Comprehensive Health Assessment Tool

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Depression, Anxiety & Stress Test (DASS 21)
According to the World Health Organization (WHO), mental health is a “state of well-being in which the individual realizes his or her own abilities, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to his or her community”.
This tool is designed to measure the emotional states of depression, anxiety and stress in an individual.
It is not intended to replace the evaluation of a medical professional. Interpretation of the result must be done by a medical professional and used in conjunction with a comprehensive clinical history and physical assessment.

Q1

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

1. I find it hard to calm myself down.

2. I am aware of the dryness of my mouth.

3. I cannot seem to experience any positive feeling at all.

Q2

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

4. I find it difficult to breathe even when I am not doing any physical activity or exertion (eg. shallow rapid breathing).

5. I find it difficult to find the initiative to do things.

6. I tend to over-react in situations.

Q3

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

7. I have trembling of the body (eg. hands trembling).

8. I feel like I have a lot of nervous energy.

9. I am worried of situations in which I might panic and make a fool of myself.

Q4

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

10. I feel like I have nothing to look forward to.

11. I find myself being restless and agitated.

12. I find it difficult to relax.

Q5

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

13. I feel down and sad.

14. I cannot tolerate things that prevent me to carry on with what I’m doing.

15. I feel like I was close to being panicked and anxious.

Q6

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

16. I am not able to be enthusiastic with anything that I do.

17. I don’t think I’m worth much as a person.

18. I feel that I am emotionally sensitive or touchy.

Q7

Please read each statement and choose number 0, 1, 2 or 3 which indicates how much the statement applied to you over the past 1 week. There are no wrong or right answers. Do not spend too much time on any statement.
  • 0= Did not apply to me at all
  • 1= Applied to me to some degree, or some of the time
  • 2= Applied to me to a considerable degree, or a lot of the time
  • 3= Applied to me very much, or most of the time

19. I am aware of my heartbeats even when I am not doing any physical activity or exertion (eg. heartbeats getting faster, heart skipping a beat etc.).

20. I feel scared without any valid reason.

21. I feel that life is meaningless.

Checking Results

Analysis in progress, please wait for one moment

Results:

  Your Score Severity
Depression
Anxiety
Stress
IMPORTANT!
  • Interpretation of the scoring above should be done by a medical professional and used in conjunction with a comprehensive clinical history and physical assessment.
  • If you feel that you are experiencing these feelings frequently and strongly or have any thoughts about harming yourselves or others, PLEASE SEEK HELP FROM A MEDICAL PROFESSIONAL IMMEDIATELY.
What is Depression?
According to World Health Organization (WHO), depression is a common mental disorder affecting more than 264 million people worldwide. The effects of depression can be long-lasting or recurrent and can dramatically affect a person’s ability to function and live a rewarding life.
Symptoms of depression may include:
  • Persistent sadness and depressed mood
  • A lack of interest or enjoyment in previously rewarding or enjoyable activities
  • Sleep disturbance
  • Change or loss of appetite
  • Tiredness and reduced energy
  • Poor concentration
  • Anxiety symptoms
  • Feelings of guilt or low self-worth
  • Thoughts of harming oneself or others
What is Anxiety?
Experiencing anxiety occasionally is a normal part of life. However, people suffering from anxiety disorders frequently have intense, excessive and persistent worry and fear about everyday situations.
There are several types of anxiety disorders: Generalized Anxiety Disorder (GAD), Panic Disorder, Phobia, Post-Traumatic Stress Disorder (PTSD) and Obsessive-Compulsive Disorder (OCD).
General characteristics of anxiety disorders are:
  • Psychological symptoms
    • Having a sense of apprehension, impending danger or dread
    • Excessive worrying or fear
    • Difficulty falling asleep or staying asleep (insomnia)
    • Feeling nervous, jumpy or tense
    • Feeling irritated
  • Physical symptoms
    • Rapid or irregular heartbeat (palpitations)
    • Experiencing gastrointestinal (GI) problems such as gnawing feeling, "butterflies in the stomach," diarrhea or irritated bowel syndrome
    • Breaking out in sweat
    • Feeling cold and clammy
    • Headache, light-headedness or dizziness
    • Bodily tension or aches
    • Fatigue or extreme tiredness
What is Stress?
The Ministry of Health Malaysia define stress as ‘the way you feel when pressures are put on you’.
Stress can be both good and bad for you. While the right amount of stress can help to motivate and encourage a person’s productivity, too much or prolonged pressure on a person can lead to an unhealthy amount of stress and this may lead to deterioration of a person’s physical and emotional ability.
How to know that you are stressed?
  • Heart rate increases
  • Muscle tense up
  • Breathing becomes quicker
  • Digestive processes slow down and more acid is produced in the stomach, leading to physical discomfort or pain
  • Negative feelings of anxiety, worry, fear or anger
  • Having sleep problems (problem getting and staying asleep, or sleeping too much)
  • Having appetite problems (not feeling hungry at meal times, or feeling hungry for most times)
Everyone experiences negative feelings, thoughts and emotions to a certain degree at various points in their life.
However, if you feel that you experience these feelings or symptoms frequently and strongly, you should always seek for the advice of a medical professional.
Reference:
  • Ministry of Health Malaysia, Depression, Anxiety, Stress Scale (DASS 21)
  • Lovibond, S.H. & Lovibond, P.F. (1995). Manual for the Depression Anxiety Stress Scales. (2nd. Ed.) Sydney: Psychology Foundation.
  • Ministry of Health Malaysia, National Health and Morbidity Survey 2015
  • World Health Organization, Depression, 30th January 2020
  • Ministry of Health Malaysia, MyHealth Portal, Anxiety
  • Ministry of Health Malaysia, MyHealth Portal, Stress Management
Need Help?

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Dr Ang Jin Kiat
Dr Ang Jin Kiat
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Dr Chan Yee Fai
Dr Chan Yee Fai
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Dr Lim Wai Jenn
Dr Lim Wai Jenn
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Dr Mohd Fadzli Bin Mohamad Isa
Dr Mohd Fadzli Bin Mohamad Isa
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Dr Phang Cheng Kar
Dr Phang Cheng Kar
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Dr Tee Bee Chin
Dr Tee Bee Chin
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Dr Ting Joe Hang
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