Preview only · not scored here
Clinician-rated. Rate each symptom as present in the past week using severity 0 (not present) to 4 (very severe).
1.Anxious mood (worries, anticipation of the worst, irritability).
2.Tension (feelings of tension, fatigability, startle response, moved to tears easily, trembling).
3.Fears (of dark, of strangers, of being left alone, of animals, of traffic, of crowds).
4.Insomnia (difficulty falling asleep, broken sleep, unsatisfying sleep, nightmares).
5.Intellectual/cognitive (difficulty concentrating, poor memory).
6.Depressed mood (loss of interest, lack of pleasure, depression, early waking, diurnal swing).
7.Somatic (muscular): pains, twitching, stiffness, myoclonic jerks, teeth grinding.
8.Somatic (sensory): tinnitus, blurred vision, hot/cold flushes, weakness, prickling.
9.Cardiovascular symptoms: tachycardia, palpitations, pain in chest, throbbing.
10.Respiratory symptoms: pressure/constriction in chest, choking, sighing, dyspnea.
11.Gastrointestinal symptoms: swallowing difficulty, wind, dyspepsia, nausea, abdominal fullness.
12.Genitourinary symptoms: frequency/urgency, amenorrhea, loss of libido, impotence.
13.Autonomic symptoms: dry mouth, flushing, pallor, sweating, giddiness, headache.
14.Behavior at interview: fidgeting, restlessness, tremor, furrowed brow, sighing, pallor.
Send it to your patient by link or email, get scores, severity bands and an AI-assisted report inside their clinical record.
Start free trial