Somatic symptom disorder questionnaire

During the past 7 days, how much have you been bothered by stomach pain

During the past 7 days, how much have you been bothered by back pain

During the past 7 days, how much have you been bothered by pain in your arms, legs, or joints (knees, hips, etc.)

During the past 7 days, how much have you been bothered by headaches

During the past 7 days, how much have you been bothered by chest pain

During the past 7 days, how much have you been bothered by dizziness

During the past 7 days, how much have you been bothered by fainting spells

During the past 7 days, how much have you been bothered by feeling your heart pound or race

During the past 7 days, how much have you been bothered by shortness of breath

During the past 7 days, how much have you been bothered by pain or problems during sexual intercourse

During the past 7 days, how much have you been bothered by constipation, loose bowels, or diarrhea

During the past 7 days, how much have you been bothered by nausea, gas, or indigestion

During the past 7 days, how much have you been bothered by feeling tired or having low energy

During the past 7 days, how much have you been bothered by trouble sleeping

During the past 7 days, how much have you been bothered by mentrual cramps or other problems with your periods (WOMEN ONLY)

Do you have troubling thoughts about the seriousness of one's symptoms?

Are you experiencing anxiety about your health or these symptoms on a daily basis?

How much time and energy do you devote to these symptoms or health concerns (taking care of/thinking/talking/reading up on it)?

At least one of these symptoms is present for 6 months (perhaps not continuously, but recurring frequently):