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Summary:

During the past week

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During the past week

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Below are a number of statements that people often use to describe themselves. Please read each statement and then circle the appropriate number next to that statement to indicate your answer. There are no right or wrong answers. Your own impression is the only thing thing that matters.

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Anxiety and depression. The following questions are about how you feel right now. Please choose the answer that best describes your current feeling. Do not think too long about your answer. These statements are about your personal impression. There are no wrong answers: it is opinion based.

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Did you have tingling fingers or hands?

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Did you have tingling toes or feet?

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Did you have numbness in your fingers or hands?

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Did you have numbness in your toes or feet?

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Did you have shooting or burning pain in your fingers or hands?

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Did you have shooting or burning pain in your toes or feet?

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Did you have cramps in your hands?

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Did you have cramps in your feet?

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Did you have problems standing or walking because of difficulty feeling the ground under your feet?

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Did you have difficulty distinguishing between hot and cold water?

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Did you have a problem holding a pen, which made writing difficult?

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Did you have difficulty manipulating small objects with your fingers (for example, fastening small buttons)?

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Did you have difficulty opening a jar or bottle because of weakness in your hands?

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Did you have difficulty walking because your feet dropped downwards?

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Did you have difficulty climbing stairs or getting up out of a chair because of weakness in your legs?

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Were you dizzy when standing up from a sitting or lying position?

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