From: Assessment of new-onset depression and anxiety associated with COVID-19
Questions | Options | |||
---|---|---|---|---|
 1. Age | Open question | |||
 2. Gender | Male, female | |||
 3. Marital status | Single, married, divorced, widower/ widow | |||
 4. For females: are you pregnant? | Yes, No | |||
 5. Nationality | Saudi, Non-Saudi | |||
 6. Job-status | Student, government sector employee, private sector employee, freelancer, retired, unemployed | |||
 7. Have you been diagnosed with COVID-19? | Yes, No | |||
 8. Do you know anyone of your relatives or friends is infected with COVID-19? | Yes, No | |||
 9. Have you been diagnosed with any psychiatric disorder and are you using medication for it? | Yes, No | |||
 10. Over the last two weeks, how often have you been bothered by any of the following problems? (Or four weeks after you've been diagnosed with COVID-19) | ||||
GAD-7 | Not all | Several days | More than half the days | Nearly every day |
 1. Feeling nervous, anxious or on edge? | 0 | 1 | 2 | 3 |
 2. Not being able to stop or control worrying? | 0 | 1 | 2 | 3 |
 3. Worrying too much about different things? | 0 | 1 | 2 | 3 |
 4. Trouble relaxing? | 0 | 1 | 2 | 3 |
 5. Being so restless that it is hard to sit still? | 0 | 1 | 2 | 3 |
 6. Becoming easily annoyed or irritable? | 0 | 1 | 2 | 3 |
 7. Feeling afraid as if something awful might happen? | 0 | 1 | 2 | 3 |
 11. Over the last two weeks, how often have you been bothered by any of the following problems? (Or four weeks after you've been diagnosed with COVID-19, if you've already been infected) | ||||
PHQ-9 | Not all | Several days | More than half the days | Nearly every day |
 1. Little interest or pleasure in doing things? | 0 | 1 | 2 | 3 |
 2. Feeling down, depressed, or hopeless? | 0 | 1 | 2 | 3 |
 3. Trouble falling or staying asleep, or sleeping too much? | 0 | 1 | 2 | 3 |
 4. Feeling tired or having little energy? | 0 | 1 | 2 | 3 |
 5. Poor appetite or overeating? | 0 | 1 | 2 | 3 |
 6. Feeling bad about yourself - or that you are a failure or have let yourself or your family down? | 0 | 1 | 2 | 3 |
 7. Trouble concentrating on things, such as reading the newspaper or watching television? | 0 | 1 | 2 | 3 |
 8. Moving or speaking so slowly that other people could have noticed? Or the opposite - being so fidgety or restless that you have been moving around a lot more than usual? | 0 | 1 | 2 | 3 |
 9. Thoughts that you would be better off dead, or of hurting yourself in some way? | 0 | 1 | 2 | 3 |