Panic Disorder Severity Scale (PDSS)

If you would prefer to fill in this questionnaire offline you can download a pdf by clicking on the link.

Several of the following questions refer to panic attacks and limited symptom attacks. For this questionnaire we define a panic attack as a sudden rush of fear or discomfort accompanied by at least 4 of the symptoms listed below. In order to qualify as a sudden rush, the symptoms must peak within 10 minutes. Episodes like panic attacks but having fewer than 4 of the listed symptoms are called limited symptom attacks. Here are the symptoms to count.

Rapid or pounding heartbeat
Sweating
Trembling or shaking
Breathlessness
Feeling of choking
Chest pain or discomfort
Nausea
Dizziness or faintness
Feelings or unreality
Numbness or tingling
Chills or hot flushes
Fear of losing control or going crazy
Fear of dying

Question 1: How many panic and limited symptoms attacks did you have during the week?

0: No panic or limited symptom episodes
1: Mild: no full panic attacks and no more than 1 limited symptom attack/day
2: Moderate: 1 or 2 full panic attacks and/or multiple limited symptom attacks/day
3: Severe: more than 2 full attacks but not more than 1/day on average
4: Extreme: full panic attacks occurred more than once a day, more days than not

Question 2: If you had any panic attacks during the past week, how distressing (uncomfortable, frightening) were they while they were happening? (If you had more than one, give an average rating. If you didn't have any panic attacks but did have limited symptom attacks, answer for the limited symptom attacks)

0: Not at all distressing, or no panic or limited symptom attacks during the past week
1: Mildly distressing (not too intense)
2: Moderately distressing (intense, but still manageable)
3: Severely distressing (very intense)
4: Extremely distressing (extreme distress during all attacks)

Question 3: During the past week, how much have you worried or felt anxious about when your next panic attack would occur or about fears related to the attacks (for example, that they could mean you have physical or mental health problems or could cause you social embarrassment)?

0: Not at all
1: Occasionally or only mildly
2: Frequently or moderately
3: Very often or to a very disturbing degree
4: Nearly constantly and to a disabling extent

Question 4: During the past week were there any places or situations (e.g., public transportation, movie theatres, crowds, bridges, tunnels, shopping malls, being alone) you avoided, or felt afraid of (uncomfortable in, wanted to avoid or leave), because of fear of having a panic attack? Are there any other situations that you would have avoided or been afraid of if they had come up during the week, for the same reason? If yes to either question, please rate your level of fear and avoidance this past week.

0: None: no fear or avoidance
1: Mild: occasional fear and/or avoidance but I could usually confront or endure the situation. There was little or no modification of my lifestyle due to this
2: Moderate: noticeable fear and/or avoidance but still manageable. I avoided some situations, but I could confront them with a companion. There was some modification of my lifestyle because of this, but my overall functioning was not impaired
3: Severe: extensive avoidance. Substantial modification of my lifestyle was required to accommodate the avoidance making it difficult to manage usual activities
4: Extreme: pervasive disabling fear and/or avoidance. Extensive modification in my lifestyle was required such that important tasks were not performed

Question 5: During the past week, were there any activities (e.g. physical exertion, sexual relations, taking a hot shower or bath, drinking coffee, watching an exciting or scary movie) that you avoided, or felt afraid of (uncomfortable doing, wanted to avoid or stop), because they caused physical sensations like those you feel during panic attacks or that you were afraid might trigger a panic attack? Are there any other activities that you would have avoided or been afraid of if they had come up during the week for that reason? If yes to either question, please rate your level of fear and avoidance of those activities this past week.

0: No fear or avoidance of situations or activities because of distressing physical sensations
1: Mild: occasional fear and/or avoidance, but usually I could confront or endure with little distress activities that cause physical sensations. There was little modification of my lifestyle due to this
2: Moderate: noticeable avoidance but still manageable. There was definite, but limited, modification of my lifestyle such that my overall functioning was not impaired
3: Severe: extensive avoidance. There was substantial modification of my lifestyle or interference in my functioning
4: Extreme: pervasive and disabling avoidance. There was extensive modification in my lifestyle due to this such that important tasks or activities were not performed

Question 6: During the past week, how much did the above symptoms altogether (panic and limited symptom attacks, worry about attacks, and fear of situations and activities because of attacks) interfere with your ability to work or carry out your responsibilities at home? (If your work or home responsibilities were less than usual this past week, answer how you think you would have done if the responsibilities had been usual)

0: No interference with work or home responsibilities
1: Slight interference with work or home responsibilities, but I could do nearly everything I could if I didn't have these problems
2: Significant interference with work or home responsibilities, but I still could manage to do the things I needed to do
3: Substantial impairment in work or home responsibilities; there were many important things I couldn't do because of these problems
4: Extreme, incapacitating impairment such that I was essentially unable to manage any work or home responsibilities

Question 7: During the past week, how much did panic and limited symptom attacks, worry about attacks and fear of situations and activities because of attacks interfere with your social life? (if you didn't have many opportunities to socialise this past week, answer how you think you would have done if you did have opportunities)

0: No interference
1: Slight interference with social activities, but I could do nearly everything I could if I didn't have these problems
2: Significant interference with social activities but I could manage to do most things if I made the effort
3: Substantial impairment in social activities; there are many social things I couldn't do because of these problems
4: Extreme, incapacitating impairment, such that there was hardly anything social I could do

The range of possible scores on the PDSS is 0-28. Interpreting the severity of the PDSS scores depends on whether agoraphobia is present. Furukawa et al. (2009) report that for people with a diagnosis of agoraphobia a score of 3-7 indicates that they are "borderline ill", 8-10, "slightly ill", 11-15 "moderately ill", 16-18 "markedly ill", and 19 plus "among the most severely ill." For people without a diagnosis of agoraphobia, a score of 0-1 is "normal", 2-5 is "borderline ill", 6-9 is 'slightly ill", 10-13 "moderately ill", 14-16 "markedly ill", and 17+ "among the most severely ill". Over the course of treatment, a decrease in scores by 75 to 100% was considered "Very much improved", by 40 to 74% "Much improved", and by 10 to 39% "Minimally improved".

References

Furukawa, T. A., Katherine Shear, M., Barlow, D. H., Gorman, J. M., Woods, S. W., Money, R., Etschel, E., Engel, R. R., & Leucht, S. (2009). Evidence-based guidelines for interpretation of the Panic Disorder Severity Scale. Depression and anxiety, 26(10), 922-929. https://doi.org/10.1002/da.20532
Shear, M. K., Brown, T. A., Barlow, D. H., Money, R., Sholomskas, D. E., Woods, S. W., ... & Papp, L. A. (1997). Multicenter collaborative panic disorder severity scale. American Journal of Psychiatry, 154(11), 1571-1575.

Important

Please treat your scores on these or any other online questionnaires with caution. Questionnaires cannot be used to make a diagnosis of a mental health condition. Where a mental health condition has been diagnosed by a suitably qualified and experienced health professional these questionnaires may be used as a guide to the current severity of your condition. Always consult with a qualified health professional if you are concerned in any way about your mental health.

If you are worried about your safety, you should immediately consult with your GP or another suitably qualified health professional. If you are in the UK the following numbers might be of help to you:

NHS Emergencies: call 999.
NHS Non-emergency number: call 111.
Samaritans: call 116 123 or email jo@samaritans.org

You can find more guidance and additional helpline numbers on this NHS page: Help for suicidal thoughts

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