Attachment B36-9 DISC MDD

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

START NEW CARD
DUP COL 1 - 10
MOD.

C

1

[11 - 12]

CARD NO. 0

1
b

[13 - 14]
[15]

MDD
I’m now going to ask you some questions about ________’s feeling sad and unhappy.
1.

In the last year – that is, since [[NAME EVENT]/[NAME CURRENT MONTH]
of last year] – was there a time when ________ often seemed sad or depressed?

0

2

7

9

[16]

IF YES, A. Was there a time in the last year when [he/she] seemed sad or
depressed for a long time each day?

0

2

7

9

[17]

B. Would you say that [he/she] seemed that way for most of the day?

0

2

7

9

[18]

C. Was there a time when [he/she] seemed sad or depressed almost every
day?

0

2

7

9

[19]

0

2*

7

9

[20]

E. When [he/she] was sad or depressed, did [he/she] seem to feel better
if something good happened or was about to happen to [him/her]?

0

2

7

9

[21]

F. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of
[LAST MONTH]]), has [he/she] seemed sad or depressed?

0

2

7

9

[22]

In the last year – that is, since [NAME CURRENT MONTH] of last year – was there
a time when it seemed like nothing was fun for [him/her] and [he/she] just wasn’t
interested in anything?

0

2

7

9

[23]

IF YES, A. Was there a time when it seemed nothing was fun for [him/her] almost
every day?

0

2

7

9

[24]

0

‹[2]› 7

9

[25]

0

2

9

[26]

IF NO, GO TO Q 2

IF NO, GO TO Q 2
IF YES, D. In the last year, were there two weeks in a row when [he/
she] seemed sad or depressed almost every day?
IF NO, GO TO Q 2

2.

IF NO, GO TO Q 3
B. In the last year, were there two weeks in a row when [he/she] seemed
like this almost every day?
IF NO, GO TO Q 3
C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of
[LAST MONTH]]), has there been a time when it seemed like nothing
was fun for [him/her]?
Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 1

7

[5/20/98]

0=NO

3.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] often was grouchy or irritable and often in a bad mood, when
even little things would make [him/her] mad?

0

2

7

9

[27]

IF YES, A. Was there a time in the last year when [he/she] was grouchy or
irritable for a long time each day?

0

2

7

9

[28]

B. Would you say that [he/she] was that way for most of the day?

0

2

7

9

[29]

C. Was there a time when [he/she] was grouchy or irritable almost every
day?

0

2

7

9

[30]

0

2*

7

9

[31]

0

2

7

9

[32]

0

2

[33]

0

‹[2]›

[34]

IF NO, GO TO NOTE 1

IF NO, GO TO NOTE 1
IF YES, D. In the last year, were there two weeks in a row when [he/
she] was grouchy or irritable almost every day?
IF NO, GO TO NOTE 1
E. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of
[LAST MONTH]]), has [he/she] often been grouchy or irritable and
in a bad mood?

NOTE 1:

WERE ANY * OR [ ] RESPONSES CODED IN Q 1 - 3?
IF YES:

ASK BOXED CONTINGENT QUESTIONS
FOR Q 4 - 22 IF CORRESPONDING STEM
QUESTION IS POSITIVE
Use first * or [ ] response coded in Q 1 - 3 as
“keyword” in [ ] when asking these questions

IF NO:

NOTE 2:

DO NOT ASK BOXED CONTINGENT
QUESTIONS

WAS THERE A * RESPONSE CODED IN Q 1 OR 3?

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 2

[5/20/98]

0=NO

4.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] lost weight?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[35]

0

2

7

9

[36]

0

2

7

9

[37]

b

[38]

IF NO, GO TO Q 5
A. Was [he/she] on a diet or trying to lose weight?
IF YES, B. In the last year, did [he/she] ever lose weight when [he/she]
wasn’t trying?
IF NO, GO TO Q 5

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:
D. You told me that in the last year there was a time when [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]. Did [he/she] lose weight
during that time?

E. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] lost weight?

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 3

0

2*# 7

9

[39]

0

2

9

[40]

7

[5/20/98]

0=NO

5.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when ________ seemed to lose [his/her] appetite or ate a lot less than usual?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[41]

A. You told me that in the last year there was a time when [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]. Did [he/she] lose [his/
her] appetite or eat a lot less during that time?

0

2*

7

9

[42]

IF YES, B. Did [he/she] seem to lose [his/her] appetite or eat less nearly
every day for two weeks or longer?

0

2#

7

9

[43]

C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] lost [his/her] appetite or eaten a lot less than usual?

0

2

7

9

[44]

In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] gained a lot of weight?

0

2

7

9

[45]

b

[46]

IF NO, GO TO Q 6

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

6.

IF NO, GO TO Q 7

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:
B. You told me that in the last year there was a time when [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]. Did [he/she] gain a lot
of weight during that time?

0

2*# 7

9

[47]

C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] gained weight?

0

2

9

[48]

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 4

7

[5/20/98]

0=NO

7.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] seemed to feel much hungrier than usual or when [he/she] ate
a lot more than usual?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[49]

A. You told me that in the last year there was a time when [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]. Was [he/she] much
hungrier or did [he/she] eat a lot more than usual during that time?

0

2*

7

9

[50]

IF YES, B. Did [he/she] seem to feel much hungrier or eat a lot more than
usual nearly every day for two weeks or longer?

0

2#

7

9

[51]

C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] seemed much hungrier or often eaten a lot more
than usual?

0

2

7

9

[52]

WAS THERE A * RESPONSE CODED IN Q 4 - 7?

0

[2]

[53]

WAS THERE A # RESPONSE CODED IN Q 4 - 7?

0

‹2›

[54]

0

2

7

9

[55]

0

2

7

9

[56]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] have
trouble sleeping during [the time [he/she] [was sad or depressed/acted like
nothing was fun/was grouchy]/that time]?

0

2*

7

9

[57]

IF YES, C. Did [he/she] have trouble sleeping nearly every night for two
weeks or longer?

0

2#

7

9

[58]

0

2

7

9

[59]

IF NO, GO TO NOTE 3

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

NOTE 3:

8.

In the last year – that is, since [NAME CURRENT MONTH] of last year – was there
a time when [he/she] had trouble sleeping – that is, trouble falling asleep, staying
asleep, or waking up too early?
IF NO, GO TO Q 9
A. When [he/she] had trouble sleeping, was that different from how [he/she]
usually sleeps?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] had trouble sleeping?

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 5

[5/20/98]

0=NO

9.

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] slept more during the day than [he/she] usually does?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[60]

A. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] sleep
more during the day during [the time [he/she] [was sad or depressed/acted
like nothing was fun/was grouchy]/that time]?

0

2*

7

9

[61]

IF YES, B. Did [he/she] sleep more during the day nearly every day for
two weeks or longer?

0

2#

7

9

[62]

C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] slept more during the day than [he/she] usually
does?

0

2

7

9

[63]

WAS THERE A * RESPONSE CODED IN Q 8 - 9?

0

[2]

[64]

WAS THERE A # RESPONSE CODED IN Q 8 - 9?

0

‹2›

[65]

0

2

7

9

[66]

0

2

7

9

[67]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] often
seem slowed down during [the time [he/she] [was sad or depressed/acted like
nothing was fun/was grouchy]/that time]?

0

2*

7

9

[68]

IF YES, C. Did [he/she] seem slowed down like this nearly every day for
two weeks or longer?

0

2#

7

9

[69]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] seemed slowed down?

0

2

7

9

[70]

IF NO, GO TO NOTE 4

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

NOTE 4:

10. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when ________ seemed to do things like walking or talking much more
slowly than usual?
IF NO, A. Did [he/she] ever say [he/she] felt slowed down?
IF NO, GO TO Q 11

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 6

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

11. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] often seemed restless … like [he/she] just had to keep walking
around?
IF NO, A.

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[71]

0

2

7

9

[72]

0

2

7

9

[73]

0

2*

7

9

[74]

0

2#

7

9

[75]

0

2

7

9

[76]

WAS THERE A * RESPONSE CODED IN Q 10 - 11?

0

[2]

[77]

WAS THERE A # RESPONSE CODED IN Q 10 - 11?

0

‹2›

[78]

Did [he/she] ever say [he/she] felt restless like this?
IF NO, GO TO NOTE 5

B. When [he/she] was restless like that, was that different from how [he/she]
usually is?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:
C. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] often
seem restless during [the time [he/she] [was sad or depressed/acted like
nothing was fun/was grouchy]/that time]?
IF YES, D. Did [he/she] seem restless like this nearly every day for two
weeks or longer?

E. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] often seemed restless?

NOTE 5:

START NEW CARD
DUP COL 1 - 12
CARD NO. 0

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 7

2
b

[13 - 14]
[15]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

12. In the last year – that is, since [NAME CURRENT MONTH] of last year – was there
a time when [he/she] seemed to have less energy than [he/she] usually does?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[16]

A. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] seem
to have less energy during [the time [he/she] [was sad or depressed/acted like
nothing was fun/was grouchy]/that time]?

0

2*

7

9

[17]

IF YES, B. Did [he/she] have less energy than usual nearly every day for
two weeks or longer?

0

2#

7

9

[18]

IF NO, GO TO Q 13

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

1
C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] had less energy than [he/she] usually does?

0

2

7

9

[19]

13. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when doing even little things seemed to make [him/her] feel really tired?

0

2

7

9

[20]

0

2

7

9

[21]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] seem
really tired during [the time [he/she] [was sad or depressed/acted like nothing
was fun/was grouchy]/that time]?

0

2*

7

9

[22]

IF YES, C. Was [he/she] really tired like this nearly every day for two
weeks or longer?

0

2#

7

9

[23]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] been really tired?

0

2

7

9

[24]

WAS THERE A * RESPONSE CODED IN Q 12 - 13?

0

[2]

[25]

WAS THERE A # RESPONSE CODED IN Q 12 - 13?

0

‹2›

[26]

IF NO, GO TO NOTE 6
A. When [he/she] was tired like this, was that different from how [he/she]
usually is?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

NOTE 6:

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 8

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

14. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] said [his/her] arms and legs felt heavy, like [he/she] was
weighed down by them?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[27]

A. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] say that
[his/her] arms and legs felt heavy during [the time [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]/that time]?

0

2

7

9

[28]

IF YES, B. Did [he/she] say [his/her] arms and legs felt heavy like this
nearly every day for two weeks or longer?

0

2

7

9

[29]

C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] said [his/her] arms and legs felt heavy?

0

2

7

9

[30]

15. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when ________ often blamed [himself/herself] for bad things that happened?

0

2

7

9

[31]

0

2

7

9

[32]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] blame
[himself/herself] like that during [the time [he/she] [was sad or depressed/
acted like nothing was fun/was grouchy]/that time]?

0

2*

7

9

[33]

IF YES, C. Did [he/she] blame [himself/herself] nearly every day for two
weeks or longer?

0

2#

7

9

[34]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] often blamed [himself/herself] for bad things that
happened?

0

2

7

9

[35]

IF NO, GO TO Q 15

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

IF NO, GO TO Q 16
A. Was that different from how [he/she] usually talked about [himself/herself]?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 9

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

16. In the last year – that is, since [NAME CURRENT MONTH] of last year – was there
a time when [he/she] said [he/she] couldn’t do anything well or that [he/she] wasn’t
as good looking or as smart as other people?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[36]

0

2

7

9

[37]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did [he/she] seem
to feel bad about [himself/herself] during [the time [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]/that time]?

0

2*

7

9

[38]

IF YES, C. Did [he/she] seem to feel like this nearly every day for two
weeks or longer?

0

2#

7

9

[39]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] seemed to feel like [he/she] couldn’t do anything
well or that [he/she] wasn’t as good looking or as smart as other people?

0

2

7

9

[40]

WAS THERE A * RESPONSE CODED IN Q 15 - 16?

0

[2]

[41]

WAS THERE A # RESPONSE CODED IN Q 15 - 16?

0

‹2›

[42]

0

2

7

9

[43]

A. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Did it seem like [he/
she] couldn’t think as clearly or as fast as usual during [the time [he/she] [was
sad or depressed/acted like nothing was fun/was grouchy]/that time]?

0

2*

7

9

[44]

IF YES, B. Did it seem like [he/she] couldn’t think as clearly or as fast as
usual nearly every day for two weeks or longer?

0

2#

7

9

[45]

C. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has it seemed like [he/she] couldn’t think as clearly or as fast as
usual?

0

2

7

9

[46]

IF NO, GO TO NOTE 7
A. When [he/she] talked about [himself/herself] in this way, was that different
from how [he/she] usually talked about [himself/herself]?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

NOTE 7:

17. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when it seemed like [he/she] couldn’t think as clearly or as fast as usual?
IF NO, GO TO Q 18

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 10

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

18. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when [he/she] often seemed to have trouble keeping [his/her] mind on ([his/
her] [schoolwork/work] or other) things?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[47]

0

2

7

9

[48]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy]). Did [he/she] often
have trouble keeping [his/her] mind on ([his/her] [schoolwork/work] or
other) things during [the time [he/she] [was sad or depressed/acted like
nothing was fun/was grouchy]/that time]?

0

2*

7

9

[49]

IF YES, C. Did [he/she] have trouble keeping [his/her] mind on [his/her]
[schoolwork/work] or other things nearly every day for two
weeks or longer?

0

2#

7

9

[50]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] often had trouble keeping [his/her] mind on ([his/
her] [schoolwork/work] or other) things?

0

2

7

9

[51]

IF NO, GO TO Q 19
A. When [he/she] had trouble keeping [his/her] mind on ([his/her] [schoolwork/
work] or other) things, was that different from how [he/she] usually is when
[he/she] is doing things?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 11

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

19. In the last year (that is, since [NAME CURRENT MONTH] of last year), was there
a time when it often seemed hard for [him/her] to make up [his/her] mind or to make
decisions?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[52]

0

2

7

9

[53]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy].) Was it hard for [him/
her] to make up [his/her] mind or to make decisions during [the time [he/she]
[was sad or depressed/acted like nothing was fun/was grouchy]/that time]?

0

2*

7

9

[54]

IF YES, C. Was it hard for [him/her] to make up [his/her] mind or to make
decisions nearly every day for two weeks or longer?

0

2#

7

9

[55]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has it often been hard for [him/her] to make up [his/her] mind
or to make decisions?

0

2

7

9

[56]

WAS THERE A * RESPONSE CODED IN Q 17 - 19?

0

[2]

[57]

WAS THERE A # RESPONSE CODED IN Q 17 - 19?

0

‹2›

[58]

0

2

7

9

[59]

0

2

7

9

[60]

B. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy]). Did [he/she] think
a lot about death or dying during [the time [he/she] [was sad or depressed/
acted like nothing was fun/was grouchy]/that time]?

0

2*

7

9

[61]

IF YES, C. Did [he/she] think about death or dying nearly every day for
two weeks or longer?

0

2#

7

9

[62]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), has [he/she] often thought about death or about people who have
died or about being dead [himself/herself]?

0

2

7

9

[63]

IF NO, GO TO NOTE 8
A. When it was hard for [him/her] to make up [his/her] mind or to make
decisions, was that different from how [he/she] usually is?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

NOTE 8:

20. In the last year – that is, since [NAME CURRENT MONTH] of last year – was there
a time when ________ said [he/she] often thought about death or about people who
had died or about being dead [himself/herself]?
IF NO, GO TO Q 21
A. Did [he/she] talk about death or dying a lot more than [he/she] usually does?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 12

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

21. In the last year, (that is since [NAME CURRENT MONTH] of last year), did
[he/she] ever talk seriously about killing [himself/herself]?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[64]

A. Did [he/she] say [he/she] thought about killing [himself/herself] many times
in the last year?

0

2

7

9

[65]

B. In the last year, did [he/she] say that [he/she] had a plan for exactly how
[he/she] would kill [himself/herself]?

0

2

7

9

[66]

C. (You told me that in the last year there was a time when [he/she] [was sad
or depressed/acted like nothing was fun/was grouchy]). Did [he/she] say [he/
she] thought about suicide during [the time [he/she] [was sad or depressed/
acted like nothing was fun/was grouchy]/that time]?

0

2*# 7

9

[67]

D. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the end of [LAST
MONTH]]), did [he/she] ever talk seriously about killing [himself/herself]?

0

2

7

9

[68]

IF YES, E. Did [he/she] say [he/she] thought about killing [himself/herself] many times in the last four weeks?

0

2

7

9

[69]

F. Did [he/she] say that [he/she] had a plan for exactly how [he/
she] would kill [himself/herself]?

0

2

7

9

[70]

IF NO, GO TO Q 22

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

START NEW CARD
DUP COL 1 - 12
CARD NO. 0
Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 13

3
b

[13 - 14]
[15]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

22. For the next question, I would like you to think about [his/her] whole life.
Has [he/she] ever, in [his/her] whole life, tried to kill [himself/herself] or made a
suicide attempt?

0

2

7

9

[16]

IF NO, GO TO NOTE 9
A. How many times has [he/she] tried to kill [himself/herself]?
CODE NUMBER OF TIMES ------------------------------------------------>
B. Now thinking about the whole last year – that is, since [[NAME EVENT]/
[NAME CURRENT MONTH] of last year] – has [he/she] tried to kill
[himself/herself]?

|____ ____|
0

2

[17-18]
7

9

[19]

IF YES, C. How many times did [he/she] try to kill [himself/herself] in the
last year?
CODE NUMBER OF TIMES -------------------------------->

|____ ____|

[20-21]

|____ ____|

[22-23]

D. How did [he/she] try to kill [himself/herself] (the last time [he/
she] tried)? What did [he/she] do?

0

2

7

9

[24]

F. You told me earlier that in the last year there was a time when
[he/she] [was sad or depressed/acted like nothing was fun/was
grouchy]. Did [he/she] try to kill [himself/herself] during that
time?

0

2*# 7

9

[25]

G. Now, what about the last four weeks?
(Since [[NAME EVENT]//the beginning of/the middle of/the
end of [LAST MONTH]]), has [he/she] tried to kill [himself/
herself]?

0

2

9

[26]

WAS THERE A * RESPONSE CODED IN Q 20 - 22?

0

[2]

[27]

WAS THERE A # RESPONSE CODED IN Q 20 - 22?

0

‹2›

[28]

E. Did [he/she] go to see a doctor, go to an emergency room, or
go into the hospital because of trying to kill [himself/herself]?

IF A * OR [ ] RESPONSE WAS CODED IN Q 1 - 3, ASK:

NOTE 9:

7

b

NOTE 10: WERE THREE OR MORE [ ] RESPONSES CODED IN Q 2
AND NOTES 2 - 9?
IF YES:
IF NO:
Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

0

2

[29]

[30]

CONTINUE
GO TO Q 35, P. 21

Page 14

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

23. You said that in the last year there was a time when [he/she] [was sad or depressed/
acted like nothing was fun/was grouchy] and that during that time [he/she] also
[NAME [ ] SYMPTOMS IN NOTES 3 - 9].
How old was [he/she] the first time [he/she] ever was like that?
CODE AGE (66 = WHOLE LIFE, ALWAYS) ---------------------------------->
IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE ------------------------------------------------------------------------->
(44 = PRE-K, 55 = KINDERGARTEN, 13 = COLLEGE FRESHMAN,
14 = SOPHOMORE, 15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.)
a:

|____ ____| YRS.

[31-32]

|____ ____| GRADE

[33-34]

IF [AGE/GRADE] GIVEN WAS CHILD’S CURRENT
[AGE/GRADE], GO TO Q 24
IF [AGE/GRADE] GIVEN WAS CHILD’S CURRENT
[AGE/GRADE] MINUS ONE, GO TO A
ALL OTHERS, GO TO B

A. Was that more than a year ago – that is, before [NAME CURRENT
MONTH] of last year?

0

2

7

9

[35]

0

2

7

9

[36]

0

2

7

9

[37]

IF NO, GO TO Q 24
B. Since that first time, was there ever a time when [he/she] was not [sad
or depressed/acting like nothing was fun/grouchy]?
IF NO, GO TO Q 24
C. Did that time when [he/she] wasn’t [sad or depressed/acting like
nothing was fun/grouchy] last for two months or more?
IF NO, GO TO Q 24
D. You said that [he/she] [was sad or depressed/acted like nothing was
fun/was grouchy] in the last year. How old was [he/she] when these
feelings began this time?
CODE AGE (88 = NEVER STARTED AGAIN) ---------------->

|____ ____| YRS.

[38-39]

IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE (44 = PRE-K, 55 = KINDERGARTEN,
13 = COLLEGE FRESHMAN, 14 = SOPHOMORE,
15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.
88 = NEVER STARTED AGAIN) ---------------------------------->

|____ ____| GRADE

[40-41]

b:

IF [AGE/GRADE] GIVEN IS CURRENT
[AGE/GRADE] MINUS ONE, GO TO E
ALL OTHERS, GO TO Q 24

E. Did [he/she] start to [be sad or depressed/act like
nothing was fun/be grouchy] again more than a year
ago – that is, before [NAME CURRENT MONTH] of
last year?
Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 15

0

2

7

9

[42]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

24. You told me that in the last year ________ had problems with [being sad or
depressed/acting like nothing was fun/being grouchy].
Did [he/she] start acting this way soon after someone [he/she] was close to died?

0

2

7

9

[43]

IF YES, A. Who died?
|____ ____|

[44-45]

|____ ____|____ ____|

[46-49]

B. When did [he/she/they] die?
(RECORD MONTH AND YEAR:)

C. After [NAME PERSON IN A] died, was [he/she] [sad or depressed/
acting like nothing was fun/grouchy] for two months or longer?

0

2

7

9

[50]

IF NO, D. Was [he/she] ever [sad or depressed/acting like nothing
was fun/grouchy] before [NAME PERSON IN A]
died?

0

2

7

9

[51]

IF YES, E. Was that in the last year?

0

2

7

9

[52]

0

2

7

9

[53]

IF YES, F. When [he/she] [was sad or
depressed/acted like nothing was fun/was grouchy]
that time, did it last for two
weeks or longer?

c:

IF ONSET (USING AGE OR GRADE) NAMED IN Q 23 WAS
LESS THAN 2 YEARS AGO, GO TO Q 26, P. 18
ALL OTHERS, CONTINUE

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 16

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

25. In the last two years, did [he/she] [become sad or depressed/start acting like nothing
was fun/become grouchy], and then get better and then [become sad or depressed/
start acting like nothing was fun/become grouchy] again?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[54]

0

2

7

9

[55]

0

2

7

9

[56]

C. Did [he/she] stay [sad or depressed/acting like nothing was
fun/grouchy] until Spring or Summer?

0

2

7

9

[57]

D. Did [he/she] start to get better in Spring or Summer?

0

2

7

9

[58]

E. Did [he/she] ever get very hyper or excited in Spring or
Summer?

0

2

7

9

[59]

F. In the last two years, did [he/she] ever [become sad or depressed/start acting like nothing was fun/become grouchy] at
other times of the year, say in Spring or Summer?

0

2

7

9

[60]

0

2

7

9

[61]

0

2

7

9

[62]

IF YES, I. Did [he/she] stay [sad or depressed/acting like
nothing was fun/grouchy] until Fall or Winter?

0

2

7

9

[63]

J. Did [he/she] start to get better in the Fall or
Winter?

0

2

7

9

[64]

K. Did [he/she] ever get very hyper or excited in Fall
and Winter?

0

2

7

9

[65]

L. In the last two years, did [he/she] [become sad or
depressed/start acting like nothing was fun/become grouchy] at any other times of the year, say
in Fall or Winter?

0

2

7

9

[66]

M. Did these times ever last for as long as two weeks
or more?

0

2

7

9

[67]

IF NO, GO TO Q 26
A. Did [he/she] start to [become sad or depressed/act like nothing was fun/
become grouchy] around the same time each year?
IF YES, B. Was this in Winter or Fall?
IF NO, GO TO H

IF NO, GO TO Q 26
G. Did these times ever last for as long as two weeks or more?
GO TO Q 26
H. Was this in Spring or Summer?

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 17

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

26. You said that in the last year ________ [was sad or depressed/acted like nothing
was fun/was grouchy] and [he/she] also [NAME [ ] SYMPTOMS IN NOTES 3 9].
Now I’d like you to think back to the time in the last year when feeling this way
caused the most problems.
At that time, did [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]]
get annoyed or upset with [him/her] because [he/she] was [being sad or depressed/
acting like nothing was fun/being grouchy]?

0

1

2

7

9

[68]

IF YES, A. How often did [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] get annoyed or upset with [him/her] because [he/she] was
this way? Would you say: a lot of the time, some of the time, or hardly
ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
27. At that time, did [being sad or depressed/acting like nothing was fun/being
grouchy] keep [him/her] from doing things or going places with [you (or [his/her]
family)/[his/her] family]?

3
2
1
7
9
0

[69]

1

2

7

9

[70]

IF YES, A. How often did being this way keep [him/her] from doing things or
going places with [you (or [his/her] family)/[his/her] family]? Would
you say: a lot of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
28. At that time, did [being sad or depressed/acting like nothing was fun/being
grouchy] keep [him/her] from doing things or going places with other [children/
people [his/her] age]?

3
2
1
7
9
0

[71]

1

2

7

9

[72]

IF YES, A. How often did being this way keep [him/her] from doing things or
going places with other [children/people [his/her] age]? Would you
say: a lot of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................

d:

IF CHILD DID NOT ATTEND SCHOOL OR WORK IN LAST
YEAR, CODE “8” IN Q 29 AND Q 30, THEN GO TO Q 31

3
2
1
7
9

[73]

START NEW CARD
DUP COL 1 - 12
CARD NO. 0

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 18

4
b

[13 - 14]
[15]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

29. When the problems were worst, did [being sad or depressed/acting like nothing was
fun/being grouchy] [make it difficult for [him/her] to do [his/her] schoolwork or
cause problems with [his/her] grades/make it difficult for [him/her] to do [his/her]
work]?

8, 88=NOT APPLICABLE

0

1

2

7

9, 99=DON’T KNOW

8

9

[16]

IF YES, A. How bad were the problems [he/she] had with [his/her] [schoolwork/
work] because [he/she] was this way? Would you say: very bad, bad,
or not too bad?
Very bad ..........................................................................................
Bad ..................................................................................................
Not too bad ......................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
30. At that time, did [being sad or depressed/acting like nothing was fun/being
grouchy], cause [his/her] [teachers/boss] to be annoyed or upset with [him/her] ?

3
2
1
7
9
0

[17]

1

2

7

8

9

[18]

IF YES, A. How often [were/was] [his/her] [teachers/boss] annoyed or upset
with [him/her] because [he/she] was this way? Would you say: a lot
of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
31. When the problems were worst, did [being sad or depressed/acting like nothing was
fun/being grouchy] seem to make [him/her] feel bad or seem to make [him/her] feel
upset?

3
2
1
7
9
0

[19]

1

2

7

9

[20]

IF YES, A. How bad did this seem to make [him/her] feel? Would you say: very
bad, bad, or not too bad?
Very bad ..........................................................................................
Bad ..................................................................................................
Not too bad ......................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
32. In the last year – that is, since [NAME CURRENT MONTH] of last year – has
[he/she] been to see someone at a hospital or a clinic or at their office because
[he/she] was [sad or depressed/acting like nothing was fun/grouchy]?

3
2
1
7
9

[21]

0

2

7

9

[22]

0

2

7

9

[23]

IF YES, GO TO OPTIONAL DETAILS, NEXT PAGE
IF NO, A. Does [he/she] have an appointment set up to see someone because
[he/she] is this way?
IF YES, GO TO OPTIONAL DETAILS, NEXT PAGE

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 19

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

OPTIONAL DETAILS:
33.

Who [did ________ see/is ________ going to see]? (WRITE IN:)
Name:

|____ ____|

[24-25]

|____ ____|

[26-27]

Profession:
Address:

A. What did the person [he/she] saw say was the matter?

e:

IF CHILD IS AGE 7 OR OLDER, CONTINUE
ALL OTHERS, GO TO Q 35

Whole Life Screen
34. You told me that in the last year [he/she] seemed [sad or depressed/like nothing was
fun/grouchy] and [he/she] also [NAME [ ] SYMPTOMS IN NOTES 3 - 9].
Now I want you to think back to before the last year … since the time [he/she] turned
five years old up until the last twelve months.
(INTERVIEWER: point out age five on whole life chart.)
Since [he/she] turned five years old, was there ever a time when [he/she] seemed
more [sad or depressed/like nothing was fun/grouchy] than [he/she] has in the last
year?

0

2

7

9

[28]

IF YES, A. How old was [he/she] when feeling this way was worse than in the last
year?
(INTERVIEWER: IF MORE THAN ONE YEAR IS REPORTED,
ASK: “During which single year of age was [he/she] the worst?” IF
MORE THAN ONE YEAR STILL REPORTED, ENTER YOUNGEST
AGE.)
CODE AGE ------------------------------------------------------------------------------>
IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE ------------------------------------------------------------------------->
(44 = PRE-K, 55 = KINDERGARTEN, 13 = COLLEGE FRESHMAN,
14 = SOPHOMORE, 15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.)

f:

|____ ____|

[29-30]

|____ ____|

[31-32]

IF FIVE OR MORE ‹ › RESPONSES WERE CODED
IN Q 2 AND NOTES 2 - 9, GO TO Q 60, P. 27
ALL OTHERS, CONTINUE

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 20

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

START NEW CARD
DUP COL 1 - 12
CARD NO. 0

DD

5
b

[13 - 14]
[15]

35. During the last year – that is, since [[NAME EVENT]/[NAME CURRENT
MONTH] of last year] – has there been a time when ________ seemed sad or
depressed a lot of the time?

0

2

7

9

[16]

IF YES, A. Has [he/she] seemed sad or depressed for at least a whole year – that
is, for twelve months or longer?

0

2

7

9

[17]

IF YES, B. During these twelve months, were there more days
when [he/she] seemed sad or depressed than days when
[he/she] felt okay?

0

2*

7

9

[18]

IF YES, C. Did [he/she] seem this way for as long as
two years?

0

2

7

9

[19]

D. On the days when [he/she] seemed sad or depressed,
would you say [he/she] was like this for most of the
day?

0

2

7

9

[20]

E. When [he/she] was sad or depressed, did [he/she] seem
to feel better if something good happened or was about
to happen to [him/her]?

0

2

7

9

[21]

F. Has [he/she] seemed sad or depressed like this in the
last four weeks – that is, since [[NAME EVENT]//the
beginning of/the middle of/the end of [LAST
MONTH]]?

0

2

7

9

[22]

36. During the last year – that is, since [NAME CURRENT MONTH] of last year – has
there been a time when [he/she] was grouchy or irritable a lot of the time?

0

2

7

9

[23]

IF YES, A. Has [he/she] been grouchy or irritable for at least a whole year – that
is, for twelve months or longer?

0

2

7

9

[24]

IF YES, B. During those twelve months, were there more days
when [he/she] was grouchy or irritable than days when
[he/she] felt okay?

0

2*

7

9

[25]

IF YES, C. Did [he/she] feel this way for as long as
two years?

0

2

7

9

[26]

D. On the days when [he/she] was grouchy or irritable,
would you say that [he/she] was like that for most of the
day?

0

2

7

9

[27]

E. Has [he/she] been grouchy or irritable like that in the
last four weeks – that is, since [[NAME EVENT]//the
beginning of/the middle of/the end of [LAST
MONTH]]?

0

2

7

9

[28]

g:

IF A * RESPONSE WAS CODED IN Q 35B, GO TO Q 37
ALL OTHERS, CONTINUE

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 21

[5/20/98]

0=NO

h:

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

IF A * RESPONSE WAS CODED IN Q 36B, CONTINUE
ALL OTHERS, GO TO MAN/HYPOMAN, P. 29

37. You just said that there were twelve months when [he/she] seemed [sad or
depressed/grouchy or irritable] most of the time. Now I want to ask you about some
other things that may happen when [he/she] seems this way.
When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] eat less or
lose [his/her] appetite?

0

[1]

[2]

7

9

[29]

IF NO, A. When [he/she] is [sad or depressed/grouchy or irritable], does [he/
she] seem to feel more hungry or eat too much?

0

[1]

[2]

7

9

[30]

38. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] have trouble
falling asleep or does [he/she] wake up too early?

0

[1]

[2]

7

9

[31]

IF NO, A. When [he/she] is [sad or depressed/grouchy or irritable], does [he/
she] sleep too much?

0

[1]

[2]

7

9

[32]

39. When ________ is [sad or depressed/grouchy or irritable], does it seem like [he/
she] doesn’t have any energy and that it takes a big effort to do anything?

0

[1]

[2]

7

9

[33]

40. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] say that [he/
she] is no good at anything or that other people don’t like [him/her]?

0

[1]

[2]

7

9

[34]

41. When [he/she] is [sad or depressed/grouchy or irritable], does it seem to be more
difficult for [him/her] to pay attention to [his/her] [schoolwork/work] or to other
things [he/she] does?

0

[1]

[2]

7

9

[35]

IF NO, A. When [he/she] is [sad or depressed/grouchy or irritable], does it seem
like it is more difficult for [him/her] to make up [his/her] mind or to
make decisions?

0

[1]

[2]

7

9

[36]

42. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] say that life
is hopeless or that [he/she] feels full of despair?

0

[1]

[2]

7

9

[37]

IF NO, A. When [he/she] is [sad or depressed/grouchy or irritable], does [he/
she] say [he/she] feels like nothing good is ever going to happen to
[him/her]?

0

[1]

[2]

7

9

[38]

43. When [he/she] is [sad or depressed/grouchy or irritable], is [he/she] often tearful,
or does it seem like [he/she] is about to cry?

0

[1]

[2]

7

9

[39]

44. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] act like
nothing is fun for [him/her], even things [he/she] usually enjoys?

0

[1]

[2]

7

9

[40]

45. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] seem bored
or just not interested in anything?

0

[1]

[2]

7

9

[41]

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 22

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

46. When [he/she] is [sad or depressed/grouchy or irritable], does it seem hard for [him/
her] to do ordinary, everyday things?

0

[1]

[2]

7

9

[42]

47. When ________ is [sad or depressed/grouchy or irritable], does [he/she] talk a lot
about bad things that happened to [him/her] in the past?

0

[1]

[2]

7

9

[43]

48. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] say [he/she]
wants to be alone or away from other people?

0

[1]

[2]

7

9

[44]

49. When [he/she] is [sad or depressed/grouchy or irritable], does [he/she] talk a lot
less?

0

[1]

[2]

7

9

[45]

i:

IF 1 OR MORE [ ] RESPONSES WERE CODED IN
Q 37 - 49, CONTINUE
ALL OTHERS, GO TO MAN/HYPOMAN, P. 29

50. You have just told me that [he/she] has been [sad or depressed/grouchy or irritable] a
lot of the time for at least twelve months, and that when [he/she] is [sad or depressed/
grouchy or irritable] [he/she] also [NAME [ ] SYMPTOMS IN Q 37 - 49].
During those twelve months, were there times that [he/she] seemed better, more
like [his/her] normal self again?

0

2

7

9

[46]

IF YES, A. Did [he/she] seem better or more like [his/her] normal self for two
months in a row or longer?

0

2

7

9

[47]

IF YES, GO TO MAN/HYPOMAN, P. 29
51. Thinking about [his/her] whole life, how old was [he/she] the first time [he/she] had
twelve months of being [sad or depressed/grouchy or irritable] most of the time?
CODE AGE (66 = WHOLE LIFE, ALWAYS) ----------------------------------->
IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE ------------------------------------------------------------------------->
(44 = PRE-K, 55 = KINDERGARTEN, 13 = COLLEGE FRESHMAN,
14 = SOPHOMORE, 15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.)

j:

|____ ____| YRS.

[48-49]

|____ ____| GRADE

[50-51]

IF [AGE/GRADE] GIVEN WAS CHILD’S CURRENT
[AGE/GRADE], GO TO INSTRUCTION BOX “l”
IF [AGE/GRADE] GIVEN WAS CHILD’S CURRENT
[AGE/GRADE] MINUS ONE, GO TO A
ALL OTHERS, GO TO B

A. Was that more than a year ago – that is, before [NAME CURRENT
MONTH] of last year?

0

2

7

9

[52]

IF NO, GO TO INSTRUCTION BOX “l”
Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 23

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

B. Since that first time, was there ever a time when these feelings of
being [sad or depressed/grouchy or irritable] went away completely?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[53]

0

2

7

9

[54]

IF NO, GO TO INSTRUCTION BOX “l”
C. Did these times of being [sad or depressed/grouchy or irritable] go
away completely for two months in a row or longer?
IF NO, GO TO INSTRUCTION BOX “l”
D. You said [he/she] was [sad or depressed/grouchy or irritable] and [he/
she] [NAME [ ] SYMPTOMS IN Q 37 - 49] in the last year.
How old was [he/she] when these feelings began this time?
CODE AGE (88 = NEVER STARTED AGAIN) ---------------->

|____ ____| YRS.

[55-56]

IF AGE NOT KNOWN, ASK: What grade was [he/she] in?
CODE GRADE (44 = PRE-K, 55 = KINDERGARTEN,
13 = COLLEGE FRESHMAN, 14 = SOPHOMORE,
15 = JUNIOR, 16 = SENIOR, 17 = POST B.A.
88 = NEVER STARTED AGAIN) ---------------------------------->

|____ ____| GRADE

[57-58]

k:

IF [AGE/GRADE] GIVEN WAS CHILD’S
CURRENT [AGE/GRADE] MINUS ONE, GO TO E
ALL OTHERS, GO TO INSTRUCTION BOX “l”

E. Did [he/she] start to be [sad or depressed/grouchy or irritable] again
more than a year ago – that is, before [NAME CURRENT MONTH]
of last year?

l:

0

2

7

9

[59]

IF THREE OR MORE [ ] RESPONSES WERE CODED IN Q 2
AND NOTES 2 - 9 IN MDD (see tally sheet) (i.e. impairment and
treatment history (Q 26 - 33) were asked),
GO TO Q 60, P. 27
ALL OTHERS, CONTINUE

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 24

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

52. You said that in the last year [he/she] was [sad or depressed/grouchy or irritable]
and [he/she] [NAME [ ] SYMPTOMS IN Q 37 - 49].
Now, I’d like you to think back to the time in the last year when feeling this way
caused the most problems.
At that time, did [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]]
get annoyed or upset with [him/her] because [he/she] was [sad or depressed/
grouchy or irritable]?

0

1

2

7

9

[60]

IF YES, A. How often did [you (or [his/her] [CARETAKERS])/[his/her] [CARETAKERS]] get annoyed or upset with [him/her] because [he/she] was
this way? Would you say: a lot of the time, some of the time, or hardly
ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
53. At that time, did being [sad or depressed/grouchy or irritable] keep [him/her] from
doing things or going places with [you (or [his/her] family)/[his/her] family]?

3
2
1
7
9
0

[61]

1

2

7

9

[62]

IF YES, A. How often did feeling this way keep [him/her] from doing things or
going places with [you (or [his/her] family)/[his/her] family]? Would
you say: a lot of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
54. At that time, did being [sad or depressed/grouchy or irritable] keep [him/her] from
doing things or going places with other [children/people [his/her] age]?

3
2
1
7
9
0

[63]

1

2

7

9

[64]

IF YES, A. How often did being this way keep [him/her] from doing things or
going places with other [children/people [his/her] age]? Would you
say: a lot of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................

m:

3
2
1
7
9

[65]

IF CHILD DID NOT ATTEND SCHOOL OR WORK IN LAST
YEAR, CODE “8” IN Q 55 AND Q 56,THEN GO TO Q 57

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 25

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

55. When the problems were worst, did being [sad or depressed/grouchy or irritable]
[make it difficult for [him/her] to do [his/her] schoolwork or cause problems with
[his/her] grades/make it difficult for [him/her] to do [his/her] work]?

8, 88=NOT APPLICABLE

0

1

2

7

9, 99=DON’T KNOW

8

9

[66]

IF YES, A. How bad were the problems with [his/her] [schoolwork/work]?
Would you say: very bad, bad, or not too bad?
Very bad ..........................................................................................
Bad ..................................................................................................
Not too bad ......................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
56. At that time, did being [sad or depressed/grouchy or irritable] cause [his/her]
[teachers/boss] to be annoyed or upset with [him/her]?

3
2
1
7
9
0

[67]

1

2

7

8

9

[68]

IF YES, A. How often [were/was] [his/her] [teachers/boss] annoyed or upset
with [him/her] because [he/she] was this way? Would you say: a lot
of the time, some of the time, or hardly ever?
A lot of the time ..............................................................................
Some of the time .............................................................................
Hardly ever .....................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................
57. When the problems were worst, did being [sad or depressed/grouchy or irritable]
seem to make [him/her] feel bad or seem to make [him/her] feel upset?

3
2
1
7
9
0

[69]

1

2

7

9

[70]

IF YES, A. How bad did this seem to make [him/her] feel? Would you say: very
bad, bad, or not too bad?
Very bad ..........................................................................................
Bad ..................................................................................................
Not too bad ......................................................................................
Refuse to answer .............................................................................
Don’t know .....................................................................................

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 26

3
2
1
7
9

[71]

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

58. In the last year – that is, since [NAME CURRENT MONTH] of last year – has
[he/she] been to see someone at a hospital or a clinic or at their office because
[he/she] was [sad or depressed/grouchy or irritable]?

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

0

2

7

9

[72]

0

2

7

9

[73]

IF YES, GO TO OPTIONAL DETAILS
IF NO, A. Does [he/she] have an appointment set up to see someone because
[he/she] is this way?
IF YES, GO TO OPTIONAL DETAILS

START NEW CARD
DUP COL 1 - 12
CARD NO. 0

6
b

[13 - 14]
[15]

OPTIONAL DETAILS:
59.

Who [did ________ see /is ________ going to see]? (WRITE IN:)
Name:

|____ ____|

[16-17]

|____ ____|

[18-19]

Profession:
Address:

A. IF SOMEONE WAS SEEN, ASK:
What did the person [he/she] saw say was the matter?

60. Some people feel very hurt if they are not invited to a party or if they are left off a
team or a project.
Does [he/she] seem to feel very bad or get upset if [he/she] is left out of something?

0

2

7

9

[20]

IF YES, A. Does [he/she] seem to stay feeling upset for more than a day?

0

2

7

9

[21]

0

2

7

9

[22]

0

2

7

9

[23]

B. Has [he/she] ever dropped a friend completely because they left
[him/her] out of something?
IF YES, C. Has that happened with more than two friends?

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 27

[5/20/98]

0=NO

1=SOMETIMES/SOMEWHAT

2=YES

7, 77=REFUSE TO ANSWER

8, 88=NOT APPLICABLE

9, 99=DON’T KNOW

INTENTIONALLY LEFT BLANK

Module C: Mood Disorders
Major Depression/Dysthymic Disorder
DISC IV-P, past year

Page 28

[5/20/98]