Q175 Have you actually been sitting Q175 Rate only if the lack of energy etc is around a lot (or spending more time in bed associated with the marked lack of physical than usual) because of lack of energy? activity referred to i.e. sits or lies around because of lack of energy. Do not ask if the 0. No respondent is or bedfast just rate 9. 1. Infrequently 2. Frequently/Persistently 8. No answer 9. Not 176 OBSERVATION VERY SLOW IN 176 Rate only if all R's movements are ALL MOVEMENTS. slow. Do not rate if obviously due to physical illness, stroke etc. This sign of 0. No retardation is present in certain types of 1. Mild depression and in some other psychiatric 2. Severe conditions. 9. Not applicable TENSION In this section rate for a sensation that is Q177 Do you get worn out (exhausted)? unpleasant, that cannot be overcome and is (IF NO:) What about towards the evening? out of proportion to the prevailing circumstances. 0. No 1. Mild Q177 Rate only tiredness that is not readily 2. Severe explained by strenuous activities. 8. No answer 9. Not asked Q178 Do you have difficulty in relaxing Q178 This refers to relaxing physically. As (resting)? in symptoms, it must present a problem for the respondent in the last 0. No month. 1. Infrequently 2. Frequently/Persistently 8. No answer 9. Not asked Q179 Do you have headaches? Q179 Include here any headaches. 0. No 1. Infrequently 2. Frequently/Persistently 8. No answer 9. Not asked
Q175 Have you actually been sitting around a lot (or spending more time in bed than usual) because of lack of energy? 0. No 1. Infrequently 2. Frequently/Persistently 8. No answer 9. Not Q175 Rate only if the lack of energy etc is associated with the marked lack of physical activity referred to i.e. sits or lies around because of lack of energy. Do not ask if the respondent is or bedfast just rate 9. 176 OBSERVATION VERY SLOW IN ALL MOVEMENTS. 0. No 1. Mild 2. Severe 9. Not applicable 176 Rate only if all R's movements are slow. Do not rate if obviously due to physical illness, stroke etc. This sign of retardation is present in certain types of depression and in some other psychiatric conditions. TENSION Q177 Do you get worn out (exhausted)? (IF NO:) What about towards the evening? 0. No 1. Mild 2. Severe 8. No answer 9. Not asked In this section rate for a sensation that is unpleasant, that cannot be overcome and is out of proportion to the prevailing circumstances. Q177 Rate only tiredness that is not readily explained by strenuous activities. Q178 Do you have difficulty in relaxing (resting)? 0. No 1. Infrequently 2. Frequently/Persistently 8. No answer 9. Not asked Q178 This refers to relaxing physically. As in symptoms, it must present a problem for the respondent in the last month. Q179 Do you have headaches? 0. No 1. Infrequently 2. Frequently/Persistently 8. No answer 9. Not asked Q179 Include here any headaches.
CFAS-II-questionnaire-part-1-v5-111008.docx