Mood & Feelings Questionnaire
This form is about how your child might have been feeling or acting recently.
For each question, please respond according to how s/he has been feeling or acting in the past two
weeks. NOT TRUE = 0; SOMETIMES = 1; TRUE = 2
Patient First Name, Last Initial *
Your First Name, Last Initial *
Relation To Patient *
NOT TRUE = 0; SOMETIMES = 1; TRUE = 2
1. S/he felt miserable or unhappy. *
Not True
True
2. S/he didn’t enjoy anything at all. *
Not True
True
3. S/he was less hungry than usual. *
Not True
True
4. S/he ate more than usual. *
Not True
True
5. S/he felt so tired s/he just sat around and did nothing. *
Not True
True
6. S/he was moving and walking more slowly than usual. *
Not True
True
7. S/he was very restless. *
Not True
True
8. S/he felt s/he was no good anymore. *
Not True
True
9. S/he blamed him/herself for things that weren’t his/her fault. *
Not True
True
10. It was hard for him/her to make up his/her mind. *
Not True
True
NOT TRUE = 0; SOMETIMES = 1; TRUE = 2
11. S/he felt grumpy and cross with his/her parents. *
Not True
True
12. S/he felt like talking less than usual. *
Not True
True
13. S/he was talking more slowly than usual. *
Not True
True
14. S/he cried a lot. *
Not True
True
15. S/he thought there was nothing good for him/her in the future. *
Not True
True
16. S/he thought that life wasn’t worth living. *
Not True
True
17. S/he thought about death or dying. *
Not True
True
18. S/he thought his/her family would be better off without him/her. *
Not True
True
19. S/he thought about killing him/herself. *
Not True
True
20. S/he didn’t want to see his/her friends. *
Not True
True
NOT TRUE = 0; SOMETIMES = 1; TRUE = 2
21. S/he found it hard to think properly or concentrate. *
Not True
True
22. S/he thought bad things would happen to him/her. *
Not True
True
23. S/he hated him/herself. *
Not True
True
24. S/he felt s/he was a bad person. *
Not True
True
25. S/he thought s/he looked ugly. *
Not True
True
26. S/he worried about aches and pains. *
Not True
True
27. S/he felt lonely *
Not True
True
28. S/he thought nobody really loved him/her. *
Not True
True
29. S/he didn’t have any fun at school. *
Not True
True
30. S/he thought s/he could never be as good as other kids. *
Not True
True
NOT TRUE = 0; SOMETIMES = 1; TRUE = 2
31. S/he felt s/he did everything wrong. *
Not True
True
32. S/he didn’t sleep as well as s/he usually sleeps. *
Not True
True
33. S/he slept a lot more than usual. *
Not True
True
34. S/he wasn’t as happy as usual, even when s/he was praised or rewarded. *
Not True
True
References:
Author: Adrian Angold

Angold, A., Costello, E. J., Messer, S. C., Pickles, A., Winder, F., & Silver, D. (1995) The development of a short questionnaire for use in epidemiological studies of depression in children and adolescents. International Journal of Methods in Psychiatric Research, 5, 237 - 249.

Messer, S. C., Angold, A., Costello, E.J., Loeber, R., Van Kammen, W., & Stouthamer-Loeber, M. (1995). Development of a short questionnaire for use in epidemiological studies of depression in children and adolescents: Factor composition and structure across development. International Journal of Methods in Psychiatric Research, 5, 251-262.

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