• Depression and Anxiety Test

    Share your name, email, WhatsApp number and make the payment to get started.
  • Format: (000) 000-0000.

  • Checkout

  • Image field 80

  • Make the payment to the QR code above. After making the payment if you are having difficulty getting back to the form, just click the link again and fill up the form again, and you can attach the payment screenshot below.

  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • For each question select one 'cue' which relates to you.

  • 1. Depressed Mood (sadness, hopeless, helpless, worthless) (Select one)*
  • 2. Feelings of Guilt (Select one)*
  • 3. Suicide (Select one)*
  • 4. Insomnia: Early in the Night (Select one)*
  • 5. Insomnia: Middle of the Night (Select one)*
  • 6. Insomnia: Early Hours of the Morning (Select one)*
  • 7. Work and Activities (Select one)*
  • 8. Retardation (slowness of thought and speech, impaired concentration, decreased motor activity) (Select one)*
  • 9. Agitation (Select one)*
  • 10, Anxiety - Psychic (Select one)*
  • 11. Anxiety - Somatic (physiological concomitants of anxiety: GI, cardiovascular, respiratory, urinary frequency, sweating) (Select one)*
  • 12. Somatic Symptoms - Gastrointestinal (Select one)*
  • 13. General Somatic Symptoms (Select one)*
  • 14. Genital Symptoms (loss of libido, menstrual disturbances) (Select one)*
  • 15. How worried are you about your health or physical symptoms? (Select one)*
  • 16. Loss of Weight - rated according to you (Select one)*
  • 17. Insight (Select one)*

  • Anxiety Rating Scale

  • This is a list of certain feeelings that people may have in thier lives, and below the options there is a list of phrases that describe certain feeling with symptoms that people have. Rate yourself by finding the answer which best describes the extent to which you have these feelings. Select one of the five responses for each of the fourteen phrases.

  • 0= Not present, 1 = Mild, 2 = Moderate, 3 = Severe, 4 = Very severe.
  • 1 Anxious mood*

  • Worries, anticipation of the worst, fearful anticipation, irritability.

  • 2 Tension*
  • Feelings of tension, fatigability, startle response, moved to tears easily, trembling, feelings of restlessness, inability to relax.
  • 3 Fears*
  • Of dark, of strangers, of being left alone, of animals, of traffic, of crowds.
  • 4 Insomnia*
  • Difficulty in falling asleep, broken sleep, unsatisfying sleep and fatigue on waking, dreams, nightmares, night terrors.
  • 5 Intellectual*
  • Difficulty in concentration, poor memory.
  • 6 Depressed mood*
  • Loss of interest, lack of pleasure in hobbies, depression, early waking, diurnal swing.
  • 7 Somatic (muscular)*
  • Pains and aches, twitching, stiffness, myoclonic jerks, grinding of teeth, unsteady voice, increased muscular tone.
  • 8 Somatic (sensory)*
  • Tinnitus, blurring of vision, hot and cold flushes, feelings of weakness, pricking sensation.
  • 9 Cardiovascular symptoms*
  • Tachycardia, palpitations, pain in chest, throbbing of vessels, fainting feelings, missing beat.
  • 10 Respiratory symptoms*
  • Pressure or constriction in chest, choking feelings, sighing, dyspnea.
  • 11 Gastrointestinal symptoms*
  • Difficulty in swallowing, wind abdominal pain, burning sensations, abdominal fullness, nausea, vomiting, borborygmi, looseness of bowels, loss of weight, constipation.
  • 12 Genitourinary symptoms*
  • Frequency of micturition, urgency of micturition, amenorrhea, menorrhagia, development of frigidity, premature ejaculation, loss of libido, impotence.
  • 13 Autonomic symptoms*
  • Dry mouth, flushing, pallor, tendency to sweat, giddiness, tension headache, raising of hair.
  • 14 Behavior at interview*
  • Fidgeting, restlessness or pacing, tremor of hands, furrowed brow, strained face, sighing or rapid respiration, facial pallor, swallowing, etc.
  • Should be Empty: