"q21_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q21_3\" name=\"responses[21]\" value=\"3\" required><label for=\"q21_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q21_4\" name=\"responses[21]\" value=\"4\" required><label for=\"q21_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>22. Worrying about your health <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q22_0\" name=\"responses[22]\" value=\"0\" required><label for=\"q22_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q22_1\" name=\"responses[22]\" value=\"1\" required><label for=\"q22_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q22_2\" name=\"responses[22]\" value=\"2\" required><label for=\"q22_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q22_3\" name=\"responses[22]\" value=\"3\" required><label for=\"q22_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q22_4\" name=\"responses[22]\" value=\"4\" required><label for=\"q22_4\">4 - Extremely<\/label><\/div><\/div><\/div><div style=\"padding: 20px; border: 1px solid #ddd; border-radius: 10px; background-color: #f9f9f9; margin-bottom: 20px;\" id=\"su\"><h2>Suicidal Urges<\/h2><p>Select the most relevant answer for each symptom (Questions 23-25).<\/p><div class=\"question\"><label>23. Do you have any suicidal thoughts? <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q23_0\" name=\"responses[23]\" value=\"0\" required><label for=\"q23_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q23_1\" name=\"responses[23]\" value=\"1\" required><label for=\"q23_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q23_2\" name=\"responses[23]\" value=\"2\" required><label for=\"q23_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q23_3\" name=\"responses[23]\" value=\"3\" required><label for=\"q23_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q23_4\" name=\"responses[23]\" value=\"4\" required><label for=\"q23_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>24. Would you like to end your life? <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q24_0\" name=\"responses[24]\" value=\"0\" required><label for=\"q24_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q24_1\" name=\"responses[24]\" value=\"1\" required><label for=\"q24_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q24_2\" name=\"responses[24]\" value=\"2\" required><label for=\"q24_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q24_3\" name=\"responses[24]\" value=\"3\" required><label for=\"q24_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q24_4\" name=\"responses[24]\" value=\"4\" required><label for=\"q24_4\">4 - Extremely<\/label><\/div><\/div><div class=\"question\"><label>25. Do you have a plan for harming yourself? <span style='color:red;'>*<\/span><\/label><br><div class=\"radio-btn\"><input type=\"radio\" id=\"q25_0\" name=\"responses[25]\" value=\"0\" required><label for=\"q25_0\">0 - Not at All<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q25_1\" name=\"responses[25]\" value=\"1\" required><label for=\"q25_1\">1 - Somewhat<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q25_2\" name=\"responses[25]\" value=\"2\" required><label for=\"q25_2\">2 - Moderate<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q25_3\" name=\"responses[25]\" value=\"3\" required><label for=\"q25_3\">3 - A lot<\/label><\/div><div class=\"radio-btn\"><input type=\"radio\" id=\"q25_4\" name=\"responses[25]\" value=\"4\" required><label for=\"q25_4\">4 - Extremely<\/label><\/div><\/div><div class=\"section-button\"><input type=\"submit\" name=\"submit_button\" value=\"Submit\"><\/div><\/div><\/form><\/div>\n\n\n\n<p class=\"wp-block-paragraph\"><\/p>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"_jetpack_memberships_contains_paywalled_content":false,"_jetpack_feature_clip_id":0,"_jetpack_memberships_contains_paid_content":false,"footnotes":"","jetpack_post_was_ever_published":false},"categories":[1],"tags":[],"class_list":["post-3940","post","type-post","status-publish","format-standard","hentry","category-experience"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/mitellus.fr\/index.php?rest_route=\/wp\/v2\/posts\/3940","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/mitellus.fr\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/mitellus.fr\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/mitellus.fr\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/mitellus.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=3940"}],"version-history":[{"count":11,"href":"https:\/\/mitellus.fr\/index.php?rest_route=\/wp\/v2\/posts\/3940\/revisions"}],"predecessor-version":[{"id":3954,"href":"https:\/\/mitellus.fr\/index.php?rest_route=\/wp\/v2\/posts\/3940\/revisions\/3954"}],"wp:attachment":[{"href":"https:\/\/mitellus.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=3940"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/mitellus.fr\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=3940"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/mitellus.fr\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=3940"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}