The patient is given a pencil and a blank sheet of paper and is asked to draw a round clock, a dial with correctly placed numbers and draw hands so that the clock shows the time determined by the psychologist (for example, fifteen minutes to two). The assessment is carried out on a 10-point formalized scale:
10 points - the norm (variants of the norm). A round clock is drawn, the numbers are in the right places, the arrows show the set time;
9 points - minor inaccuracies in the location of the arrows;
8 points - more noticeable errors in the location of the arrows;
7 points - the hands show a completely wrong time;
6 points - the arrows do not fulfill their function (for example, the right time is circled or indicated by other signs);
5 points - incorrect arrangement of numbers on the dial: they follow in the reverse order or the distance between the numbers is not the same;
4 points - the integrity of the watch is lost, some of the numbers are missing or located outside the circle;
3 points - the numbers and the dial are no longer related to each other;
2 points - the patient's activity shows that he is trying to follow the instructions, but to no avail;
1 point - the patient makes no attempts to follow the instructions.
A test result of less than 10 points indicates the possible presence of cognitive impairment.
In case of an incorrectly executed independent drawing, the psychologist gives the task to finish the arrows on the already drawn dial with numbers. With dementia of the frontal and subcortical type, mainly independent drawing suffers, and with dementia of the Alzheimer's type, both independent drawing and the ability to place hands on the dial are impaired (visuospatial disorders).
Test 5 words
The patient is asked to read and memorize 5 words (cinema, lemonade, grasshopper, saucer, truck) written in large columns in a column on an A4 sheet. After reading the words four times, the patient is asked to find in this list the name of the building, the name of the drink, etc.
Then, direct reproduction is examined. If the patient has trouble remembering a word, a categorical prompt is given (eg, "What was the drink?"). After an interfering task (usually a clock drawing test), delayed playback is examined. The result is the sum of independent answers and answers after categorical prompts. Maximum score: 5+5=10 points. This technique is highly specific in the differential diagnosis of Alzheimer's disease and vascular cognitive disorders. If the patient, after a categorical prompt, does not remember the word, this is a sign of a defect in primary memory, that is, Alzheimer's disease.
Repetition of numbers in forward and reverse order
The patient is asked to repeat a digital series after the psychologist, starting with two numbers: 25, 582, 6439, 75 831, 586 924. Attention and short-term memory are evaluated. After that, reproduction is examined in reverse order (i.e., it is necessary to repeat the numbers from the end of the row): 25 - the patient repeats "52", 397 - repeats "793" and so on.
Violation of the repetition of numbers in reverse order indicates dysfunction of the frontal lobes, which is typical for vascular cognitive impairment.
The use of neuropsychological testing methods to assess the state of cognitive functions, along with the assessment of motor, coordinating, sensory, autonomic and other functions, must be included in the algorithm for examining patients with brain damage of various etiologies, primarily vascular. Although in most cases the test results reflect one or another stage of cognitive deficit, this is not an absolute pattern, and the obtained digital indicators should be evaluated in conjunction with the other criteria outlined above.
Thus, the timely detection and analysis of cognitive impairments in cerebrovascular pathology is the most important task both at the outpatient and inpatient levels. Due to the relative simplicity and availability of screening methods for neuropsychological diagnostics, they should be mandatory when
examination of patients not only with signs of vascular lesions of the brain, but also those with risk factors for the development of cognitive impairment, especially in the elderly and elderly.
Wrist and table, wall and sand, pocket and fireplace, tower and "cuckoo" ... Clocks make our life more orderly. At the same time, they remind us that time does not stand still, which means we need to hurry, otherwise all the most interesting will pass by. And with the help of a watch, you can determine the level of our vital energy. This is claimed by the developers of the graphic express test, which is called “Clock”. Shall we try?
Before you is a schematically depicted alarm clock. Your task is to redraw the picture on a piece of paper and give it a finished look. You can draw only the necessary missing details, or you can also highlight the background, add some interior items ... As your heart desires!
Job completed? We start the discussion.
Arrows
So, the arrows are an essential attribute of any watch ... If they are directed in your drawing up- there is no reason for concern: everything is in order with your vital energy: you are cheerful, full of strength and, undoubtedly, great achievements await you.
If the arrows "look" down, probably your strength is running out, which means it makes sense to think about "recharging".
Things don't matter at all if your alarm clock shows half past six. This indicates a serious energy decline. And there is no time for reflection: no matter how your life circumstances develop now, health comes first. Therefore, it is definitely worth taking a timeout.
Numbers
If you depicted, first of all, the numbers, focused on them, or drew the dial with special care, not forgetting the second divisions, then today you are leading a rather hectic life. You probably lack regularity and orderliness. Try, if possible, to put things in order in everyday affairs. By becoming an effective time manager for yourself, you will be surprised to find that by wisely planning your time, you can save energy and do a lot more.
call button
If you have shaded this element, it looks like what you are currently doing professionally is by no means your dream job. Perhaps you should look for a job you like. And then life will shine with new colors, and the morning trill of the alarm clock will cause not the usual irritation, but the joy that a new, interesting day begins.
If you paid increased attention to the background, the interior surrounding the clock - you drew a table, "put" a napkin under the alarm clock, "placed" a vase of flowers next to it, "scattered" pencils on the table top - you are most likely "recharged" by communicating with other people. Shining in society, catching admiring glances on yourself, attracting the increased attention of others, you draw energy and vitality. By the way, how long ago did you go out "in the light" last time? Perhaps this is exactly what you need now?
Willingly, especially since today it is quite often used in psychological testing of the cognitive sphere, for example, in clinical trials of drugs or in the diagnosis of dementia. However, it should be borne in mind that the question of using this technique in the context of neuropsychological diagnostics seems debatable. Clock Drawing Test (CDT) developed by Western psychologists (Lovenstone, Gauthier, 2001).
The subject is given a blank sheet of unlined paper and a pencil. The instruction sounds like this: “Please draw a round clock with numbers on the dial. Now draw the hands on the clock so that they show fifteen minutes to two. The performance of this test involves a quantitative assessment on a 10-point scale: 10 points - normal performance; 9 - minor inaccuracies in the location of the arrows; 8 - more noticeable errors in the location of the arrows; 7 - arrows show completely wrong time; 6 - arrows do not perform their function (for example, the right time is circled); 5 - the numbers on the dial follow in reverse order or the distance between the numbers is not the same; 4 - the integrity of the clock is lost, some of the numbers are missing or located outside the circle; 3 - the numbers and the dial are no longer connected to each other; 2 - the patient unsuccessfully tries to follow the instruction; 1 - the patient makes no attempt to follow the instruction.
Now that you have familiarized yourself with this technique in detail, the statement with which we preceded its description becomes clear. The technique is aimed only at assessing the state of a particular optical-spatial skill; the types of errors identified in it do not correlate in any way with lesions of certain areas of the brain. Consequently, it can hardly be used for the purposes of topical neuropsychological diagnostics.
q A geographic map is included in the complex of Luriev's methods for studying optical-spatial perception. How is the subject supposed to work with it?
Indeed, such a technique exists, and in two versions (Luriya, 1962; Neuropsychological diagnostics. Classical Stimulus Materials, 2010). The first is an independent drawing of a geographical map. The psychologist gives the subject a blank sheet of A4 or A5 paper, asks to put a small circle in the center of the sheet and write the word "Moscow" next to it. Then the subject is asked to imagine that he has a map in front of him. He must place letters along the edges of the sheet indicating the cardinal points (north, south, west, east), and then indicate the location of several geographical objects (for example, St. Petersburg, Minsk, the Ural Mountains, the Black Sea).
The second option is the choice of the correct geographic map. The subject is presented with two images of a contour map of the European part of the USSR. All the details of both images are identical, but one of them is correctly oriented relative to the cardinal points, the other is mirrored (east and west are mixed up on it). The subject must make a choice and justify it by explaining why one card is correct and the other is not (Fig. 5).
q In what brain lesions will the most distinct violations of the performance of these tasks be observed?
With lesions of the parieto-occipital regions of the right or left hemispheres of the brain. Patients with such disorders make mistakes in indicating the cardinal directions, cannot correctly locate certain geographical objects or select the correct map. Numerous examples of such errors are given in the works of A.R. Luria (1962, 1971).
Rice. 5. Geographic map
q And how do healthy subjects draw a geographical map?
This question also interested us. We examined 120 mentally healthy subjects aged 18 to 66 years. Among them were 86% women and 14% men; 98% of subjects with incomplete higher or higher education; 7% were left-handed and ambidexter, the rest of the subjects considered themselves right-handed. Successfully (without errors) coped with the task 21% of the subjects. It turned out that not all parts of the task were carried out equally successfully. So, if the cardinal directions indicated everything correctly, then the location of individual geographical points in a number of cases was indicated erroneously. For example, the location of St. Petersburg in relation to Moscow was correctly indicated by 81% of the subjects, 18% located it in the north or northeast, and one of the subjects - in the southwest. The Black Sea was correctly positioned on an impromptu map by 67% of the subjects, the rest made certain mistakes: 18% of the subjects drew it in the southeast, 13% moved it very much to the west, 2% placed it in the northeast or northwest . Thus, we can conclude that in the norm there are practically no errors in indicating the cardinal points, however, more or less significant inaccuracies in the location of individual geographical objects are quite common. The subjects aged 60 years and older coped best with the card drawing. More details can be found in our articles. (Balashova, Kovyazina, 2006c, b).
Appendix 1
Test "5 words" (B. Dubois, 2002)
1. Presentation of the material (the patient is given a list of 5 words: cinema, lemonade, grasshopper, saucer, truck)
2. Direct reproduction (the doctor takes a list of words from the patient and asks him to repeat it)
3. Interfering task (to distract the patient's attention for a sufficient period of time (from 3 to 5 minutes)
4. Delayed recall (the patient is asked to recall 5 words).
results
Direct playback:
0-5 points
Delayed playback:
0-5 points
Outcome: 0-10 points (8-9 points or less - dementia of the Alzheimer's type).
application 2
Schulte test
is carried out using a special table in which the numbers are arranged in random order from 1 to 25. The doctor marks the time spent by the patient to find the numbers with a stopwatch.
| 21 | 12 | 7 | 1 | 20 |
| 6 | 15 | 17 | 3 | 18 |
| 19 | 4 | 8 | 25 | 13 |
| 24 | 2 | 22 | 10 | 5 |
| 9 | 14 | 11 | 23 | 16 |
Normally, the execution time of the Schulte test is 25-30 seconds.
appendix 3
Clock drawing test
(S. Lovenstone et S. Gauthier, 2001)
| Number of points | Completing a task |
| 10 points | norm, a circle is drawn, the numbers are in the right places, the arrows show the specified time |
| 9 points | minor inaccuracies in the location of the arrows |
| 8 points | more noticeable errors in arrow placement |
| 7 points | the hands show the wrong time |
| 6 points | arrows do not perform their function (for example, the right time is circled) |
| 5 points | incorrect arrangement of numbers on the dial: they follow in reverse order (counterclockwise) or the distance between the numbers is not the same |
| 4 points | the integrity of the watch is lost, some of the numbers are missing or located outside the circle |
| 3 points | numbers and clock face are no longer related to each other |
| 2 points | the patient's activity shows that he is trying to follow the instruction, but without success |
| 1 point | the patient does not attempt to follow the instructions |
The patient is given a pencil and a blank sheet of unlined paper and is asked to independently draw a round clock, put the numbers in the desired positions on the dial and draw hands showing the specified time. A test result of less than 10 points indicates the presence of cognitive disorders.
annex 4
Mini Mental Status Study
(English Mini-Mental State Examination, M. Folstein et al., 1975)
| Try | Evaluation (points) |
| Time Orientation: Name the date (day, month, year, day of the week, season) | 0-5 |
| Orientation in place: Where are we located (country, region, city, clinic, floor)? | 0-5 |
| Perception: Repeat three words: pencil, house, penny | 0-3 |
| Concentration of attention: Serial score (subtract 7 from 100, then 7 again, five times in total) | 0-5 |
| Memory: Remember 3 words (see point 3) | 0-3 |
| Speech: We show a pen and a watch, ask: “What is it called?” | 0-2 |
| Please repeat the sentence: “No ifs, and or buts” | 0-1 |
| Running the 3-step command: “Take a sheet of paper with your right hand, fold it in half and put it on the table” | 0-3 |
| Reading: "Read and Follow" close your eyes Write a proposal Draw a picture (two intersecting pentagons with equal angles) | 0-3 |
| Total score | 0-30 |
Orientation in time: the maximum score (5) is given if the patient independently and correctly names the day, month and year. If you have to ask additional questions, 4 points are given. Each mistake or lack of answer reduces the score by one point;
Orientation in place: each mistake or lack of answer reduces the score by one point;
Perception: the correct repetition of the word by the patient is estimated at one point for each of the words;
Attention concentration: each mistake reduces the score by one point;
Memory: each correctly named word is worth one point;
Speech: each correct answer is worth one point;
3-stage team: each action is worth one point;
Reading: each mistake reduces the score by one point;
Draw a picture: each mistake reduces the score by one point.
The test results may have the following meaning:
28-30 points - no cognitive impairment
24-27 points - predementia cognitive impairment
20-23 points - mild dementia
11-19 points - moderate dementia
0-10 points - severe dementia.
annex 5
Frontal dysfunction battery
(English Frontal Assessment Batter - FAB, B. Dubois et al., 1999)
1. Conceptualization. The patient is asked: "What do an apple and a pear have in common?" The answer that contains a categorical generalization ("It's a fruit") is considered correct. If the patient finds it difficult or gives a different answer, he is told the correct answer. Then they ask: “What do a coat and a jacket have in common?” ... "What is common between a table and a chair?". Each categorical generalization is worth 1 point. The maximum score in this test is 3, the minimum is 0.
2. fluency of speech. They are asked to close their eyes and for a minute say words starting with the letter “s”. In this case, proper names are not counted. Result: more than 9 words per minute - 3 points, from 7 to 9 - 2 points, from 4 to 6 - 1 point, 3 or less - 0 points.
3. Dynamic praxis. The patient is invited to repeat after the doctor with one hand a series of three movements: fist (placed horizontally, parallel to the surface of the table) - rib (the brush is placed vertically on the medial edge) - palm (the brush is placed horizontally, palm down). At the first presentation of the three series described above, the patient only follows the doctor, at the second presentation of the three series, he repeats the movements of the doctor, and finally, he does the next two times three series on his own. When self-fulfilling tips to the patient are unacceptable. Result: correct execution of nine series of movements - 3 points, six series - 2 points, three series (together with the doctor) - 1 point.
4. A simple choice reaction. The instruction is given: “Now I will check your attention. We will tap out the rhythm. If I hit once, you must hit twice in a row. If I strike twice in a row, you must strike only once.” The following rhythm is tapped out: 1-1-2-1-2-2-2-1-1-2. Evaluation of the result: correct execution - 3 points, no more than 2 errors - 2 points, many errors - 1 point, complete copying of the doctor's rhythm - 0 points.
5. Complicated choice reaction. The instruction is given: “Now if I strike once, you must do nothing. If I strike twice in a row, you must strike only once.” The rhythm is tapped: 1-1-2-1-2-2-2-1-1-2. Evaluation of the result is similar to paragraph 4.
6. Study of grasping reflexes. The patient sits, he is asked to put his hands on his knees with palms up and check the grasping reflex. The absence of a grasping reflex is estimated at 3 points. If the patient asks if he should grab, a score of 2 is given. If the patient grabs, he is instructed not to, and the grasping reflex is retested. If the reflex is absent during the re-examination, 1 is assigned, otherwise - 0 points.
Evaluation of results: 17-18 - normal, 12-16 - mild cognitive impairment, 11 points or less - frontal dementia
annex 6
0 points - no violations
0-5 points - "doubtful" dementia
Memory: persistent minor forgetfulness, incomplete recall of past events, "benign forgetfulness"
Orientation: fully oriented, but there may be inaccuracies in naming the date
Thinking: minor difficulties in solving problems, analyzing similarities and differences
Social interaction: minor difficulties
Household behavior and hobbies: minor difficulties
Self service: no violations
1 point - mild dementia
Memory: greater forgetfulness of current events that interferes with daily life
Orientation: not fully oriented in time, but always correctly names the place; at the same time, there may be difficulties in self-orientation on the ground
Thinking: moderate difficulty in solving problems, analyzing similarities and differences that do not affect everyday life
Social interaction: independence is lost, however, it is possible to carry out certain social functions. On a superficial acquaintance, violations may not be obvious
Household behavior and hobbies: mild but distinct domestic difficulties, loss of interest in complex activities
Self service: needs reminders
2 points - moderate dementia
Memory: pronounced forgetfulness, current events do not remain in memory, only memories of the most significant events of life are preserved
Orientation: disoriented in time, not fully oriented in place
Thinking: pronounced difficulty in solving problems and analyzing similarities and differences that have a negative impact on daily activities
Social interaction: lost autonomy outside of home, but can engage in social interaction under the control of others
Household behavior and hobbies: extreme limitation of interest, the ability to perform only the simplest activities
Self service: needs help with dressing, hygiene procedures, natural functions
3 points - severe dementia
Memory: fragmented memories of life Orientation: focused only on one's own personality
Thinking: solving intellectual problems is impossible
Social interaction: impairments hinder social interaction outside of one's home
Household behavior and hobbies: incapable of performing household duties
Self service: constantly needs care; frequent incontinence
annex 7
General scale of violations
(English Global deterioration scale, B. Reisberg et al., 1982)
1 - no subjective or objective symptoms of impaired memory or other cognitive functions.
2 - very mild disorders: complaints of memory loss, most often of two types: (a) does not remember what he put where; (b) forgets the names of close acquaintances. In a conversation with the patient, memory impairments are not detected. The patient fully copes with work and is independent in everyday life. Adequately alarmed by the existing symptoms.
3 - mild disorders: mild but clinically delineated symptoms. At least one of the following: (a) being unable to find your way when traveling to an unfamiliar place; (b) the patient's co-workers are aware of his cognitive problems; (c) difficulty in finding a word and forgetfulness of names is obvious to households; (d) the patient does not remember what he has just read; (e) does not remember the names of people he meets; (e) placed somewhere and could not find an important item; (g) on neuropsychological testing, there may be a violation of serial counting. It is possible to objectify cognitive disorders only with the help of a thorough study of higher brain functions. Violations can affect work and life. The patient begins to deny his violations. Often mild or moderate anxiety.
4 - moderate violations: obvious symptoms. The main manifestations are: (a) the patient is not sufficiently aware of the events taking place around him; (b) impaired memory of some life events; (c) the serial score is violated; (d) the ability to find a way, carry out financial transactions, etc. is impaired.
Usually there are no violations: (a) orientation in place and in one's own personality; (b) recognizing close acquaintances; (c) the ability to find a well-known path.
Inability to complete complex tasks. The denial of the defect becomes the main mechanism of psychological defense. There is a flattening of affect and avoidance of problem situations.
5 - moderately severe violations: loss of independence. Inability to remember important life circumstances, such as home address or phone number, names of family members (for example, grandchildren), the name of the educational institution from which he graduated.
Usually disorientation in time or place. Serial counting difficulties (from 40 to 4 or from 20 to 2).
At the same time, basic information about yourself and others is preserved. Patients never forget their own name, the name of their spouse and children. No assistance required for eating and natural excretion, although there may be difficulty in dressing.
6 - severe violations: it is not always possible to remember the name of a spouse or other person on whom there is a complete dependence in everyday life. Amnesia for most life events. disorientation in time. Difficulty counting from 10 to 1, sometimes also from 1 to 10. Most of the time needs assistance, although sometimes the ability to find a well-known way is retained. The sleep-wake cycle is often disrupted. The recollection of one's own name is almost always preserved. Usually the recognition of familiar people is preserved. Personality and emotional state change. There may be: (a) delusions and hallucinations, such as the idea that a spouse has been changed; conversation with imaginary persons or with one's own reflection in the mirror; (b) obsessions; (c) anxiety, psychomotor agitation, aggression; (d) cognitive aboulia - the absence of purposeful activity as a result of the loss of the ability for it.
7 - very severe disorders: Usually there is no speech. Urinary incontinence, need help with eating. Loss of basic psycho-motor skills, including the skill of walking. The brain is no longer able to control the body. Neurological symptoms of decortication are noted.
annex 8
Khachinski ischemic scale (Hachinski et al., 1975)
1) sudden onset (2 points)
2) step-like flow (1 point)
3) the presence of fluctuations (2 points)
4) night confusion (1 point)
5) relative safety of personality (1 point)
6) depression (1 point)
7) somatic complaints (1 point)
8) incontinence of emotional reactions (1 point)
9) arterial hypertension (history or present) (1 point)
10) history of stroke (2 points)
11) other (somatic) signs of atherosclerosis (1 point)
12) subjective neurological symptoms (2 points)
13) objective neurological symptoms (2 points)
A score of more than 7 points suggests a vascular cause of dementia, 4 or less points does not confirm the vascular etiology of the process.
annex 9
Hamilton Scale (HDRS)
| row number | Symptoms of depression |
| 1 |
Depressive mood (depression, hopelessness, helplessness, feeling of low worth) 0 = no; 1 = expression of said feeling only when asked directly; 2 = speaks out in complaints spontaneously; 3 = determined not by verbal expression, but by observation: facial expressions, posture, voice, tearfulness; 4 = Patient only expresses these feelings both spontaneously and non-verbally. |
| 2 |
Guilt 0 = not available; 1 = self-deprecation; believes he let others down; 2 = self-guilt or agonizing thoughts about past mistakes or sins; 3 = present illness is regarded as a punishment; delusional ideas of guilt; 4 = verbal hallucinations of accusing and condemning content and/or visual hallucinations of threatening content. |
| 3 |
Suicidal Intentions 0 = not available; 1 = feeling that life is not worth living, 2 = wishing for death or any thoughts about the possibility of one's own death; 3 = suicidal statements or gestures; 4 = suicidal attempts (any serious attempt is scored as a "4") |
| 4 |
early insomnia 0 = no difficulty falling asleep; 1 = complaints of episodic difficulty falling asleep (longer than 30 minutes); 2 = complaining about not being able to sleep every night |
| 5 |
Average insomnia 0 = not available; 1 = complaints of restless sleep throughout the night; 2 = multiple awakenings throughout the night - any getting out of bed is scored as a "2" (excluding physiological needs). |
| 6 |
late insomnia 0 = not available; 1 = early morning awakening followed by sleep; 2 = final early morning awakening |
| 7 |
Efficiency and activity 0 = no difficulty; 1 = thoughts and feelings of failure, feeling tired and weak associated with activities (work or hobbies); 2 = loss of interest in activities (work or hobbies), expressed directly in complaints or indirectly, through apathy and indecision (feeling of the need for additional effort to start work or be active); 3 = decrease in real time of manifestation of activity or decrease in productivity; in a hospital setting, a score of "3" is given if the patient's activity is manifested for at least 3 hours a day (work in a hospital or hobby); 4 = refusal to work due to present illness; in a hospital, a score of "4" is given if the patient is not active at all or cannot even cope with routine household activities without outside help. |
| 8 |
Lethargy (slow thinking and speech, impaired ability to concentrate, decreased motor activity)
0 = normal speech and thinking; 1 = slight retardation in conversation; 2 = marked slowness in conversation; 3 = severe difficulty in interviewing; 4 = complete stupor |
| 9 |
Agitation (alarming) 0 = no; 1 = anxiety; 2 = restless hand movements, hair pulling, etc.; 3 = mobility, restlessness; 4 = constant fingering, nail biting, hair pulling, lip biting. |
| 10 |
mental anxiety 0 = not available; 1 = subjective tension and irritability; 2 = anxiety for minor reasons; 3 = anxiety reflected in facial expression and speech; 4 = fear expressed without questioning |
| 11 |
Somatic anxiety (physiological manifestations of anxiety: gastrointestinal - dry mouth, flatulence, dyspepsia, diarrhea, spasms, belching; cardiovascular - palpitations, headaches; respiratory - hyperventilation, shortness of breath, frequent urination; increased sweating). 0 = no; 1 = weak; 2 = medium; 3 = strong; 4 = extremely strong |
| 12 |
Gastrointestinal somatic symptoms 0 = no; 1 = loss of appetite, but eating without strong compulsion; feeling of heaviness in the abdomen; 2 = eating only with persistent compulsion; need for laxatives or drugs to relieve gastrointestinal symptoms |
| 13 |
General somatic symptoms 0 = no; 1 = heaviness in the limbs, back or head, muscle pain; feeling of loss of energy or loss of strength; 2 = any severe symptoms |
| 14 |
Genital symptoms (loss of libido, menstrual irregularities)
0 = no symptoms; 1 = mild; 2 = strongly pronounced |
| 15 |
Hypochondria 0 = no; 1 - self-absorption (bodily); 2 = excessive health concern; 3 = frequent complaints, asking for help, etc.; 4 = hypochondriacal delusions. |
| 16 A |
Weight loss (either item A or B is assessed) A. According to the anamnesis: 0 = no weight loss; 1 = probable weight loss due to present illness; 2 = apparent (according to the patient) weight loss; 3 = not assessable |
| 16 B |
B. If weight changes occur on a weekly basis 0 = weight loss less than 0.5 kg per week; 1 = more than 0.5 kg per week; 2 = more than 1 kg per week; 3 = not assessable |
| 17 |
Critical attitude towards the disease 0 = awareness that he is ill with depression or any disease; 1 = awareness of the painful condition, but attributing this to poor food, climate, overwork at work, viral infection, need for rest, etc .; 2 = complete lack of awareness of the disease |
| 18 A |
Daily fluctuations A. Specify when the symptoms are more severe, morning or evening; if there are no daily fluctuations, mark 0 points 0 = no oscillation; 1 - worse in the morning; 2 = worse in the evening |
| 18 B |
B. If there are daily fluctuations, evaluate their severity; in the absence of hesitation, mark the item "absent" 0 = none; 1 = weak; 2 = strong |
| 19 |
Depersonalization and derealization (for example, feeling the unreality of the environment) 0 = not available; 1 = weak; 2 = moderate; 3 = strong; 4 = intolerable |
| 20 |
paranoid symptoms 0 = none; 1 = suspicious; 2 = ideas of relation; 3 = delusions of relationship and persecution |
| 21 |
Obsessional and compulsive symptoms 0 = none; 1 = lungs; 2 = heavy |
0-6 - no depressive episode, 7-15 - minor depressive episode, 16 and above - major depressive episode.
application 10
CES-D Depression Self-Questionnaire
|
1. I'm nervous about things that didn't bother me before.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
2. I don't enjoy food, I have a poor appetite.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
|
3. Despite the help of friends and family members, I cannot get rid of the feeling of longing.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
4. It seems to me that I am no worse than others
0 Most of the time 1 Much of the time 2 Sometimes 3 Very rarely or never |
|
5. I find it difficult to concentrate on what I have to do.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
6. I feel overwhelmed
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
|
7. Everything I do requires extra effort from me.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
8. I hope for a good future
0 Most of the time 1 Much of the time 2 Sometimes 3 Very rarely or never |
|
9. I feel like my life has turned out badly.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
10. I experience anxiety, fears
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
|
11. I have a bad night's sleep.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
12. I feel like a happy person
0 Most of the time 1 Much of the time 2 Sometimes 3 Very rarely or never |
|
13. It seems that I began to talk less
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
14. Feeling lonely bothers me.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
|
15. People around me are unfriendly
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
16. Life gives me pleasure
0 Most of the time 1 Much of the time 2 Sometimes 3 Very rarely or never |
|
17. I can cry easily
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
18. I feel sad, spleen
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
|
19. It seems to me that people do not like me.
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
20. I do not have the strength and desire to start doing something
0 Very rarely or never 1 Sometimes 2 Much of the time 3 Most of the time |
If the patient scores 19 or more points, then with very high certainty we can talk about the presence of a depressive disorder. A score from 19 to 26 corresponds to mild depression, from 27 to 36 - moderate depression. If the patient scores 37 or more points, this indicates that he has severe depression.
Our section is created especially for lovers of smaller words and big actions. English tests for children and adults will help you consolidate your theoretical knowledge and acquire new ones in practice. Even perfect knowledge of the rules loses its value if it is not used in specific examples and tasks.
Lexical tests will help not only check vocabulary level but also expand it. And they can also be useful to everyone, regardless of the depth of knowledge in English.
Grammar tests will test your level of tenses, as well as the ability to coordinate tenses in a sentence. They will assess the knowledge of the correct arrangement of words in a sentence and such special parts of speech in the English language as gerund, article, etc. Modal verbs, prepositions, participles, passive voice, infinitive and other topics are also not deprived of attention in this section. You also have the opportunity to check grammar for free on iloveenglish.
Such parts of speech as nouns, pronouns, verbs, adjectives and adverbs are separated into independent subsections due to the variety of issues covered. In the "Nouns" section, knowledge of vocabulary is checked at the same time, and clarity is introduced into the understanding of the differences between words similar in meaning. In other sections, you can be tested on the knowledge of the most common words belonging to a particular part of speech, the details of their use in English are specified.
The most popular electronic test is the English level test and it is available on our website.
English tests will help to identify gaps in knowledge and at the same time improve previously acquired ones. For example, identify your catch-up gaps in Skype English classes. Completing assignments online and getting instant results is an easy and convenient way to get closer to perfection in learning English.
