| In the past 4 weeks, about how often did you feel tired out for no good reason? |
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| In the past 4 weeks, about how often did you feel nervous? |
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| In the past 4 weeks, about how often did you feel so nervous that nothing could calm you down? |
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| In the past 4 weeks, how often did you feel hopeless? |
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| In the past 4 weeks, how often did you feel restless or fidgety? |
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| In the past 4 weeks, how often did you feel so restless you could not sit still? |
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| In the past 4 weeks, how often did you feel depressed? |
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| In the past 4 weeks, how often did you feel that everything was an effort? |
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| In the past 4 weeks, how often did you feel so sad that nothing could cheer you up? |
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| In the past 4 weeks, how often did you feel worthless? |
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The scores for the following four questions do not count toward the overall score for the K-10. You are encouraged to complete these questions as your responses may further indicate how your anxiety / depression is affecting your daily functioning and level of impairment. This information may be helpful should you seek assistance from a medical professional or other support.
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In the past four weeks, how many days were you totally unable to work, study or manage your day to day activities because of these feelings?
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Aside from those days, in the past four weeks, how many days were you able to work or study or manage your day to day activities, but had to cut down on what you did because of these feelings?
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In the past four weeks, how many times have you seen a doctor or any other health professional about these feelings?
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None of the time |
A little of the time |
Some of the time |
Most of the time |
All of the time |
| In the past four weeks, how often have physical health problems been the main cause of these feelings? |
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