Do you have physical symptoms such as chest pain, dizziness, palpitations, shortness of breath or gastrointestinal problems?

Never
Sometimes
Often
Allways

Do you feel psychic symptoms like tension, irritation, insomnia, restless or concentration?

Never
Sometimes
Often
Allways

How long do you have these symptoms?

Two Days
Five Days
One Week
One month or more

Are you able to control or avoid these symptoms in your daily life?

Allways
Often
 Raramente
Never

Do you tend to lose control over unimportant things and doesn't even realize it?

Never
Sometimes
Often
Allways

Do you think that something bad is going to happen to you at any moment?

Never
Sometimes
Often
Allways

Indicate the intensity of the symptoms experienced.

Low
Moderate
High
Very High

 

This test is for guidance only and does not replace an evaluation by a physician. www.coracaoansioso