General Symptoms

The General Symptoms are based on the Patient Health Questionnaire Physicial Symptoms PHQ-15.

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• Symptom Assessment
• Well-Being Assessment
• CDC Health Risk Assessments

Over the last 4 weeks, how often have you been bothered by the following problems?	Not bothered at all	Bothered a little	Bothered a lot
1. Stomach pain	0	1	2
2. Back pain	0	1	2
3. Pain in your arms, legs, or joints (knees, hips, etc.)	0	1	2
4. Menstrual cramps or other problems with your period - WOMEN ONLY	0	1	2
5. Headaches	0	1	2
6. Chest pain	0	1	2
7. Dizziness	0	1	2
8. Fainting spells	0	1	2
9. Feeling your heart pound or race	0	1	2
10. Shortness of breath	0	1	2
11. Pain or problems during sexual intercourse	0	1	2
12. Constipation, loose bowels, or diarrhea	0	1	2
13. Nausea, gas, or indigestion	0	1	2
14. Feeling tired or having low energy	0	1	2
15. Trouble failing or staying asleep, or sleeping too much	0	1	2
Total the score	0	_____	+_____
		_____	=Total Score

Interpreting PHQ-15 Scores

PHQ-15 Score	Levels of Somatic Symptom Severity
0-4	Minimal
5-9	Low
10-14	Medium
15-30	High

The PHQ-15 is described in more detail at the Pfizer website.