The Post-Stroke Depression Rating Scale of Gainotti et al

depressed mood

well-balanced mood, at times happier, at times worried, but not more than before illness

0

mood a little more sad and worried than before illness

1

mood clearly more oriented toward sadness and pessimism than before illness

2

mood clearly oriented toward sadness and pessimism, with fits of crying from time to time

3

very sad and disheartened mood; cries rather often and for long periods

4

gloomy, black mood, cries continuously, no way to hearten the patient

5

guilt feelings

good level of self-esteem; feeling of having had an essentially positive life without much self-reproach

0

acceptable level of self-esteem, but with some self-reproach in limited areas

1

rather low level of self-esteem, with some self-reproach in various areas

2

little self-esteem; many guilt feelings, but does not think illness has been a just punishment

3

very little self-esteem and many guilt feelings; thinks illness has been a just punishment

4

spontaneously verbalizes serious expressions of self-accusation, unworthiness, guilt

5

suicide

thinks life is always worth living

0

thinks life is worth living only if health, affective and economic conditions are acceptable

1

thinks life in general is not worth living, but has never thought of taking it

2

besides often thinking that life is a burden, recently has had vague ideas about killing self

3

recently has had recurring ideas about suicide, but without making specific plans or concrete attempts

4

recently has made detailed plans to commit suicide, or has made serious attempts

5

sleep disorders (vegetative)

no sleep disorder

0

some difficulty in falling asleep or frequent nocturnal awakenings

1

awakens very early in the morning and is unable to fall back to sleep again; drug poorly effective

2

major disorders in all sleep phases; does not allow others to sleep during the night; drugs completely ineffective

3

appetite disorders (vegetative)

no appetite disorder

0

clear loss of appetite, but no weight loss

1

complete loss of appetite associated with weight loss

2

interest in other patients and own state of health (apathy/abulia)

adequate (interested, asks information, tries to be useful)

0

rather scarce both toward other patients and own morbid condition

1

completely absent

2

interest in family members and friends (apathy/abulia)

adequate, waits impatiently for visits, asks about individuals and situations in family circle, reacts appropriately to emotionally significant events

0

rather scarce; clearly reduced compared to premorbid condition

1

completely absent

2

interest in social situations (apathy/abulia)

adequate, corresponding to premorbid levels regarding public and political events or work situations

0

clearly reduced compared to premorbid situation

1

psychic anxiety

calm enough; rarely tense or nervous or apprehensive

0

appears rather tense, nervous, irritable; sometimes expresses fears and worries;

1

often appears nervous, apprehensive, irritable; frequently expresses fears about own condition; often needs to be reassured

2

somatic anxiety

no somatic sign of anxiety; does not complain of headaches, tremors or tachycardia

0

complains of headaches, tremors, palpitations, or other gastrointestinal or urinary somatic disorders

1

often appears pale, sweaty; every day complains of headaches, diffuse pains, sense of precordial oppression or other somatic symptoms

2

psychomotor agitation

the same as before the illness

0

marked restlessness or real psychomotor agitation

1

catastrophic reaction

well-controlled reaction to possible difficulties encountered during examination

0

rather controlled reaction but some signs of impatience, irritation, restlessness

1

more evident anxious or aggressive manifestations; frequent cursing or expressions of depression

2

clear manifestations of anxiety at somatic and/or vegetative level but without fits of crying

3

clear signs of anxiety with sporadic fits of crying or refusal to continue test

4

test practically impossible to carry out due to seriousness of behavioral disorganization and fits of anxiety and crying

5

difficulty in emotional control

manages to control emotional reactions normally

0

recently becomes emotional a little more than usual

1

at times laughs or cries even to light stimuli; not able to interrupt an emotional outburst provoked by an appropriate stimulus

2

often reacts in an emotionally excessive way with fits of laughter or crying; able to control self in the presence of strangers

3

bursts out laughing or crying, even in the presence of strangers and finds it difficult to break off these attacks

4

completely incapable of controlling emotional reactions

5

pleasure from visits of friends or relatives (anhedonia)

the same as before the illness

0

less than before the illness

1

gives me no pleasure

2

pleasure from a better than usual meal (anhedonia)

the same as before the illness

0

less than before the illness

1

gives me no pleasure

2

pleasure from my team winning (anhedonia)

it pleases me the same as before

0

it no longer interests me

1

pleasure from seeing an erotic scene on TV (anhedonia)

please me like before

0

has no effect on me

1

pleasure from the visit of a beautiful child (anhedonia)

cheers me up the same as before

0

no longer gives me pleasure

1

time of day with maximal depression (diurnal variation)

always in the early morning, when I wake up and have a whole useless day before me to fill

-2

varies from one day to the other, but usually worse in the early morning when I wake up

-1

always feel more or less depressed in the same way (no variation)

0

usually feel more depressed when something happens that makes me feel handicapped

+1

always when the situation makes me feel disabled and unable to do basic things

+2