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Detailed Chronic Case Taking Questionnaire Page 2 of 2

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Sent up for Sekir.

rajivprasad last decade
Bringing this up.
Cordial last decade
i have filled the questionire for my sickness plz read and give suggestion thx.

(1) I get anxious before an important event. (always)
(2) I have a strong craving for sweet things. (always)
(3) My memory is not very good (often)
(4) I often have a fear of going out, or of walking over bridges, of heights or of closed
places like elevators (lifts). (fear of going out and hights always)
(5) I often find myself walking fast, even when there is no reason to hurry.(often)
(6) Sometimes I have strong impulses to do strange or dangerous things but I do not
act on them.
(7) I feel more comfortable in cold, fresh air.
(8) I have bloating or diarrhea.
(9) I worry about my own health or about the well-being of my family.(always)
(10) I am fussy about cleanliness.
(11) When I feel anxious I pace about the room, especially at night, sometimes to the
point of exhaustion.(always)
(12) I am a terrible worrier about small things.(always)
(13) I generally do not have much appetite, but I like to sip warm drinks frequently.(often)
(14) I often cannot sleep at night, or I wake up with anxiety.(always)
(15) I am worse when it is cold and better when it is hot.
(16) I have dry, flaky skin.
(17) I have suffered from depression my whole life.(always)
(18) I have considered suicide.(occasionally)
(19) I feel I have to do something important with my life.(always)
(20) Failure is my worst fear.(always)
(21) Music is soothing to me.(often)
(22) Generally I feel better in the summer.
(23) My aches and pains feel better at night.
(24) I crave open air.
(25) I worry about what other people think of me.(always)
(26) I enjoy eating eggs, especially soft boiled.
(27) I work slowly, but I am reliable.(rarely)
(28) I feel as if I am cracking up and won't be able to cope.(rarely)
(29) I often wear socks at night because my feet are cold in bed.(i do wear in when its very cold)
(30) As a child, I had a larger than average head.
(31) I tend to put on weight easily.(never)
(32) I am troubled by nightmares.(occasionally)
(33) I sleep with my knees tucked up to my chest.(never)
(34) I have lots of moles and birth marks.(never)
(35) I enjoy travelling.(always)
(36) I enjoy eating chocolate.(occasionally)
(37) I am a perfectionist.(rarely)
(38) I love a good thunderstorm.(never)

(40) I put other's needs in front of my own.(rarely i am very selfish)
(41) Injustice makes me angry.(often)
(42) My voice is hoarser.(never)
(43) I am sensitive to changes in the weather.(rarely)
(44) I am sensitive to the suffering of others.(rarely mostly i feel happy at other people sufferings specially who i envy)
(45) I sometimes stammer, mispronounce words, or have to repeat a question before
answering it.(alwas)
(46) I have suffered long lasting stress in my personal life.(always)
(47) I might lose a little urine now and then, especially during coughing or sneezing.(never)
(48) I have had warts near the tip of my fingers or on my face.(rarely)
(49) I have been hurt deeply in love.(yes)
(50) I often find myself sighing.(often)
(51) I get a lump in my throat.(never)
(52) I hate to be consoled when I'm sad.(often)
(53) My muscles twitch.(never)
(54) My physical condition can change very rapidly and unpredictably.(rarely)
(55) Emotional shock has caused many of my problems.(always)
(56) I am very sensitive to pain, smells or sound.(occasionally)
(57) I am very talkative and tend to wander from one topic to another during a
(58) I am a jealous or envious person.(always and always want bad things to happen to that person even death)
(59) I am suspicious of other people's motives.(often)
(60) People describe me as an intense person.(occasionally)
(61) I can't stand to be overheated.
(62) I feel bad after waking up, either from a short or long sleep.(often)
(63) I blush easily.(often)
(64) I hate clothes that are too tight around my neck or chest.(often)
(65) I don't like to speak in public, or to take on new responsibilities, but I do fine once
I get started.(often)
(66) I am reserved or aloof, and feel more comfortable keeping people at a distance.(often)
(67) I have poor self-confidence.(always)
(68) I prefer small groups of close friends rather than large social gatherings.(always)
(69) I have a low energy period from 4 pm to about 8 pm in the evening.
(70) I may get sentimental and weep when someone thanks me or expresses
(71) I dislike being alone in the house, yet I dislike staying in the same room with
someone.(often i like to sit alone in the room and also eat alone)
(72) I frequently suffer from gas or some other kind of digestive complaints.(occasionally
(73) I like to be near the ocean.(rarely)
(74) My performance is erratic; sometimes very
good, sometimes bad.(often bad)
(75) I have had infections or discharges from my genital organs.
(76) I am afraid of closed narrow places, such as elevators.(rarely)
(77) I remember having sexual feelings a child.(occasionally)
(78) I tend to be lively at night, but I have a hard time getting going
in the morning.
(79) I crave oranges, or sour fruit, or like to chew on ice.(i like sour fruits often)
(80) I often have hot feet and like to stick them out from under the bed covers.(rare)
(81) I find it hard to cry in public even after very sad news.(always)
(82) People talk to me about their problems, but I don't like others to console me or
make a fuss about me.(often)
(83) I am very sensitive to being hurt or humiliated.(always)
(84) I think about past disappointments, or hold grudges for a long time.(always)
(85) I feel worse in the sun or when the weather warms up in summer.(often)
(86) I get cold sores on my lips.(never)
(87) I suffer from insomnia as a result of grief or insults.(occasionally)
(88) I often have a strong desire for salty things.(often)
(89) I get irritated if I can't get things done right.(always)
(90) I am bothered by sloppiness or inefficiency.(always)
(91) I am an ambitious and competitive person.(never)
(92) I have a bad temper but may feel sorry about it afterwards.(often)
(93) I am irritated by loud noise.(occasionally)
(94) I feel worse in the morning.(often)
(95) I often wake early, and have trouble falling asleep again.(often)
(96) I tend to overindulge in food, drink, or sex.(i masturbate a lot)
(97) I am outgoing, and make contact easily, and have lots of friends.(rarely)
(98) I am very sensitive to other people and also easily influenced by them (always)
(99) I am fearful of the dark, or of thunderstorms, or of deep water.(fear of deep water always)
(100) I readily understand other people's feelings.(rarely)
(101) I like cold, juicy and refreshing things, like iced water or ice-cream.(always)
(102) I tend to get nosebleeds or bruise easily, or have bleeding gums.(never)
(103) I function on high energy yet I burn out easily, feeling fatigued afterwards.(often)
(104) I get tired quickly and feel better after a short sleep.(often)
(105) I long for affection and like to be hugged or held.(always)
(106) My moods and inclinations change quickly.(always)
(107) I have difficulty making decisions.(always)
(108) When I have a problem, I feel better if I can talk to someone about it.(often)
(109) I dislike the fat on meat, or other fatty, greasy things.(i like)
(110) I have pain or discomfort that changes locations frequently.(rarely)
(111) I have nasal congestion (catarrh) which is worse in a hot room.(rare)
(112) I am sensitive to the cold, but I dislike hot, stuffy rooms, and often need
fresh air when others are comfortable.(rarely)
(113) At times I lose affection for my family and friends.(often)
(114) I have very little interest in sex.(i musturbate alot even i suffer erectile dysfunction)
(115) I say nasty things to my family and then feel guilty for doing so.(i say nasty things but silently even i abuse but not them just i can hear my words)
(116) I do not like to be cold.(often)
(117) When I am depressed, I prefer to be left alone.(always)
(118) I feel better after dancing, intense exercise, or listening to lively music.(i love music which gives me bit of relief)
(119) I feel nauseated from the smell of cooking, or lose my appetite completely.(rarely)
(120) I have suffered from sluggish digestion or chronic constipation.(occasionally)
(121) I am afraid of sharp objects.(rarely)
(122) I have low self-confidence, give in easily, and lack courage when it comes to standing up for myself, or to speaking in public.(always)
(123) I have difficulty making up my mind, because I get caught up in the details, rather
than seeing the big picture.(always)
(124) I feel tired or rundown, but still push myself to finish things.(often)
(125) I tend to develop scar tissue after injuries or surgery.
(126) My hands are cold and sweaty.(occasionally sweat)
(127) My nails break easily and/or my hair is fine in texture.(i bite my nails and pluck my hair)
(128) I get infections easily.(occasionally)
(129) I hold in my anger or sometimes don't even realize I'm angry until
several days later.(i get angry after long time has passed to the event)
(130) I get angry about mistreatment of me by other people.(always)
(131) I have had styes in my eves.(never)
(132) I tend to fantacise or dwell on sexual matters.(always)
(133) I sometimes masturbate to fall asleep at night.(very often)
(134) I tend to itch all over my body.(not all body but hands,head,chin)
(135) My bladder gives me problems.
(136) I feel sleepy during the day and sleepless at night.(occasionally)
(137) I am intelligent and imaginative, and I can turn useless things into something
(138) I tend to be messy or untidy.
(139) I have strong opinions and enjoy discussion and debate with others.(often)
(140) I am outgoing and sociable.(rarely)
(141) I like to eat spicy, rich food.(always)
(142) I don't like to stand for long periods, and I prefer to slouch in the nearest
chair or couch.(always)
(143) I often feel too hot; even in winter, or I have dry burning skin.(occasionally)
(144) I feel thirsty.(often)
(145) I feel fragile like I am made of glass.(never)
(146) I feel phoney or artificial or as if I am hiding something - people wouldn't like me if they knew what I am like.(always)
(147) I am secretive.
(148) I hate onions or onions really upset my system.(never)
(149) I have warts or I used to have many warts.(never)
(150) Some of my health problems started after vaccinations.(never)
(151) My perspiration is sweet smelling or offensive.(offensive)
(152) I have dreams of falling. (rarely)
gossip_khan 7 years ago

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