Cognitive deficits in Depression

AGE A. 20-30 Yrs

B. 31-40 Yrs
C. 41-50Yrs

SEX A. MALE B. FEMALE

EDUCATIONAL STATUS A. LOW ILLITERATE

B. JUST LITERATE (READ AND WRITE WITHOUT SCHOOL1NC
C MIDDLE PRIMARY/MIDDLE/HIGH SCHOOL
D. HIGH COLLEGE, TECHNICAL SCHOOL/COLLEGE

OCCUPATIONAL STATUS A. LOW LAND/BUSINESS HOLDER (SMALL)

B. MIDDLE SKILLED WORKER/CLERICAL WORKER/
(MEDIUM)
•
C.HIGH PHYSICIAN/LAWYER/MANAGER/BANKER

HOUSING A. LOW >4 PERSONS / LIVING ROOM

B. MIDDLE 2-4 PERSONS / LIVING ROOM
C. HIGH <2 PERSONS / LIVING ROOM

NCOME STATUS A. UPPER INCOME > RS. 1800 AND ABOVE

PER CAPITA MONTHLY) B. MIDDLE INCOME RS. 900-RS.1799
RS. 500-RS. 899
C. LOWER INCOME RS. 270-RS.539
BELOW RS. 270

4ARITAL STATUS A. SINGLE ......................

B. MARRIED
C. REMARRIED
D. SEPARATED/DIVORCED/WIDOWED

ELIGION A. HINDU
B. MUSLIM
C. CHRISTIAN

0MICILE A. URBAN
B. RURAL
C. SEMI-URBAN
• AMILY TYPE A. JOINT
B. NUCLEAR
DIAGNOSIS BY DSM-IV
A. MAJOR DEPRESSIVE DISORDER, SINGLE EPISODE
B. MAJOR DEPRESSIVE DISORDER, RECURRENT
C. DYSTHYMIC DISORDER
D. DEPRESSIVE DISORDER NOS

DURATION f

A ONE YEAR.
B.TWO YEAR
C.THREE YEAR
E. MORE THAN THREE YEAR

IAMELTON RATING SCALE FOR DEPRESSION

GI BATTERY FOR BRAIN DYSFUNCTON

Score
REATMENT RECEIVED
A. PSYCHOTHOCAPY
B. PHARMACOTHERAPY
C. COMBINATION

'JRATION
A.6 MONTH
B.ONE YEAR
C.TWO YEAR
D.THREE YEAR
E. MORE THAN THREE YEAR.
 HAMILTON DEPRESSION RATING SCALE
1) Depressed Mood (Sadness, Hopeless, Helpless, Worthless)
0:- Absent­
ia These feeling states only on questioning.
2:- These feeling states spontaneously reported verbally.
3Communicates feeling states nonverbally - Le. through fecial expression,
posture, voice & tendency to weep.
4:- Patient reports VIRTUALLY ONLY these feeling states in his spontaneous
verbal and nonverbal communication.

2) Feelings of Guilt-

0:- Absent

1. Selfreproach feels he has let people down.

2. Ideas ofguilt or rumination over past errors or sinful deeds..
3. Present illness is a punishment. Delusions ofguilt.
.4. Hears accusatory or denunciatory, voices and/or experiences threatening visual
hallucinations.

3. SUICWE

0. Absent
1. Feels life is not worth living.
2. Wishes he were dead or any thoughts ofpossible death to self.
3. Suicide ideas or gesture.
4. Attempts at suicide (any serious attempt rates 4)

4. Insomnia Early :

0. No difficulty felling asleep.

1. Complains ofoccasional difficulty felling asleep,

ie. more than 14 hour.
2. Complains ofnightly difficulty felling asleep.

5. Insomnia Middle

0. No difficulty.

1. Patient complains ofbeing restless and disturbed during the night.

2. Waking during the night - any getting out ofbed rates 2 except for purpose of
voiding.
6. Insomnia late.

0. No difficulty

1. Waking in early hours ofthe morning but goes back to sleep.

2. Unable to fell asleep again ifgets out ofbed.

7. Work And Activities :

0. No difficulty

1. Thoughts and feeling of incapacity, fetigue or weakness related to activities, work or

hobbies.

2. Loss ofinterest in activity, hobies or work either directly reported by patient or indirect
in listlessness, indecesion and variation (feels he has to push self to work or activities)

3. Decrease in actual time spent in activities or decrease in productivity. In ho spitaL, rate 3

patient does not spend at least 3 hours'a day in activities (hospital job or hobbies)
exclusive ofward chores. —

4. Stopped working because ofpresent illness. Inhospital, rate 4 ifpatient engages in no

activities exceptward chores, or ifpatient fells to perform ward chores unassisted.

8. Retardation (Slowness of thought and speech, impaired ability to

concentrate, decreased motor activity)

0. Normal speech & thought.

1. Slight retardation at interview
2. Obvious retardation at interview.
3. Interview Difficult
4. Complete stupor.

9. AGITATION

0. None

1. “Playing with” hand, hair, etc.

2. Hand- wringing, nail biting, hair pulling, biting oflips.

10. Anxiety Psychic.

0. No Difficulty

1. Subjective Tension and Irritability.

2. Worrying about minor matters.
3. Apprehensive attitude apparent in face or speech.
4. Fears experessed without questioning.

11. Anxiety Somatic

0. Absent Physiological Concomitants of

1. Mild anxiety such as:
2. Moderate Gastro Intestinal-drymouth, wind,
indigestion, diarrhea, cramps, belching
3. Severe cardio vascular- Palpitation, headaches
4. Incapacitating Respiratory- hyper ventilation, sighing, frequent urination/
urinary frquency, sweating.

12. Somatic Symptoms Gastro Intenstinal

0. None
1. Loss ofappetite but eating with staffencouragement Heavy feelings in abdomen

2. Difficulty eating without stafiurging. Requests or requires laxatives or medication for

bowels or medfcatkrafbr G J. symptoms.

13. Somatie shymptoms general:

0. None , "

1. Heaviness in limbs, back or head, backaches, headaches, muscle aches, loss of energey
and fatigability.

2. Any clear cut shymptom rates ?

14. Genital symptoms :

0. Absent Loss of libido

1. , Mild Menstrual disturbances.
2. Severe.
25. Hypochodriasis:

0. Not Present

1. Self-Absorption
2. Preoccupation with health.
3. Frequent complaints, requests for help etc.
4. Hypochondriacal Delusions.

16. Loss of Weight:

A- When Rating by History

0. No weight toss
1. Probable weight toss associated with present illness.
2. Definite weight toss (according to patient)
B. On weekly ratings by ward psychiatrist, when actual weight changes are measured.
0. Less than lib weight toss in week.
1. Greater than 1 lb weight toss in week.
2. Greater than 2 lb weight toss in week.

27. Insight:

" 0. Acknowledges being depressed & ill

1. Acknowledges illness but attributes cause to badfood, climate, overwork, virus, need for
rest etc.
2. Denies being ill at all

18. Divmal variation :

AM PM.
0 Mild 0 Ifsymptoms are worse in the morning
1 Modecate 1 or evening, note which it is and rate
2 Severe 2 severity ofvariation.

19. Depersonalization and Derealization.

0. Absent Such as:

1. Mild
2. Moderate Feeling ofunreality
3. Severe Nihilistic Ideas
4. Incapacitaing.

20. Paranoid symptoms:

0. None
* * Suspiciousness

3. Ideas ofreference
4. Delusion ofreference & persecution.
21. Obsessional and compulsive symptom:

0. Absent
1. MDd
2. Severe

22. Helplessness:

0. Not present
1. Subjective feelings which are elicited only by inquiry.
2. Patient volunteers his helpless feelings.
3. Requires urging, guidance and reassurance to accomplish ward chores or personal
hygiene.
4. Requires physical assistance for dress, grooming, eating, bedside tasks or personal
hygiene.

23. Hopelessness:

0. Not present
1. Intermittently doubts that “things will improve” but can be reassured.
2. Consistently feels “hopeless” but accepts reassurances.
3. Expresses feelings ofdiscouragement, despair, pessimism about future, which can not
be dispelled,
4. Spontaneously and inappropriately perseverates “I “II never get well” or its equivalent.

24. Worthlessness (Rangesfrom mild loss of esteem, feelings of inferiority,

self-depreciation, to delusional notions of worthlessness)

0. .Not present/ ’ ~~
1. Indicates feelings ofworthlessness (loss ofself-esteem) only on questioning.
2. Spontaneously indicates feelings ofworthlessness (loss of self- esteem)
3. Different from 2 by degreee. Patient volunteers that he is “no good”, “inferior” etc.
4. Delusional notions ofworthlessness-Le., “I am a heap ofgarbage or its equivalent)
 Response Sheet
of

Jwarka Pershad (Chandigarh)

PGI—BBD
(English Version)
>. K. Verma (Chandigarh)

Dlease fill up the following informations :■

Name.....................................................................
Age....................................................................... Sex...
Education.............................................................Date,

, No. Test Variables----- Dysfunction Rating Score

Sub-tests | , 3 2 o'

1. Remote Memory 0-2 3-4 5+

2. Recent Memory 0-2 3—A 5+
3. Mental Balance 0-2 3-4 5+
4. Attention and Concentration 0-2 3—4 5+
5. Delayed Recall 0-2 3—4 5+
6. Immediate Recall 0-2 3-4 5+
7. Retention for Simitar Pairs 0-2 3-4 . 5+
8. Retention for Dissimilar Pairs 0-2 3-4 5+
9. Visual Retention 0-2 . 3-4 5+
I0. Recognition 0-2 3-4 5+
11. *p 251 + 200-250 upto 199
-~x100

12. Performance Quotient 60 61-80 81 +

13. T. Q. On Information 60 61-80 81 +
14. T. Q. on Digit Span 60 61-80 81 +
15. T. Q. on Arithmetic 60 ’ ' 61-80 81 +
16. ,T. Q. on Comprehension 60 61-80 81 +
17. . Ciir'erence in P. Q. and V. Q. 24+$/ 15-23 upto 14
18. Nahor & Benson Test ' 6+ 4-5 0-3
19. Bender-Gestalt Test 9+ 5-8 0-4
TOTAL
Remarks Dysfunction Rating Spore =

istd. 1971 .... 0 : (0562) 364926

NATIONAL PSYCHOLOGICAL CORPORATION

4/230, KACHERI GHAT, AGRA-282 004 (INDIA)
) 2001. All rights reserved. Reproduction in any form is a violation of Copyright Act P. G. I.—Battery of Brain Dysfunction.
................... - - - » - - - - -------- - ■ ‘ * - - --------- ............... ......... - - - - - - ■-------------- -------
 (2)

Sub-Test I. Memory Scale

I. Remote Memory
'1. How old are you ? 1
✓ 2. Where were you born ?
3. (a) When were you married ?
(b) When did you start earning ?
(c) When did you left study/pass high school ?
4. How old is your youngest child/brother/sister ?
5. When did you come first time in this clinic/department (Hospital) ?
p. When did you come here last time ?
II. Recent Memory
A. What did you eat in your~last dinner ?
,2. What did you eat this morning ?'
^3. What is the name of this month ?
4. What day is today ?
-5. Who came to visit you or to whom you visited yesterday ? •
[II. Mental Balance
f 1. Recite A to Z (Alphabet of any language).
> 2. Count backward from 20 to 1.
3. Count backward by minusing 3s starting from 40.
[V. Attention and Concentration
1.1 am going to say some numbers. Listen them carefully, when I read them, you will repeat
them in the same order.
' 5—7—3 ✓4—1—7,
.5 3—8—7 ✓ 6—1—5—8
1—6—4—9—5 2—9—7—6—3
X 3—4—1—7—9—6 < 6—1—5—8—3—9
7 2 5 9—4—8—3 .* " 5 -3—8~ —*^3
/j 7—2—9— 1 6 1 8""5 9—2—8—8—3—1—7—4
..... " “■ ■" "■ ■■■ • ............................................. .... *"■ f ,------------------------------

2.1 am going to read some more numbers but you will be required to repeat them bacirr.-Td,
for example, I say 2,5 you will say 5,2.
/ 8—5 /2 • 8
4— -3—7 r&-5—l
8—5—6—3 3—7—5—9 .
4—7—2—9—1 9—2 5—8—4
2 5 9-4-8—3 7—1—5—3—9—6
3—5—8—6—1—9—2 ' —3——7— 1 ~ • {1.-8... ~ 5
8—5—2—3—r-6r—1-—9—4 2—g—4—5 9 7 1 3
 (3)

V. Delayed Recall
1 2
I am going to read name of some
objects. Listen carefully and when I ask ■X/mbrella -Fish
you to repeat, you will do so (read at the -'Flower ✓Lamp
rate of one word per second and ask the
subject to repeat, it after an interval of M^lock , Rupee
one minute). * Picture *. Taj
^Pencil /■Toy

VI. Immediate Recall

I am going to read a few small sentences one by one. Listen them carefully because when I am
through I would like you to tell me the whole sentence as precisely as you can..
1. Ram got up from the chair, opened tlie door and went to market.
y if /
2. Patient was asked to lieNdown on the table, he was seen, medicine was prescribed and was
told to come next day.
3. Mohan did not have wat^r in his house, he picked-up the bucket, went to street well, filled it
up and returned back.
II. Verbal Retention for Similar Pairs
Now, I am going to read to you a list of pairs, i.e., two words at a^time. Listen .carefully. When 1
ame one word of the pair you will tell the second word of the pair (read the pairs at the rate of 2
;conds per pair, with a pause of 5 seconds between-pairs; give an interval of 10 seconds after read-
g last pair and then present a stimulus word of the pair and ask the subject to recall the 2nd word
? the pair).

1.7® Tree Flower

Sweet Sour r . •

Man Woman

■* ✓ Day : Night
• v Black White

II-. Verbal Retention for Dissimilar Pairs

Instruction and administration procedure is the same-as above for subtest VII, with a difference
t stimulus words are to be presented in the order as mentioned for each of the trial. If subject
s to give correct answer, correct it and proceed to next stimulus word. If all his answers are cor-
t in first trial even then other two trials are to be completed but in no' case, pairs be repeated,
y incorrect answers are to be corrected. •
 (4)

j Table—Black •/ 4 J 2 / 1

Tree—High ✓ 2, v 1 ./ 5

Lamp—Uneven / 1 i 5 J 3

Child—Bitter + 3 . ^ 4 * 2

Dream—Deep * 5 + 3 x 4
, i

IX. Visual Retention

J am going to show you a card, see it carefully. After some time (15 seconds) I will take it aw*
and when I ask you (after 30 seconds) to draw them, draw the things you saw in the card from voi
memory on this paper (give a paper, a pencil and an erasure to the subject but do not instru<
whether he can use the erasure or not).

X. Recognition ~

lam showing you a card containing-pictures of many objects, see the whole card attentively (ej
■pose for 30 seconds).: After some time (120 seconds'interval) I will place before you another care
From this you will be required to identify and name the objects you saw in earlier card (Do not te
the subject, the exact number of objects seen in first card and how many things he is yet to identify).

SUMMARY OF MEMORY SCALE

Sub-tests 1 II III IV V VI VII VIII IX x. Total

Raw Scores

Converted Scores
 (5)

Sub-Test IL Battery o! Performance Tests of Intelligence

... , .i

KOHS* .BLOCK PASSALONG

Remarks
Item No. Time taken Score Item No. Time taken Score

' Bi
b2 Bi
b3 Bz
b4 b3
Bs • ~ - b4
Be Bs
B7 Be
- Be b7
B9 Be
Bio
Total Score Total Score
T.Q. T.Q.

Performance Quotient =
 (6)

Sub-Test III. Verbal Adult Intelligence Scale (VAIS)

1. INFORMATIONS • 2. DIGIT SPAN

Discontinue after 7 consecutive failures response. Discontinue after failure on BOTH TRIALS of any item.

1. Bail DIGITS FORWARD SCORE =

2. Year
3. Thermometer ' DIGITS BACKWARD SCORE =
4. Sun
5. Prime Minister TOTALSCORE =
6. Guru Nanak
7. Flag
8. Lohri
9. Ramayana
10. Kuran/Bible
M.WomenHt
12. Independence 3. ARITHMETIC
13. Birbal Discontinue after 5 consecutive failures.
14. Gandhi
15. Rubber Problem Score
6. Taj Mahal • 1 or 0
7. Population 1.
8. Triveni 2.
9. Bombay 3.
0. Direction-Delhi-Madras 4.
1. Curd 5.
2. Dark coloured clothes' 6.
3. Year-Weeks 7.
4. Temperature 8.
5. Ceylone 9.
3. England 10.
7. Geeta 11.
3. Meghdoot 12.
3. Mahabharata 13.
). Vedas 14.
l. Delhi-Bombay Distance 15._________________________________
Lok Sabh'a TOTAL SCOREi'=
l Veins

TOTAL SCORE —
 (7)

4. COMPREHENSION
Discontinue after 6 failures Score
Response
1. Engine
2. Clothes
*3. Health
4. Badhabbits
5. Movie (Cinema Hall)
6. City land
* 7. Eatables
8. Credit
9. Envelope I

*10. Cheque
11. Tax
12. Unity
13. Empty Vessel
14. Forest
*15. Child law
16. Driving Licence
17. Deaf man
18. Strike-iron
TOTAL SCORE (Max. 36)
* If the .subject replies with only one idea, ask for a second response. Rephrase the test item appropriately,
saying, Tell me another reason why (another thing people can do).

SUMMARY OFVAIS
m
Sub-tests Information Digit Span Arithmetic Comprehension
Raw Scores
,Test Quotients \
i ■ ' \
Verbal I. Q.~
 (8)

Response For Nahor Benson Test,

I

(9)
 (10)

Sub-Test IV. Nahor Benson. Test

Item No. 1 II III IV V VI VII VIII Total Score

Figures wrongly
reproduced

Sub-Test V. Bender Gestalt Test

Score

—Perseveration 4
-rRotatlon or Reversal 4
—Concretism 4
—Added angles 3
—Separation of lines 3
—Overlap 3
—Distortion 3
—Embolishments 2
—Partial Rotation 2
-^Omission 1
—Abbreviation 1
—Separation 1
—Absence of erasure 1
—Closure 1
—Point of contact 1

TOTALSCORE
 COGNITIVE DE FI CITS-IN DEPRESSION

.
RESPONSE SHEET
.No........................ Date.................

NAME

PERMANENT ADDRESS

CORRESPONDENCE ADDRESS

SOCIO DEMOGRAPHIC PROFILE •:

□
1. AGE 2. SEX
□
3. INCOME SATTUS 4. OCCUPATIONAL STATUS

5. . EDUCATIONAL STATUS □ 6 HOUSING

7. MARITAL STATUS □ 8. RELIGION

9. DOMICILE □ 10. FAMILY TYPE

DIAGNOSIS BY DSM-IV □

DURATION

HAM - D (HAMILTON RATING SCALE FOR DEPRESSION)

i. □ 2. □ 3.
□ 4; CL5: XI 5- □ 7. □ 8.

*• □ 10. p 11.
□ 12.
□
p 13. 14. p 15. p If
17. p 18. QJ 19.
□ 20.
□
Q 21. 22. p 2.3. |-----1 2^

TOTAL SCORE :

P.G.I. BATTERY FOR BRAIN DYSFUNCTION

SCORE : DYSFUNCTION RATING SCORE

TREATMENT RECEIVED [
DURATION f