Anxiety Disorder Screening

Zung Assessment Tool Read each sentence carefully. For each statement, select the response that best corresponds to how often you have felt that way in the last 2 weeks. Print out this test and discuss your answers with your health care provider on your next visit. If your score is 50 or higher, consider printing the results of your test to show it to your health care provider. Ask him or her to evaluate you for anxiety disorder. Please Note: Only a health care professional can actually diagnose anxiety disorder. 1. I feel more nervous and anxious than usual 1. I feel more nervous and anxious than usual = Not Often 1. I feel more nervous and anxious than usual = Sometimes 1. I feel more nervous and anxious than usual = Often 1. I feel more nervous and anxious than usual = All the time Not often Sometimes Often All the time 2. I feel afraid for no reason at all 2. I feel afraid for no reason at all = Not Often 2. I feel afraid for no reason at all = Sometimes 2. I feel afraid for no reason at all = Often 2. I feel afraid for no reason at all = All the time Not often Sometimes Often All the time 3. I get upset easily or feel panicky 3. I get upset easily or feel panicky = Not Often 3. I get upset easily or feel panicky = Sometimes 3. I get upset easily or feel panicky = Often 3. I get upset easily or feel panicky = All the time Not often Sometimes Often All the time 4. I feel like I'm falling apart and going to pieces 4. I feel like I'm falling apart and going to pieces = Not Often 4. I feel like I'm falling apart and going to pieces = Sometimes 4. I feel like I'm falling apart and going to pieces = Often 4. I feel like I'm falling apart and going to pieces = All the time Not often Sometimes Often All the time 5. I feel that everything is all right and nothing bad will happen 5. I feel that everything is all right and nothing bad will happen = Not Often 5. I feel that everything is all right and nothing bad will happen = Sometimes 5. I feel that everything is all right and nothing bad will happen = Often 5. I feel that everything is all right and nothing bad will happen = All the time Not often Sometimes Often All the time 6. My arms and legs shake and tremble 6. My arms and legs shake and tremble = Not Often 6. My arms and legs shake and tremble = Sometimes 6. My arms and legs shake and tremble = Often 6. My arms and legs shake and tremble = All the time Not often Sometimes Often All the time 7. I am bothered by headaches, neck and back pains 7. I am bothered by headaches, neck and back pains = Not Often 7. I am bothered by headaches, neck and back pains = Sometimes 7. I am bothered by headaches, neck and back pains = Often 7. I am bothered by headaches, neck and back pains = All the time Not often Sometimes Often All the time 8. I feel weak and get tired easily 8. I feel weak and get tired easily = Not Often 8. I feel weak and get tired easily = Sometimes 8. I feel weak and get tired easily = Often 8. I feel weak and get tired easily = All the time Not often Sometimes Often All the time 9. I feel calm and can sit still easily 9. I feel calm and can sit still easily = Not Often 9. I feel calm and can sit still easily = Sometimes 9. I feel calm and can sit still easily = Often 9. I feel calm and can sit still easily = All the time Not often Sometimes Often All the time 10. I can feel my heart beating fast 10. I can feel my heart beating fast = Not Often 10. I can feel my heart beating fast = Sometimes 10. I can feel my heart beating fast = Often 10. I can feel my heart beating fast = All the time Not often Sometimes Often All the time 11. I am bothered by dizzy spells 11. I am bothered by dizzy spells = Not Often 11. I am bothered by dizzy spells = Sometimes 11. I am bothered by dizzy spells = Often 11. I am bothered by dizzy spells = All the time Not often Sometimes Often All the time 12. I have fainting spells or feel like it 12. I have fainting spells or feel like it = Not Often 12. I have fainting spells or feel like it = Sometimes 12. I have fainting spells or feel like it = Often 12. I have fainting spells or feel like it = All the time Not often Sometimes Often All the time 13. I can breathe in and out easily 13. I can breathe in and out easily = Not Often 13. I can breathe in and out easily = Sometimes 13. I can breathe in and out easily = Often 13. I can breathe in and out easily = All the time Not often Sometimes Often All the time 14. I get feelings of numbness and tingling in my fingers and toes 14. I get feelings of numbness and tingling in my fingers and toes = Not Often 14. I get feelings of numbness and tingling in my fingers and toes = Sometimes 14. I get feelings of numbness and tingling in my fingers and toes = Often 14. I get feelings of numbness and tingling in my fingers and toes = All the time Not often Sometimes Often All the time 15. I am bothered by stomach aches or indigestion 15. I am bothered by stomach aches or indigestion = Not Often 15. I am bothered by stomach aches or indigestion = Sometimes 15. I am bothered by stomach aches or indigestion = Often 15. I am bothered by stomach aches or indigestion = All the time Not often Sometimes Often All the time 16. I have to empty my bladder often 16. I have to empty my bladder often = Not Often 16. I have to empty my bladder often = Sometimes 16. I have to empty my bladder often = Often 16. I have to empty my bladder often = All the time Not often Sometimes Often All the time 17. My hands are usually warm and dry 17. My hands are usually warm and dry = Not Often 17. My hands are usually warm and dry = Sometimes 17. My hands are usually warm and dry = Often 17. My hands are usually warm and dry = All the time Not often Sometimes Often All the time 18. My face gets hot and blushes 18. My face gets hot and blushes = Not Often 18. My face gets hot and blushes = Sometimes 18. My face gets hot and blushes = Often 18. My face gets hot and blushes = All the time Not often Sometimes Often All the time 19. I fall asleep easily and get a good night's rest 19. I fall asleep easily and get a good night's rest = Not Often 19. I fall asleep easily and get a good night's rest = Sometimes 19. I fall asleep easily and get a good night's rest = Often 19. I fall asleep easily and get a good night's rest = All the time Not often Sometimes Often All the time 20. I have nightmares 20. I have nightmares = Not Often 20. I have nightmares = Sometimes 20. I have nightmares = Often 20. I have nightmares = All the time Not often Sometimes Often All the time