Anxiety Questionnaire

  • Hamilton Anxiety Scale 💚

    In the last three days, please indicate the degree to which you have experienced the following.

    0 – not present
    1 – mild degree
    2 – moderate degree
    3 – marked degree
    4 – maximum degree
  • e.g. worries, anticipation of the worst, fearful anticipation, irritability.
  • e.g. feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax.
  • e.g. of dark, of strangers, of being left alone, of animals, of traffic, of crowds.
  • e.g. difficulty in falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.
  • e.g. difficulty in concentration, poor memory.
  • e.g. loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.
  • e.g. pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
  • e.g. tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.
  • e.g. tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing bea
  • e.g. pressure or constriction in chest, choking feelings, sighing, dyspnea.
  • e.g. difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.
  • e.g. frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence
  • e.g. dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.
  • For confirmation email