II. Indications

III. Scale: Answers

  1. Score 0: Not at All
  2. Score 1: A Little
  3. Score 2: A Lot

IV. Questions: Over the last 4 weeks, how much have you been bothered by the following (use the answer scale for each symptom)

  1. Back pain
  2. Chest Pain
  3. Constipation, loose bowels or Diarrhea
  4. Dizziness
  5. Fainting
  6. Feeling tired or having low energy
  7. Felling your heart pound or race
  8. Headaches
  9. Menstrual Cramps or other problems with your periods (women)
  10. Nausea, gas or indigestion
  11. Pain or problems during sexual intercourse
  12. Shortness of Breath
  13. Stomach Pain
  14. Trouble Sleeping

V. Interpretation

  1. Score 0-4
    1. No Somatic Symptom Disorder
  2. Score 5-9
    1. Mild Somatic Symptom Disorder
  3. Score 10-14
    1. Moderate Somatic Symptom Disorder
  4. Score 15 or higher
    1. Severe Somatic Symptom Disorder

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