The Clinical Anxiety Scale (CAS) is an instrument for quickly measuring the severity of anxiety in a patient. It was derived from the Hamilton Anxiety Scale. The authors are from the University of Leeds.
Parameters - based on how the patient has felt during the past 2 days:
(1) psychic tension
(2) ability to relax (muscular tension)
(3) startle response (hyperarousability)
(4) worrying
(5) apprehension, with groundless anticipation of disaster
(6) restlessness
|
Parameter |
Finding |
Points |
|
psychic tension |
within population norms |
0 |
|
|
a slight feeling of being tense without distress |
1 |
|
|
a definite experience of being tense which is sufficient to cause some although not severe distress |
2 |
|
|
marked feelings of being tense that fluctuate during the course of the day |
3 |
|
|
very marked and distressing, with little change throughout the waking hours |
4 |
|
muscular tension |
no subjective muscular tension, or tension that can be easily controlled at will |
0 |
|
|
slight recurrent muscular tension but which does not cause distress |
1 |
|
|
muscular tension in some part of the body to cause some but not severe distress |
2 |
|
|
severe tension limited to certain muscles and which may fluctuate in severity throughout the day |
3 |
|
|
severe tension throughout much of the body's skeletal muscles most of the waking day, with no ability to relax the muscles at will |
4 |
|
startle response |
within population norms |
0 |
|
|
slightly "jumpy" but not distressed |
1 |
|
|
unexpected noises may cause definite but not severe distress |
2 |
|
|
unexpected noise causes severe distress that is either psychic or somatic but not both |
3 |
|
|
unexpected noise causes severe distress that has both psychic and somatic components |
4 |
|
worrying |
within population norms |
0 |
|
|
worries a little more than necessary about minor matters but does not cause much distress |
1 |
|
|
painful thoughts out of proportion to the patient's situation keep intruding into consciousness but the patient is able to dispel or dismiss them |
2 |
|
|
painful thoughts that fluctuate in intensity throughout the waking hours, and the distressing thoughts may cease for an hour or two, especially if the patient is distracted by an activity requiring attention |
3 |
|
|
continuous preoccupation with painful thoughts which cannot be stopped voluntarily and the distress is out of proportion to the subject matter of the thoughts |
4 |
|
apprehension |
none |
0 |
|
|
slight but does not cause distress |
1 |
|
|
sensation that is not severe but which causes some distress |
2 |
|
|
feels on the brink of disaster but no more than once a day |
3 |
|
|
feels on the brink of some disaster that cannot be explained; the experience need not be continuous and may occur in short bursts several times a day |
4 |
|
restlessness |
none |
0 |
|
|
slight, does not cause distress |
1 |
|
|
feeling a "need to be on the move" which causes some, but not severe, distress |
2 |
|
|
restless, but able to keep still for an hour or so at a time |
3 |
|
|
unable to keep still for more than a few minutes and engages in restless pacing or other purposeless activities |
4 |
Additional parameter (scored separately):
(1) panic attacks: sudden experience of groundless terror accompanied by marked autonomic symptoms, feelings of imminent collapse or loss of control over reason and self-integrity
|
Parameter |
Finding |
Points |
|
panic attack |
no episodic sudden increase in the level of anxiety |
0 |
|
|
episodic slight increases in the level of anxiety which are only precipitated by definite events or activities |
1 |
|
|
episodes occurring once or twice a week; generally less severe but can still cause distress |
2 |
|
|
episodes occurring no more than once a day |
3 |
|
|
episodes occurring several times a day, very severe |
4 |
clinical anxiety scale =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 24
• maximum points for panic attacks: 4
• The higher the score, the greater the degree of anxiety.
Specialty: Psychiatry
