Not present
Mild
Moderate
Severe
Very severe
1. Anxious mood Worries, anticipation of the worst, fearful anticipation, irritability.Not present Mild Moderate Severe Very Severe
2. Tension Feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax.Not present Mild Moderate Severe Very Severe
3. Fears Of dark, of strangers, of being left alone, of animals, of traffic, of crowds.Not present Mild Moderate Severe Very Severe
4. Insomnia Difficulty in falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.Not present Mild Moderate Severe Very Severe
5. Intellectual Difficulty in concentration, poor memory.Not present Mild Moderate Severe Very Severe
6. Depressed mood Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.Not present Mild Moderate Severe Very Severe
7. Somatic (muscular) Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.Not present Mild Moderate Severe Very Severe
8. Somatic (sensory) Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.Not present Mild Moderate Severe Very Severe
9. Cardiovascular symptoms Tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.Not present Mild Moderate Severe Very Severe
10. Respiratory symptoms Pressure or constriction in chest, choking feelings, sighing, dyspnea.Not present Mild Moderate Severe Very Severe
11. Gastrointestinal symptoms Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation. Not present Mild Moderate Severe Very Severe
12. Genitourinary symptoms Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence.Not present Mild Moderate Severe Very Severe
13. Autonomic symptoms Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.Not present Mild Moderate Severe Very Severe
14. Behavior at interview Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.Not present Mild Moderate Severe Very Severe
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