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The IDS-SR [4–5] is a 30-item questionnaire measuring depressive symptoms. Each item has four statements that reflect various degrees of symptom severity, scored on a four-point scale from 0 to 3. The items scores were summed up. The total score indicates the severity of complaints. A score of 0 to 13 indicates no severity, 14 to 25 indicates mild severity, 26 to 38 indicated average severity, 39 to 48 indicates severe and 49 and higher for very severe complaints.