Somatic Symptoms & Signs Scale
IN THE PAST WEEK, HOW SEVERE WERE THE SYMPTOMS OF THE PERSON YOU TAKE CARE FOR ...
Heart & Circulation
Fast/slow/ irregular heartbeat, high/low blood pressure, chest tightness or pain, lightheaded when standing up, fainting
Weight & Metabolism
Weight gain, appetite changes, abnormal blood sugar/ triglycerides/ cholesterol
Sleep, Alertness & Energy
Trouble falling asleep, restless or light sleep, waking up often or too early, feeling agitated/ tense, inner restlessness, sleeping too much, feeling sleepy during day, tiredness, lack of energy
Nerves & Muscles
Shaking/tremors, muscle cramps/ spasm, muscle pain, muscle stiffness, involuntary movements, clumsiness/ dyscoordination, dizziness, headache/migraine, seizures
Sexual & Reproductive health
Increased/ decreased sexual drive, impulsive sexual behavior, period changes, breast swelling or discharge, trouble reaching orgasm, erection problems, high prolactin
Stomach & Digestion & Liver & Bile
Dry mouth, too much saliva, nausea, vomiting, stomach pain/ cramps, diarrhea, constipation, bloating/gas, jaundice, gall stones
Breathing & Lungs
Fast breathing, shallow breathing, pauses in breathing, difficulty breathing, runny nose, wheezing, snoring
Skin & Hair
Rash, itching, tingling, burning, moles, skin sensitivity to sunlight, hair loss, high/low temperature
Eyes & Ears & Other senses
Double vision, blurred vision, dry eyes, eye twitching, cataracts, sensitivity to light, sensitivity to sound, ringing in ears, head spinning/ vertigos, taste alterations
Kidney, Bladder & Prostate
Kidney pain, kidneystones, urinary hesitancy, urinary incontinence
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