Table of Contents
Instructions:
Please read each statement and decide how much of the time the statement describes how you have been feeling during the past several days.
| A little of the time | Some of the time | Good part of the time | Most of the time | |
| I feel down-hearted and blue | 1 | 2 | 3 | 4 |
| Morning is when I feel the best | 4 | 3 | 2 | 1 |
| I have crying spells or feel like it | 1 | 2 | 3 | 4 |
| I have trouble sleeping at night | 1 | 2 | 3 | 4 |
| I eat as much as I used to | 4 | 3 | 2 | 1 |
| I still enjoy sex | 4 | 3 | 2 | 1 |
| I notice that I am losing weight | 1 | 2 | 3 | 4 |
| I have trouble with constipation | 1 | 2 | 3 | 4 |
| My heart beats faster than usual | 1 | 2 | 3 | 4 |
| I get tired for no reason | 1 | 2 | 3 | 4 |
| My mind is as clear as it used to be | 4 | 3 | 2 | 1 |
| I find it easy to do the things I used to | 4 | 3 | 2 | 1 |
| I am restless and can’t keep still | 1 | 2 | 3 | 4 |
| I feel hopeful about the future | 4 | 3 | 2 | 1 |
| I am more irritable than usual | 1 | 2 | 3 | 4 |
| I find it easy to make decisions | 4 | 3 | 2 | 1 |
| I feel that I am useful and needed | 4 | 3 | 2 | 1 |
| A little of the time | Some of the time | Good part of the time | Most of the time | |
| My life is pretty full | 4 | 3 | 2 | 1 |
| I feel that others would be better off if I were dead | 1 | 2 | 3 | 4 |
| I still enjoy the things I used to do. | 4 | 3 | 2 | 1 |
Description
The Zung Self-Rating Depression Scale is a short self-administered survey to quantify the depressed status of adult patients. There are 20 items on the scale that rate the four common characteristics of depression, divided into 4 subscales: core depressive factor; cognitive factor; an anxiety factor; and a somatic factor. This scale is suitable for inpatient use and also the elderly.
Validity and Reliability
Knight, Waal-Manning, Hendrika and Spears (1983) validated the Zung Self-Rating Depression Scale with 2,120 New Zealanders between 16 and 89 years of age. High estimates of reliability based on internal consistency statistics were found, with females scoring higher. Scores were inversely correlated with age, indicating the importance of specific and appropriate norms in assessing affective states. Split-half reliability studies in a psychiatric population found a correlation (r) of 0.73 (Zung, 1972). In a community survey of 1,173 subjects, Cronbach’s alpha was satisfactory at 0.79 (Knight et al., 1983). Zung (1965) reported a range of Zung SDS index scores from 0.63 to 0.90 with a mean of 0.74 (total score equivalent of 59) in depressed outpatients, whereas hospital staff control subjects showed a range of 0.25–0.43 with a mean of 0.33 (total score equivalent of 26). Thus, Zung SDS scores discriminated depressed from non-depressed samples. Romera et al., (2008) examine the symptomatic dimensions of depression in 1049 patients with major depressive disorder (MDD) in the primary care setting by means of a factor analysis, finding four factors: core depressive factor; cognitive factor; an anxiety factor; and a somatic factor. The 4-factor structure was validated and high coefficients of congruence were obtained (0.98, 0.95, 0.92 and 0.87 for factors I, II, III and IV, respectively). Guy (1976) found that mean total scores for five diagnostic groups were as follows: 65 for depressive disorders (n = 96), 53 for anxiety disorders (n = 22), 48 for transient situational disorder (i.e., adjustment disorder) (n = 12), 52 for schizophrenia (n = 25), and 56 for personality disorders (n = 54). Thus, the Zung SDS is a non–diagnostically specific indicator of depressive symptomatology.
Interpretation
Results consist of a total score as well as scores for the 4 subscales: Total scores range from 20 through 80. The average score for an individual with a depressive disorder is 65. Scores are broken down into the following ranges: – 20-49 Normal Range – 50-59 Mildly Depressed – 60-69 Moderately Depressed – 70 and above Severely Depressed The core depressive factor is computed from items 1, 3, 6, 14, 17, 18, 19 and 20. The minimum score is 8 and the maximum score is 32. The cognitive factor is computed from items 10, 11, 12, and 16. The minimum score is 4 and the maximum score is 16. The anxiety factor is computed from items 4, 13 and 15. The minimum score is 3 and the maximum score is 12. The somatic factor is computed from items 5, 7 and 9. The minimum score is 3 and the maximum score is 12.
Developer
Zung, W.W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 63–70.
Number Of Questions
20
References
Romera, I., Delgado-Cohen, H., Perez, T., Caballero, L., and Gilaberte, I. 2008. Factor analysis of the Zung self-rating depression scale in a large sample of patients with major depressive disorder in primary care. BMC Psychiatry, 8, 4. Knight, R. G., Waalâ€Manning, H. J., & Spears, G. (1983). Some norms and reliability data for the Stateâ€Trait Anxiety Inventory and the Zung Selfâ€Rating Depression scale. British Journal of Clinical Psychology, 22(4), 245-249.
Zung, W. W. K., & Zung, E. M. (1986). Use of the Zung Self-Rating Depression Scale in the Elderly. Clinical Gerontologist, 5(1-2), 137-148.
Developer Reference:
Zung, W.W. (1965). A self-rating depression scale. Archives of General Psychiatry, 12, 63–70.