1. Have you been feeling down much of the day for the past few weeks?
2. Do you find that you don’t experience pleasure or enjoyment from your usual activities, not because of pain, but because you just don’t feel interested? (depression)
3. During the last six months have you been nervous or worried a lot of the time about bad things that might happen?
4. Has worry at night – or during the day – kept you from being able to sleep soundly? (anxiety)
5. Have you experienced a past or recent loss with which you are still having some difficulty coping? (bereavement)
6. Are you currently worried about your family members’ ability to cope with your illness? (relationships)
7. Have you found that you are struggling to find a sense of purpose in your life or to feel more hopeful?
8. Have you been struggling with your faith as a result of your illness? (existential, spiritual)
9. What is most stressful to you about your illness? (e.g. change in function or appearance, fear of dying)
10. Circle the number below that best describes in general how much distress you have been experiencing in the past week including today:
    No Distress__1__2__3__4__5__6__7__8__9__10 Extremely Distressed

(6+ on scale or 5+ “yes” answers > consider psych referral)

Psychosocial Distress Mnemonic (BATHE)

• Background (what is going on?)
• Affect (how feel?)
• Trouble (what bothers?)
• Handle (how cope?)
• Empathy

Depression screen

• Have you been bothered by feeling down, depressed, or hopeless?
• Have you been bothered by a lack of pleasure in doing things?