General Health Questionnaire Name Date

General Health Questionnaire Name

Date

Please consider the last four weeks and answer the following questions by selecting and circling one of the four answer options. Question 1 2 3 4 1. Been able to concentrate on Better than Same as Less than Much less what you’re doing usual usual usual than usual 2. Lost much sleep over worry Not at all No more Rather more Much more than usual than usual than usual 3. Felt you were playing a More so Same as Less useful Much less useful part in things than usual usual than usual useful 4. Felt capable of making More so Same as Less useful Much less decisions about things than usual usual than usual useful 5. Felt constantly under strain Not at all No more Rather more Much more than usual than usual than usual 6. Felt you couldn’t overcome Not at all No more Rather more Much more your difficulties than usual than usual than usual 7. Been able to enjoy your More so Same as Less useful Much less normal day-to-day activities than usual usual than usual useful 8. Been able to face up to your More so Same as Less useful Much less problems than usual usual than usual useful 9. Been feeling unhappy and Not at all No more Rather more Much more depressed than usual than usual than usual 10. Been losing confidence in Not at all No more Rather more Much more yourself than usual than usual than usual 11. Been thinking of yourself Not at all No more Rather more Much more as a worthless person. than usual than usual than usual 12. Been feeling reasonably More so About the Less so than Much less happy, all things considered than usual same as usual than usual usual