Panic Attack Screening, PHQ-PD Test - the question form
Questions: 15 · 3 minutes
1. In the past 4 months, have you had panic attacks—sudden episodes of anxiety, fear, or terror?
Yes
No
2. Have you ever had attacks like this before?
Yes
No
3. Have any of these attacks occurred unexpectedly, in situations where you would not usually feel anxious or uncomfortable?
Yes
No
4. Do you fear having a panic attack or its consequences?
Yes
No
5. During your most recent panic attack, did you have shortness of breath or rapid breathing?
Yes
No
6. Heart pounding, racing, or skipping, or feeling as though your heart stopped?
Yes
No
7. Pain or discomfort in the left side of the chest?
Yes
No
8. Sweating?
Yes
No
9. Shortness of breath or feeling unable to get enough air?
Yes
No
10. Hot or cold flashes?
Yes
No
11. Nausea, stomach discomfort, diarrhea, or feeling like you need to have a bowel movement?
Yes
No
12. Dizziness, unsteadiness, lightheadedness, or feeling faint?
Yes
No
13. Tingling or numbness in your body or limbs?
Yes
No
14. Trembling in your body or limbs, twitching, or a feeling of tightness in your body (or limbs)?
Yes
No
15. Fear of dying or of irreversible consequences of an attack?
Yes
No