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Screening Tool: Physical Symptoms

The survey below is the PHQ-15, and is designed to see how many physical symptoms a person has. No matter what your score is, you should seek help from a health professional if you have any concerns about yourself or your loved ones.


During the past four weeks, how much have you been bothered by any of the following problems:

1. Stomach pain
2. Back pain
3. Pain in your arms or legs or other joints
4. Menstrual cramps or other problems with your periods (for women only)
5. Headaches
6. Chest pain
7. Dizziness
8. Fainting spells
9. Feeling your heart pound or race
10. Shortness of breath
11. Pain or problems during sexual intercourse
12. Constipation, loose bowels or diarrhea
13. Nausea, gas or indigestion
14. Feeling tired, or having low energy
15. Trouble sleeping

For more information about this survey

  • Kroenke K, Spitzer RL, Williams JBW. The PHQ-15: Validity of a new measure for evaluating somatic symptom severity. Psychosom Med 2002;64:258-266. 


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