Below is a list of phrases that describe certain feeling that people have. Rate the patients by finding the answer which best describes the extent to which he/she has these conditions. Select one of the five responses for each of the fourteen questions.

  Not Present Mild Moderate Severe 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 rigidity, 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.
Sources
  1. M Hamilton. The Assessment of Anxiety States by Rating. 32 Br J Med Psychol 50-55. .
  2. W Maier, R Buller, M Philipp, & I Heuser. The Hamilton Anxiety Scale: Reliability, Validity and Sensitivity to Change in Anxiety and Depressive Disorders. 14(1) J Affect Disord 61-68. .