Positive Symptom Severity Assessment Form
Please complete the Positive Symptom Severity Assessment Form by rating each symptom below according to its severity or frequency. Your responses help provide a structured assessment of positive symptoms.
Hallucinations
*
None
0
1
2
3
4
Severe
5
0 is None, 5 is Severe
Delusions
*
None
0
1
2
3
4
Severe
5
0 is None, 5 is Severe
Disorganized Speech
*
None
0
1
2
3
4
Severe
5
0 is None, 5 is Severe
Disorganized or Catatonic Behavior
*
None
0
1
2
3
4
Severe
5
0 is None, 5 is Severe
Suspiciousness or Persecutory Ideas
*
None
0
1
2
3
4
Severe
5
0 is None, 5 is Severe
Grandiosity
*
None
0
1
2
3
4
Severe
5
0 is None, 5 is Severe
Which symptom has been most prominent in the past week?
*
Hallucinations
Delusions
Disorganized Speech
Disorganized or Catatonic Behavior
Suspiciousness or Persecutory Ideas
Grandiosity
Other
Overall, how would you rate the impact of positive symptoms on daily functioning?
*
No impact
Mild impact
Moderate impact
Severe impact
In the last week, how often have positive symptoms occurred?
*
Not at all
Rarely
Sometimes
Often
Almost constantly
Additional Comments (optional)
Submit Assessment
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