1. Is your mood anxious?
- You worry a lot
- You anticipate the worst in any situation
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2. Do you feel tense?
- Do you startle easily, cry easily, feel restless or tremble often?
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3. Are you experiencing fear?
- Fear of the dark
- Fear of strangers
- Fear of being alone
- Fear of animal
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4. Are you suffering from insomnia?
- Difficulty falling asleep or staying asleep
- Difficulty with nightmares
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5. How is your intellectual state?
- Poor concentration
- Memory impairment
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6. Do you suffer from depressed mood?
- Decreased interest in activities
- Anhedonia (loss of joy in activities you earlier enjoyed)
- Anergia (feel you lack energy)
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7. Do you have muscular somatic complaints?
- Muscle aches or pains
- Bruxism (grinding of teeth in sleep or during the day)
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8. Do you have sensory complaints?
- Tinnitus (ringing or buzzing sound in the ears)
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9. Do you have cardiovascular symptoms?
- Tachycardia (an abnormally rapid heart rate)
- Palpitations (a noticeably rapid; strong; or irregular heartbeat due to agitation; exertion; or illness)
- Chest pain
- Sensation of
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10. Do you have respiratory symptoms?
- Chest pressure
- Choking sensation
- Shortness of breath
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11. Do you have gastrointestinal symptoms?
- Dysphagia
- Nausea or vomiting
- Constipation
- Weight loss
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12. Do you have genitourinary symptoms?
- Urinary frequency or urgency
- Dysmenorrhea (pain during periods)
- Impotence
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13. Do you have autonomic symptoms?
- Dry mouth
- Flushing
- Pallor
- Sweating
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14. Do you experience the following in an interview?
- Fidgeting
- Tremors
- Restlessness
- Need to pace up and down
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