The following questionnaire is a screening tool to assess a patient’s mental state for the presence of symptoms of anxiety to help diagnose Generalized Anxiety Disorder (GAD, ICD-10: F41.1).

The result obtained from the questionnaire does not mandate a medical diagnosis, but it serves as a guide in the patient’s decision whether to see a psychiatrist and psychologist.

Instructions for completing the questionnaire:

• The questions relate to the last 2 weeks.
• Please tick the answer that most accurately describes the frequency of the symptoms and feelings described in the question.
• When marking a particular answer, please do so without thinking about it further.

How often have you experienced the following symptoms in the last 14 days?