Mood and Feelings Questionnaire: Child

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Today's Date* This field is required.

Date

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Your Name * This field is required.

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Your Date of Birth * This field is required.

Date

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TOTAL SCORE (Interpret the score using the table below):INTERPRETATION OF SCORES: 0-7: No Depression, 8-11: Mild Depression, 12 or higher: Significant depressive symptoms, suggesting the need for further evaluation.

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Total Score	Interpretation
0 - 7	No Depression
8 - 11	Mild Depression
12 or higher	Significant depressive symptoms, suggesting the need for further evaluation.

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DIRECTIONS: For each question, please select the option that best describes how you have been feeling or acting over the past two weeks. If a sentence was not true about you, check NOT TRUE. If a sentence was only sometimes true, check SOMETIMES. If a sentence was true about you most of the time, check TRUE.

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1. I felt miserable or unhappy.* This field is required.

Not True

Sometimes

True

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2. I didn’t enjoy anything at all.* This field is required.

Not True

Sometimes

True

9

3. I felt so tired I just sat around and did nothing.* This field is required.

Not True

Sometimes

True

10

4. I was very restless.* This field is required.

Not True

Sometimes

True

11

5. I felt I was no good anymore.* This field is required.

Not True

Sometimes

True

12

6. I cried a lot.* This field is required.

Not True

Sometimes

True

13

7. I found it hard to think properly or concentrate.* This field is required.

Not True

Sometimes

True

14

8. I hated myself.* This field is required.

Not True

Sometimes

True

15

9. I was a bad person.* This field is required.

Not True

Sometimes

True

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10. I felt lonely.* This field is required.

Not True

Sometimes

True

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11. I thought nobody really loved me.* This field is required.

Not True

Sometimes

True

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12. I thought I could never be as good as other kids.* This field is required.

Not True

Sometimes

True

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13. I did everything wrong.* This field is required.

Not True

Sometimes

True