Over the past two months, have you experienced feelings of anxiety, tension, fear, or intense discomfort that escalated rapidly over a short period (a panic attack)? *

Over the past two months, have you taken any psychiatric medication? *

Have you been diagnosed with any psychological disorder? *

What is the diagnosis? *

Have you been diagnosed with any physical illness? *

1. Have you had panic attacks without warning or triggers? *

2. Do you feel extreme distress or worry about the possibility of having another panic attack? *

3. Has the recurrence of panic attacks affected your work or studies? *

4. Did the panic attack affect your social relationships (friends, colleagues, family visits)? *

5. Have panic attacks influenced your behavior, such as avoiding certain places or situations? *

6. Have panic attacks affected your home life, including relationships with family members or assisting with household matters? *

7. During a panic attack, do you feel like you are about to die? *

8. Do you feel when panic attacks occur that you In an unreal world? *

9. Do you feel during panic attacks that you will lose control of yourself or that you will go crazy? *

10. Do you believe you have a serious undiagnosed illness? *

11. Do you experience persistent anxiety, tension, or discomfort without an apparent reason? *

12. As for the first panic attack that happened to you, was it after you were exposed to a painful incident or shock? *

13. Do you experience symptoms of panic attacks when you remember a traumatic event that you were exposed to in the past? *

14. Does your panic attack occur with behaviors that you can control (such as washing your hands)? *

15. Does being in a group of people or friends cause you distress to the point that you become tense? *