Canadian Community Health Survey (CCHS) - Mental Health

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Table of Contents

Survey Introduction (INT)

Survey Introduction (INT) - Question identifier:INT_R01

Your answers will be kept strictly confidential and will not be shared or disclosed without your consent. Statistics Canada will use your answers only for statistical purposes and will publish the information from this survey in aggregate form. While participation is voluntary, your assistance is essential if the results are to be accurate.

Age of respondent (AN3)

Age of respondent (AN3) - Question identifier:AN3_R01

For some of the questions I'll be asking, I need to know your exact date of birth.

Age of respondent (AN3) - Question identifier:AN3_Q02

So your age is ^DV_AGE.
Is that correct?

1. Yes
2. No, return and correct date of birth
3. No, collect age

Age of respondent (AN3) - Question identifier:AN3_Q03

What is your age?

Age of respondent (AN3) - Question identifier:AN3_R04

Because you are less than 15 years old, you are not eligible to participate in the Canadian Community Health Survey on Mental Health.

General Health (GEN)

General Health (GEN) - Question identifier:GEN_R01

This survey deals with various aspects of your health. The following questions ask about physical activity, social relationships and health status. By health, we mean not only the absence of disease or injury but also physical, mental and social well-being.

General Health (GEN) - Question identifier:GEN_Q01

In general, would you say your health is...?

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
8. RF
9. DK

General Health (GEN) - Question identifier:GEN_Q02A

Compared to one year ago, how would you say your health is now? Is it...?

1. Much better now than 1 year ago
2. Somewhat better now (than 1 year ago)
3. About the same
4. Somewhat worse now (than 1 year ago)
5. Much worse now (than 1 year ago)
8. RF
9. DK

General Health (GEN) - Question identifier:GEN_Q02A_1

How often do you have trouble going to sleep or staying asleep?

1. None of the time
2. A little of the time
3. Some of the time
4. Most of the time
5. All of the time
8. RF
9. DK

General Health (GEN) - Question identifier:GEN_Q02B

Using a scale of 0 to 10 where 0 means "Very dissatisfied" and 10 means "Very satisfied", how do you feel about your life as a whole right now?

0. Very dissatisfied
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very satisfied
98. RF
99. DK

General Health (GEN) - Question identifier:GEN_Q07

Thinking about the amount of stress in your life, would you say that most days are...?

1. Not at all stressful
2. Not very stressful
3. A bit stressful
4. Quite a bit stressful
5. Extremely stressful
8. RF
9. DK

General Health (GEN) - Question identifier:GEN_Q08

Have you worked at a job or business at any time in the past 12 months?

1. Yes
2. No
8. RF
9. DK

General Health (GEN) - Question identifier:GEN_Q09

The next question is about your main job or business in the past 12 months. Would you say that most days at work were...?

1. Not at all stressful
2. Not very stressful
3. A bit stressful
4. Quite a bit stressful
5. Extremely stressful
8. RF
9. DK

General Health (GEN) - Question identifier:GEN_Q10

How would you describe your sense of belonging to your local community? Would you say it is...?

1. Very strong
2. Somewhat strong
3. Somewhat weak
4. Very weak
8. RF
9. DK

Screening Section (SCR)

Screening Section (SCR) - Question identifier:SCR_R01

The next questions are about your well-being and areas of your life that could affect your physical and emotional health. Take your time to think about each question before answering.

Screening Section (SCR) - Question identifier:SCR_Q08A

In general, would you say your physical health is... ?

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q08B

In general, would you say your mental health is... ?

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q21

Have you ever in your life had a period lasting several days or longer when most of the day you felt sad, empty or depressed?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q22

Have you ever had a period lasting several days or longer when most of the day you were very discouraged about how things were going in your life?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q23

Have you ever had a period lasting several days or longer when you lost interest in most things you usually enjoy like work, hobbies and personal relationships?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_R24

Some people have periods lasting several days or longer when they feel much more excited and full of energy than usual. Their minds go too fast. They talk a lot. They are very restless or unable to sit still and they sometimes do things that are unusual for them. For example, they may drive too fast or spend too much money.

Screening Section (SCR) - Question identifier:SCR_Q24

During your life, have you ever had a period like this lasting several days or longer?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q25A

Have you ever had a period lasting several days or longer when most of the time you were very irritable, grumpy or in a bad mood?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q25B

Have you ever had a period lasting several days or longer when most of the time you were so irritable that you either started arguments, shouted at people or hit people?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q26A

Did you ever have a time in your life when you were a "worrier"; that is, when you worried a lot more about things than other people with the same problems as you?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q26B

Did you ever have a time in your life when you were much more nervous or anxious than most other people with the same problems as you?

1. Yes
2. No
8. RF
9. DK

Screening Section (SCR) - Question identifier:SCR_Q26C

Did you ever have a period lasting 6 months or longer when you were anxious and worried most days?

1. Yes
2. No
8. RF
9. DK

Height and weight - Self-reported (HWT)

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q1

It is important to know when analyzing health whether or not the person is pregnant. Are you pregnant?

1. Yes
2. No
8. RF
9. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q2

The next questions are about height and weight. How tall are you without shoes on?

0. Less than 1' / 12" (less than 29.2 cm.)
1. 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
2. 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
3. 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
4. 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
5. 5'0" to 5'11" (151.1 to 181.5 cm.)
6. 6'0" to 6'11" (181.6 to 212.0 cm.)
7. 7'0" and over (212.1 cm. and over)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2A

Select the exact height.

0. 1'0" / 12" (29.2 to 31.7 cm.)
1. 1'1" / 13" (31.8 to 34.2 cm.)
2. 1'2" / 14" (34.3 to 36.7 cm.)
3. 1'3" / 15" (36.8 to 39.3 cm.)
4. 1'4" / 16" (39.4 to 41.8 cm.)
5. 1'5" / 17" (41.9 to 44.4 cm.)
6. 1'6" / 18" (44.5 to 46.9 cm.)
7. 1'7" / 19" (47.0 to 49.4 cm.)
8. 1'8" / 20" (49.5 to 52.0 cm.)
9. 1'9" / 21" (52.1 to 54.5 cm.)
10. 1'10" / 22" (54.6 to 57.1 cm.)
11. 1'11" / 23" (57.2 to 59.6 cm.)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2B

Select the exact height.

0. 2'0" / 24" (59.7 to 62.1 cm.)
1. 2'1" / 25" (62.2 to 64.7 cm.)
2. 2'2" / 26" (64.8 to 67.2 cm.)
3. 2'3" / 27" (67.3 to 69.8 cm.)
4. 2'4" / 28" (69.9 to 72.3 cm.)
5. 2'5" / 29" (72.4 to 74.8 cm.)
6. 2'6" / 30" (74.9 to 77.4 cm.)
7. 2'7" / 31" (77.5 to 79.9 cm.)
8. 2'8" / 32" (80.0 to 82.5 cm.)
9. 2'9" / 33" (82.6 to 85.0 cm.)
10. 2'10" / 34" (85.1 to 87.5 cm.)
11. 2'11" / 35" (87.6 to 90.1 cm.)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2C

Select the exact height.

0. 3'0" / 36" (90.2 to 92.6 cm.)
1. 3'1" / 37" (92.7 to 95.2 cm.)
2. 3'2" / 38" (95.3 to 97.7 cm.)
3. 3'3" / 39" (97.8 to 100.2 cm.)
4. 3'4" / 40" (100.3 to 102.8 cm.)
5. 3'5" / 41" (102.9 to 105.3 cm.)
6. 3'6" / 42" (105.4 to 107.9 cm.)
7. 3'7" / 43" (108.0 to 110.4 cm.)
8. 3'8" / 44" (110.5 to 112.9 cm.)
9. 3'9" / 45" (113.0 to 115.5 cm.)
10. 3'10" / 46" (115.6 to 118.0 cm.)
11. 3'11" / 47" (118.1 to 120.6 cm.)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2D

Select the exact height.

0. 4'0" / 48" (120.7 to 123.1 cm.)
1. 4'1" / 49" (123.2 to 125.6 cm.)
2. 4'2" / 50" (125.7 to 128.2 cm.)
3. 4'3" / 51" (128.3 to 130.7 cm.)
4. 4'4" / 52" (130.8 to 133.3 cm.)
5. 4'5" / 53" (133.4 to 135.8 cm.)
6. 4'6" / 54" (135.9 to 138.3 cm.)
7. 4'7" / 55" (138.4 to 140.9 cm.)
8. 4'8" / 56" (141.0 to 143.4 cm.)
9. 4'9" / 57" (143.5 to 146.0 cm.)
10. 4'10" / 58" (146.1 to 148.5 cm.)
11. 4'11" / 59" (148.6 to 151.0 cm.)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2E

Select the exact height.

0. 5'0" (151.1 to 153.6 cm.)
1. 5'1" (153.7 to 156.1 cm.)
2. 5'2" (156.2 to 158.7 cm.)
3. 5'3" (158.8 to 161.2 cm.)
4. 5'4" (161.3 to 163.7 cm.)
5. 5'5" (163.8 to 166.3 cm.)
6. 5'6" (166.4 to 168.8 cm.)
7. 5'7" (168.9 to 171.4 cm.)
8. 5'8" (171.5 to 173.9 cm.)
9. 5'9" (174.0 to 176.4 cm.)
10. 5'10" (176.5 to 179.0 cm.)
11. 5'11" (179.1 to 181.5 cm.)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_N2F

Select the exact height.

0. 6'0" (181.6 to 184.1 cm.)
1. 6'1" (184.2 to 186.6 cm.)
2. 6'2" (186.7 to 189.1 cm.)
3. 6'3" (189.2 to 191.7 cm.)
4. 6'4" (191.8 to 194.2 cm.)
5. 6'5" (194.3 to 196.8 cm.)
6. 6'6" (196.9 to 199.3 cm.)
7. 6'7" (199.4 to 201.8 cm.)
8. 6'8" (201.9 to 204.4 cm.)
9. 6'9" (204.5 to 206.9 cm.)
10. 6'10" (207.0 to 209.5 cm.)
11. 6'11" (209.6 to 212.0 cm.)
98. RF
99. DK

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q3

How much do you weigh?

Height and weight - Self-reported (HWT) - Question identifier:HWT_N4

Was that in pounds or kilograms?

1. Pounds
2. Kilograms

Height and weight - Self-reported (HWT) - Question identifier:HWT_Q4

Do you consider yourself...?

1. Overweight
2. Underweight
3. Just about right
8. RF
9. DK

Chronic Conditions (CCC)

Chronic Conditions (CCC) - Question identifier:CCC_R011

Now I'd like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.

Chronic Conditions (CCC) - Question identifier:CCC_Q031

Do you have asthma?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q051

(Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.)

Do you have arthritis, excluding fibromyalgia?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q061

(Do you have:)

...back problems, excluding fibromyalgia and arthritis?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q071

(Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.)

Do you have high blood pressure?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q072

Have you ever been diagnosed with high blood pressure?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q081

Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.

Do you have migraine headaches?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q091

(Do you have:)

...chronic bronchitis, emphysema or chronic obstructive pulmonary disease or COPD?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q101

(Do you have:)

...diabetes?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q111

Do you have epilepsy?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q121

(Do you have:)

...heart disease?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q131

(Do you have:)

...cancer?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q132

Have you ever been diagnosed with cancer?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q151

Do you suffer from the effects of a stroke?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q171A

Do you have a bowel disorder such as Crohn's Disease, ulcerative colitis, Irritable Bowel Syndrome or bowel incontinence?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q171B

What kind of bowel disease do you have?

1. Crohn's Disease
2. Ulcerative colitis
3. Irritable Bowel Syndrome
4. Bowel incontinence
5. Other
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q181

Do you have Alzheimer's disease or any other dementia?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q251

Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.

Do you have chronic fatigue syndrome?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q261

Do you have multiple chemical sensitivities?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q271A

Do you have schizophrenia?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q271B

Have you ever been diagnosed with schizophrenia?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q272A

Do you have any other psychosis?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q272B

Have you ever been diagnosed with any other psychosis?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q280A

Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.

Do you have a mood disorder such as depression, bipolar disorder, mania or dysthymia?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q280B

What kind of mood disorder do you have?

1. Depression
2. Bipolar disorder (manic depression)
3. Mania
4. Dysthymia
5. Other
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q290A

Do you have an anxiety disorder such as a phobia, obsessive-compulsive disorder or a panic disorder?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q290B

What kind of anxiety disorder do you have?

1. Phobia
2. Obsessive-compulsive disorder (OCD)
3. Panic disorder
4. Other
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q311

Do you have post-traumatic stress disorder?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q331

Remember, we're interested in conditions diagnosed by a health professional and are expected to last or have already lasted 6 months or more.

Do you have a learning disability?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q332

(Do you have:)

...Attention Deficit Disorder?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q341

(Do you have:)

...an eating disorder such as anorexia or bulimia?

1. Yes
2. No
8. RF
9. DK

Chronic Conditions (CCC) - Question identifier:CCC_Q901

Do you have any other long-term physical or mental health condition that has been diagnosed by a health professional?

1. Yes
2. No
8. RF
9. DK

Pain and discomfort (HUP)

Pain and discomfort (HUP) - Question identifier:HUP_R1

The next set of questions asks about the level of pain or discomfort you usually experience. They are not about illnesses like colds that affect people for short periods of time.

Pain and discomfort (HUP) - Question identifier:HUP_Q28

Are you usually free of pain or discomfort?

1. Yes
2. No
8. RF
9. DK

Pain and discomfort (HUP) - Question identifier:HUP_Q29

How would you describe the usual intensity of your pain or discomfort?

1. Mild
2. Moderate
3. Severe
8. RF
9. DK

Pain and discomfort (HUP) - Question identifier:HUP_Q30

How many activities does your pain or discomfort prevent?

1. None
2. A few
3. Some
4. Most
8. RF
9. DK

Physical Activity - Short Form (PHS)

Physical Activity - Short Form (PHS) - Question identifier:PHS_R01

The next questions are about physical activity done for leisure, work, housework, or for transportation.

Physical Activity - Short Form (PHS) - Question identifier:PHS_Q01

In the past 7 days, how many times did you participate in moderate or vigorous physical activity?

Physical Activity - Short Form (PHS) - Question identifier:PHS_Q02

About how much time did you spend on each occasion?

1. 0 to 15 minutes
2. 16 to 30 minutes
3. 31 to 60 minutes
4. 61 minutes to 2 hours
5. More than 2 hours
8. RF
9. DK

Positive Mental Health (PMH)

Positive Mental Health (PMH) - Question identifier:PMH_R01

(Please refer to page 1 of the booklet.)

The following questions are about how you have been feeling during the past month.

Positive Mental Health (PMH) - Question identifier:PMH_Q01

In the past month, how often did you feel:

...happy?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q02

(In the past month, how often did you feel:)

...interested in life?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q03

(In the past month, how often did you feel:)

...satisfied with your life?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q04

In the past month, how often did you feel:

...that you had something important to contribute to society?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q05

(In the past month, how often did you feel:)

...that you belonged to a community (like a social group, your neighbourhood, your city, your school)?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q06

(In the past month, how often did you feel:)

...that our society is becoming a better place for people like you?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q07

In the past month, how often did you feel:

...that people are basically good?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q08

(In the past month, how often did you feel:)

...that the way our society works makes sense to you?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q09

(In the past month, how often did you feel:)

...that you liked most parts of your personality?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q10

In the past month, how often did you feel:

...good at managing the responsibilities of your daily life?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q11

(In the past month, how often did you feel:)

...that you had warm and trusting relationships with others?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q12

(In the past month, how often did you feel:)

...that you had experiences that challenge you to grow and become a better
person?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q13

In the past month, how often did you feel:

...confident to think or express your own ideas and opinions?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Positive Mental Health (PMH) - Question identifier:PMH_Q14

(In the past month, how often did you feel:)

...that your life has a sense of direction or meaning to it?

1. Every day
2. Almost every day
3. About 2 or 3 times a week
4. About once a week
5. Once or twice
6. Never
8. RF
9. DK

Stress - Sources (STS)

Stress - Sources (STS) - Question identifier:STS_R1

Now a few questions about the stress in your life.

Stress - Sources (STS) - Question identifier:STS_Q1

In general, how would you rate your ability to handle unexpected and difficult problems, for example, a family or personal crisis?

Would you say your ability is...?

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
8. RF
9. DK

Stress - Sources (STS) - Question identifier:STS_Q2

In general, how would you rate your ability to handle the day-to-day demands in your life, for example, handling work, family and volunteer responsibilities?

Would you say your ability is...?

1. Excellent
2. Very good
3. Good
4. Fair
5. Poor
8. RF
9. DK

Stress - Sources (STS) - Question identifier:STS_Q3

Thinking about stress in your day-to-day life, what would you say is the most important thing contributing to feelings of stress you may have?

1. Time pressures / not enough time
2. Own physical health problem or condition
3. Own emotional or mental health problem or condition
4. Financial situation (e.g., not enough money, debt)
5. Own work situation (e.g., hours of work, working conditions)
6. School
7. Employment status (e.g, unemployment)
8. Caring for - own children
9. Caring for - others
10. Other personal or family responsibilities
11. Personal relationships
12. Discrimination
13. Personal and family's safety
14. Health of family members
15. Other - Specify
16. Nothing
98. RF
99. DK

Stress - Sources (STS) - Question identifier:STS_Q4

Now think about this biggest source of stress in your day-to-day life. Please tell me how much you agree with the following statements.


When faced with this source of stress, you can count on people that you know to help you deal with the situation. Do you...?

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Stress - Sources (STS) - Question identifier:STS_Q5

When faced with this source of stress, you have the personal ability to deal with the situation. Do you...?

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Distress (DIS)

Distress (DIS) - Question identifier:DIS_R01

The following questions deal with feelings you may have had during the past month.

Distress (DIS) - Question identifier:DIS_Q01A

(Please refer to page 2 of the booklet.)

During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:

...tired out for no good reason?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01B

During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:

... nervous?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01C

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...so nervous that nothing could calm you down?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01D

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...hopeless?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01E

During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:

...restless or fidgety?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01F

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...so restless you could not sit still?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01G

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...sad or depressed?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01H

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...so depressed that nothing could cheer you up?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01I

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...that everything was an effort?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01J

(During the past month, that is, from ^DTE1MOAGOE to yesterday, about how often did you feel:)

...worthless?

1. All of the time
2. Most of the time
3. Some of the time
4. A little of the time
5. None of the time
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01K

We just talked about feelings that occurred to different degrees during the past month.
Taking them altogether, did these feelings occur more often in the past month than is usual for you, less often than usual or about the same as usual?

1. More often
2. Less often
3. About the same
4. Never have had any
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01L

Is that a lot more, somewhat more or only a little more often than usual?

1. A lot
2. Somewhat
3. A little
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01M

Is that a lot less, somewhat less or only a little less often than usual?

1. A lot
2. Somewhat
3. A little
8. RF
9. DK

Distress (DIS) - Question identifier:DIS_Q01N

During the past month, how much did these feelings usually interfere with your life or activities?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Depression (DEP)

Depression (DEP) - Question identifier:DEP_Q01A

Earlier, you mentioned having periods that lasted several days or longer when you felt sad, empty or depressed most of the day.

During such episodes, did you ever feel discouraged about how things were going in your life?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q01A_1

During the episodes of being sad, empty or depressed, did you ever lose interest in most things like work, hobbies or other things you usually enjoyed?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q01B

During the episodes of being sad, empty or depressed, did you ever lose interest in most things like work, hobbies or other things you usually enjoyed?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q02

Earlier, you mentioned having periods that lasted several days or longer when you felt discouraged about how things were going in your life.

During such episodes, did you ever lose interest in most things like work, hobbies or other things you usually enjoy?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q09

Earlier, you mentioned having periods that lasted several days or longer when you lost interest in most things like work, hobbies or other things you usually enjoy.

Did you ever have such a period that lasted for most of the day, nearly every day, for 2 weeks or longer?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q12

Did you ever have a period of being ^DT_KEYPHRASE1 that lasted for most of the day, nearly every day, for 2 weeks or longer?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q16

Think of periods lasting 2 weeks or longer when ^DT_PROBLEMS with your mood ^DT_WERE most severe and frequent. During those periods, did your feelings of being ^DT_KEYPHRASE3 usually last?

1. Less than one hour
2. 1 hour to less than 3 hours
3. 3 hours to less than 5 hours
4. 5 hours or more
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q17

During those periods, how severe was your emotional distress?

1. Mild
2. Moderate
3. Severe
4. Very severe
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q18

During those periods, how often was your emotional distress so severe that nothing could cheer you up?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q19

During those periods, how often was your emotional distress so severe that you could not carry out your daily activities?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_R21

People with episodes of being ^DT_KEYPHRASE3 often have other problems at the same time. These include things like feelings of low self-worth and changes in sleep, appetite, energy and ability to concentrate and remember.

Depression (DEP) - Question identifier:DEP_Q21

Did you ever have problems like this during one of your episodes of being ^DT_KEYPHRASE3?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q22A

Please think of an episode of being ^DT_KEYPHRASE3 that lasted 2 weeks or longer when, at the same time, you also had the largest number of these other problems.

Is there one particular episode that stands out as the worst one you ever had?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q22A_1

How old were you when that worst episode started?

Depression (DEP) - Question identifier:DEP_Q22B

How long did it last (in terms of days, weeks, months or years)?

Depression (DEP) - Question identifier:DEP_N22C

Was that in days, weeks, months or years?

1. Days
2. Weeks
3. Months
4. Years

Depression (DEP) - Question identifier:DEP_Q23A

Think of the last time you had a bad episode of being ^DT_KEYPHRASE3 like this. How old were you when that last episode occurred?

Depression (DEP) - Question identifier:DEP_Q23B

How long did that episode last?

Depression (DEP) - Question identifier:DEP_N23C

Was that in days, weeks, months or years?

1. Days
2. Weeks
3. Months
4. Years

Depression (DEP) - Question identifier:DEP_R24

In answering the next questions, think about the period of 2 weeks or longer when your feelings of being ^DT_KEYPHRASE3 and other problems were most severe and frequent. During that period, tell me which of the following problems you had for most of the day, nearly every day.

Depression (DEP) - Question identifier:DEP_Q24A

Did you feel sad, empty or depressed most of the day, nearly every day, during that period of 2 weeks or longer?

1. Yes (KEY_PHRASE = feeling sad, empty or depressed)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q24B

Nearly every day, did you feel so sad that nothing could cheer you up?

1. Yes (KEY_PHRASE = feeling that nothing could cheer you up)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q24C

During that period of 2 weeks or longer, did you feel discouraged most of the day, nearly every day, about how things were going in your life?

1. Yes (KEY_PHRASE = feeling discouraged about things in your life)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q24D

Did you feel hopeless about the future nearly every day?

1. Yes (KEY_PHRASE = feeling hopeless about the future)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q24E

During that period of 2 weeks or longer, did you lose interest in almost all things like work, hobbies and things you like to do for fun?

1. Yes (KEY_PHRASE = losing interest in almost all things)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q24F

Did you feel like nothing was fun even when good things were happening?

1. Yes (KEY_PHRASE = feeling that nothing was fun)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26A

During that period of 2 weeks or longer, did you, nearly every day, have a much smaller appetite than usual?

1. Yes (KEY_PHRASE = having a much smaller
appetite)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26B

Did you have a much larger appetite than usual nearly every day?

1. Yes (KEY_PHRASE = having a much larger appetite)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26C

During that period of 2 weeks or longer, did you gain weight without trying to?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26C_1

Was this weight gain due to a physical growth^DT_PREGNANCY?

1. Yes
2. No (KEY_PHRASE = gaining weight without trying to)
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26D

How much did you gain?

Depression (DEP) - Question identifier:DEP_N26D

Was that in pounds or kilograms?

1. Pounds
2. Kilograms

Depression (DEP) - Question identifier:DEP_Q26E

Did you lose weight without trying to?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26E_1

Was this weight loss a result of a diet or a physical illness?

1. Yes
2. No (KEY_PHRASE = losing weight without trying to)
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26F

How much did you lose?

Depression (DEP) - Question identifier:DEP_N26F

Was that in pounds or kilograms?

1. Pounds
2. Kilograms

Depression (DEP) - Question identifier:DEP_Q26G

During that period of 2 weeks or longer, did you have a lot more trouble than usual either falling asleep, staying asleep or waking up too early nearly every night?

1. Yes (KEY_PHRASE = having trouble falling
or staying asleep or waking up too early)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26H

During that period of 2 weeks or longer, did you sleep a lot more than usual nearly every night?

1. Yes (KEY_PHRASE = sleeping a lot more
than usual)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26I

Did you sleep much less than usual and still not feel tired or sleepy?

1. Yes (KEY_PHRASE = sleeping much less than usual)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26J

During that period of 2 weeks or longer, did you feel tired or low in energy nearly every day, even when you had not been working very hard?

1. Yes (KEY_PHRASE = feeling tired or low in
energy)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26K

During that period of 2 weeks or longer, did you have a lot more energy than usual nearly every day?

1. Yes (KEY_PHRASE = having a lot more
energy than usual)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26L

Did you talk or move more slowly than is normal for you nearly every day?

1. Yes (KEY_PHRASE = talking or moving more slowly than normal)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26M

Did anyone else notice that you were talking or moving slowly?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26N

Were you so restless or jittery nearly every day that you paced up and down or couldn't sit still?

1. Yes (KEY_PHRASE = feeling restless or jittery, or couldn't sit still)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26O

Did anyone else notice that you were restless?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26P

During that period of 2 weeks or longer, did your thoughts come much more slowly than usual or seem mixed up nearly every day?

1. Yes (KEY_PHRASE = thinking much more
slowly than usual)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26Q

Did your thoughts seem to jump from one thing to another or race through your head so fast you couldn't keep track of them?

1. Yes (KEY_PHRASE = having thoughts race through your head)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26R

Nearly every day, did you have a lot more trouble concentrating than is normal for you?

1. Yes (KEY_PHRASE = having more trouble concentrating)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26S

Were you unable to make up your mind about things you ordinarily have no trouble deciding about?

1. Yes (KEY_PHRASE = being unable to make your mind about things)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26T

Did you lose your self-confidence?

1. Yes (KEY_PHRASE = losing your self-confidence)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26U

Nearly every day, did you feel that you were not as good as other people?

1. Yes (KEY_PHRASE = feeling not as good as other people)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26V

Did you feel totally worthless nearly every day?

1. Yes (KEY_PHRASE = feeling worthless)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26W

Did you feel guilty nearly every day?

1. Yes (KEY_PHRASE = feeling guilty every day)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26X

Did you feel irritable, grouchy or in a bad mood nearly every day?

1. Yes (KEY_PHRASE = feeling grouchy)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26Y

Did you feel nervous or anxious most days?

1. Yes (KEY_PHRASE = feeling nervous or anxious)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26Z

During that period of 2 weeks or longer, did you have any sudden attacks of intense fear or panic?

1. Yes (KEY_PHRASE = having attacks of fear or panic)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26ZFF

Did you feel that you could not cope with your everyday responsibilities?

1. Yes (KEY_PHRASE = feeling you couldn't cope with your responsibilities)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26ZGG

Did you feel like you wanted to be alone rather than spend time with friends or relatives?

1. Yes (KEY_PHRASE = wanting to be alone)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26ZHH

Did you feel less talkative than usual?

1. Yes (KEY_PHRASE = feeling less talkative)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26ZII

Were you often in tears?

1. Yes (KEY_PHRASE = being often in tears)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26AA

Did you often think a lot about death, either your own, someone else's or death in general?

1. Yes (KEY_PHRASE = thinking about death)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q26BB

During that period, did you ever think that it would be better if you were dead?

1. Yes (KEY_PHRASE = thinking you were better dead)
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q28A

You mentioned having a number of the problems that I just asked you about.

During that episode, how much did your feelings of being ^DT_KEYPHRASE3 and having these other problems interfere with either your work, your social life or your personal relationships?

1. Not at all
2. A little
3. Some
4. A lot
5. Extremely
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q28B

Earlier, you mentioned having a number of problems during the period of 2 weeks or longer when your feelings of being ^DT_KEYPHRASE3 were most frequent and severe. During that episode, how much did your feelings of being ^DT_KEYPHRASE3 and having these other problems interfere with either your work, your social life or your personal relationships?

1. Not at all
2. A little
3. Some
4. A lot
5. Extremely
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q28C

During that episode, how often were you unable to carry out your daily activities because of your feelings of being ^DT_KEYPHRASE3?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q29A

Episodes of this sort sometimes occur as a result of a physical illness or injury or the use of medication, drugs or alcohol. Do you think your episodes of feeling ^DT_KEYPHRASE3 ever occurred as the result of physical causes, medication, drugs or alcohol?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q29B

Do you think your episodes were always the result of physical causes, medication, drugs or alcohol?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q29C

What were the causes?

1. Exhaustion
2. Hyperventilation
3. Hypochondria
4. Menstrual cycle
5. Pregnancy / postpartum
6. Thyroid disease
7. Cancer
8. Overweight
9. Medication (excluding illicit drugs)
10. Illicit drugs
11. Alcohol
12. Chemical Imbalance / Serotonin Imbalance
13. Chronic Pain
14. Caffeine
15. No specific diagnosis
16. Accident / Injury
17. Emotional, social or economic reason
18. Other - Specify
98. RF
99. DK

Depression (DEP) - Question identifier:DEP_Q30A

Did your episodes of feeling ^DT_KEYPHRASE3 ever occur just after someone close to you died?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q30B

Did your episodes of feeling ^DT_KEYPHRASE3 always occur just after someone close to you died?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_R31

In the next questions, the word "episode" means a period lasting 2 weeks or longer when, nearly every day, you were ^DT_KEYPHRASE3 and you also had some of the other problems we just mentioned. The end of an episode is when you no longer have the problems for two weeks in a row.

Depression (DEP) - Question identifier:DEP_Q31

During your life, how many episodes of feeling ^DT_KEYPHRASE3 with some other problems lasting two weeks or longer have you ever had?

Depression (DEP) - Question identifier:DEP_Q37

Was that episode brought on by some stressful experience or did it happen out of the blue?

1. Brought on by stress
2. Out of the blue
3. Don't remember
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q38A

At any time in the past 12 months, did you have an episode lasting 2 weeks or longer when you felt ^DT_KEYPHRASE3 and also had some of the other problems already mentioned?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q38A_1

How recently was it?

1. During the past month
2. Between 1 and 6 months ago
3. More than 6 months ago
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q38B

During the past 12 months, about how many days out of 365 were you in such an episode? (You may use any number between 1 and 365 to answer.)

Depression (DEP) - Question identifier:DEP_Q38C

How old were you the last time you had one of these episodes?

Depression (DEP) - Question identifier:DEP_Q39

What is the longest episode you ever had when, most of the day, nearly everyday, you were feeling ^DT_KEYPHRASE3 and you also had some of the other problems we just mentioned?

Depression (DEP) - Question identifier:DEP_N39_1

Was that in days, weeks, months or years?

1. Days
2. Weeks
3. Months
4. Years

Depression (DEP) - Question identifier:DEP_Q53

Earlier, you mentioned that you had ^DT_SEVERAL episode(s) of feeling ^DT_KEYPHRASE3 with some other problems lasting 2 weeks or longer in your life.

How many of these episodes were brought on by some stressful experience?

Depression (DEP) - Question identifier:DEP_R64A

For the next questions, think about the period of 2 weeks or longer during the past 12 months when your feelings of being ^DT_KEYPHRASE3 were most severe and frequent.

Depression (DEP) - Question identifier:DEP_Q64A

During this period, how often did you feel cheerful?

1. Often
2. Sometimes
3. Occasionally
4. Never
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q64B

How often did you feel as if you were slowed down?

1. Often
2. Sometimes
3. Occasionally
4. Never
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q64C

How often could you enjoy a good book or radio or TV program?

1. Often
2. Sometimes
3. Occasionally
4. Never
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q65A

During this period, how often did you still enjoy the things you used to enjoy?

1. As much as usual
2. Not quite as much as usual
3. Only a little
4. Not at all
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q65B

How often could you laugh and see the bright side of things?

1. As much as usual
2. Not quite as much as usual
3. Only a little
4. Not at all
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q65C

How often did you take interest in your physical appearance?

1. As much as usual
2. Not quite as much as usual
3. Only a little
4. Not at all
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q65D

How often did you look forward to enjoying things?

1. As much as usual
2. Not quite as much as usual
3. Only a little
4. Not at all
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_R66

(Please refer to page 3 of the booklet.)

Think about the period of time that lasted one month or longer when your feelings of being ^DT_KEYPHRASE1 were most severe in the past 12 months. Please tell me what number best describes how much these feelings interfered with each of the following activities. For each activity, answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference".

Depression (DEP) - Question identifier:DEP_Q66A

In the past 12 months, how much did your feelings of being ^DT_KEYPHRASE1 interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Depression (DEP) - Question identifier:DEP_Q66B_1

How much did your feelings interfere with your ability to attend school?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Depression (DEP) - Question identifier:DEP_Q66B_2

How much did they interfere with your ability to work at a job?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Depression (DEP) - Question identifier:DEP_Q66C

Again thinking about that period of time lasting one month or longer during the past 12 months when your feelings of being ^DT_KEYPHRASE1 were most severe, how much did they interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 "very severe interference".)

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Depression (DEP) - Question identifier:DEP_Q66D

How much did they interfere with your social life?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Depression (DEP) - Question identifier:DEP_Q68

In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your feelings of being ^DT_KEYPHRASE1? (You may use any number between 0 and 365 to answer.)

Depression (DEP) - Question identifier:DEP_Q72

Did you ever in your life see, or talk on the telephone to, a medical doctor or other professional about your feelings of being ^DT_KEYPHRASE1? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q86

During the past 12 months, did you receive professional treatment for your feelings of being ^DT_KEYPHRASE1?

1. Yes
2. No
8. RF
9. DK

Depression (DEP) - Question identifier:DEP_Q87

During your life, were you ever hospitalized overnight for your feelings of being ^DT_KEYPHRASE1?

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI)

Suicide - sub block (SUI) - Question identifier:SUI_R01

(Please refer to page 4 of the booklet.)

Three experiences are listed, EXPERIENCE A, B and C.

Suicide - sub block (SUI) - Question identifier:SUI_Q01

Think of the period of 2 weeks or longer when your feelings of being ^DT_KEYPHRASE3 and other problems were most severe and frequent. During that time, did EXPERIENCE A happen to you?

INTERVIEWER: EXPERIENCE A is "You seriously thought about committing suicide or taking your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_R02

(Please refer to page 4 of the booklet.)

The following questions may be sensitive to some people, but we have to ask the same questions of everyone. Three experiences are listed, EXPERIENCE A, B and C.

Suicide - sub block (SUI) - Question identifier:SUI_Q02

Has EXPERIENCE A ever happened to you?

INTERVIEWER: EXPERIENCE A is "You seriously thought about committing suicide or taking your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q03

In the past 12 months, did EXPERIENCE A happen to you?

INTERVIEWER: EXPERIENCE A is "You seriously thought about committing suicide or taking your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q03_1

How old were you the last time this experience happened to you?

Suicide - sub block (SUI) - Question identifier:SUI_Q04A

Now look at the second experience on the list, EXPERIENCE B. During that period of 2 weeks or longer, did EXPERIENCE B happen to you?

INTERVIEWER: EXPERIENCE B is "You made a plan for committing suicide."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q04B

^DT_NODEPB Did EXPERIENCE B ever happen to you?

INTERVIEWER: EXPERIENCE B is "You made a plan for committing suicide."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q05

Did EXPERIENCE B happen to you at any time in the past 12 months?

INTERVIEWER: EXPERIENCE B is "You made a plan for committing suicide."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q05_1

How old were you the last time EXPERIENCE B happened to you?

Suicide - sub block (SUI) - Question identifier:SUI_Q06A

Now, look at the third experience on the list, EXPERIENCE C. During that period of 2 weeks or longer, did EXPERIENCE C happen to you?

INTERVIEWER: EXPERIENCE C is "You attempted suicide or tried to take your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q06B

^DT_NODEPC Has EXPERIENCE C ever happened to you?

INTERVIEWER: EXPERIENCE C is "You attempted suicide or tried to take your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q06C

How many times did EXPERIENCE C ever happen to you in your lifetime?

Suicide - sub block (SUI) - Question identifier:SUI_Q10

During the last 12 months, did EXPERIENCE C happen to you?

INTERVIEWER: EXPERIENCE C is "You attempted suicide or tried to take your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q10_1

How old were you ^DT_WHENLAST EXPERIENCE C happened to you?

INTERVIEWER: EXPERIENCE C is "You attempted suicide or tried to take your own life."

Suicide - sub block (SUI) - Question identifier:SUI_Q11

Did it result in an injury or poisoning?

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q12

Did it require medical attention (following the most recent time EXPERIENCE C happened to you)?

INTERVIEWER: EXPERIENCE C is "You attempted suicide or tried to take your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q13

Were you hospitalized overnight or longer (following this most recent time since EXPERIENCE C happened to you)?

INTERVIEWER: EXPERIENCE C is "You attempted suicide or tried to take your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q16

During the past 12 months, have you seen, or talked on the telephone to, a professional about EXPERIENCE A?

INTERVIEWER: EXPERIENCE A is "You seriously thought about committing suicide or taking your own life."

1. Yes
2. No
8. RF
9. DK

Suicide - sub block (SUI) - Question identifier:SUI_Q19

During the past 12 months, have you seen, or talked on the telephone to, a professional about EXPERIENCE A or EXPERIENCE C?

INTERVIEWER: EXPERIENCE A is "You seriously thought about committing suicide or taking your own life."
EXPERIENCE C is "You attempted suicide or tried to take your own life."

1. Yes
2. No
8. RF
9. DK

Mania (MIA)

Mania (MIA) - Question identifier:MIA_R01

Earlier, you mentioned having a period lasting several days or longer when you felt much more excited and full of energy than usual. During this same period, your mind also went too fast.

Mania (MIA) - Question identifier:MIA_Q01

People who have periods like this often have changes in their thinking and behaviour at the same time, like being more talkative, needing very little sleep, being very restless, going on buying sprees, and behaving in ways they would normally think are inappropriate.

Tell me, did you ever have any of these changes during the periods when you were excited and full of energy?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q02

Please think of the period of several days or longer when you were very excited and full of energy and you had the largest number of changes like these at the same time. Is there one episode of this sort that stands out in your mind?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q03A

How old were you when that episode occurred?

Mania (MIA) - Question identifier:MIA_Q03B

How long did that episode last (in terms of hours, days, weeks, months or years)?

Mania (MIA) - Question identifier:MIA_N03

Was that in hours, days, weeks, months or years?

1. Hours
2. Days
3. Weeks
4. Months
5. Years

Mania (MIA) - Question identifier:MIA_Q03C

Then think of the most recent time you had an episode like this. How old were you when that most recent episode occurred?

Mania (MIA) - Question identifier:MIA_Q03D

How long did that episode last (in terms of hours, days, weeks, months or years)?

Mania (MIA) - Question identifier:MIA_N03D

Was that in hours, days, weeks, months or years?

1. Hours
2. Days
3. Weeks
4. Months
5. Years

Mania (MIA) - Question identifier:MIA_R04

During that episode, tell me which of the following changes you experienced.

Mania (MIA) - Question identifier:MIA_Q04

Were you so irritable or grouchy that you started arguments, shouted at people or hit people?

1. Yes (KEY_PHRASE = being irritable or grouchy)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_R05

Earlier, you mentioned having a period lasting several days or longer when you became so irritable or grouchy that you either started arguments, shouted at people or hit people.

Mania (MIA) - Question identifier:MIA_Q05A

People who have periods of irritability like this often have changes in their thinking and behaviour at the same time, like being more talkative, needing very little sleep, being very restless, going on buying sprees, and behaving in ways they would normally think are inappropriate.

Tell me, did you ever have any of these changes during the periods when you were very irritable or grouchy?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q05B

Please think of the period of several days or longer when you were very irritable or grouchy and you had the largest number of changes like these at the same time. Is there one episode of this sort that stands out in your mind?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q06A

How old were you when that episode occurred?

Mania (MIA) - Question identifier:MIA_Q06B

How long did that episode last (in terms of hours, days, weeks, months or years)?

Mania (MIA) - Question identifier:MIA_N06B

Was that in hours, days, weeks, months or years?

1. Hours
2. Days
3. Weeks
4. Months
5. Years

Mania (MIA) - Question identifier:MIA_Q06C

Then think of the most recent time you had an episode like this. How old were you when that most recent episode occurred?

Mania (MIA) - Question identifier:MIA_Q06D

How long did that episode last (in terms of hours, days, weeks, months or years)?

Mania (MIA) - Question identifier:MIA_N06D

Was that in hours, days, weeks, months or years?

1. Hours
2. Days
3. Weeks
4. Months
5. Years

Mania (MIA) - Question identifier:MIA_R07

During that episode, tell me which of the following changes you experienced.

Mania (MIA) - Question identifier:MIA_Q07A

Did you become so restless or fidgety that you paced up and down or couldn't stand still?

1. Yes (KEY_PHRASE = being restless)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07B

Did you become overly friendly or outgoing with people?

1. Yes (KEY_PHRASE = becoming overly friendly or outgoing with people)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07C

Did you behave in any other way that you would ordinarily think is inappropriate, like talking about things you would normally keep private or acting in ways that you would usually find embarrassing?

1. Yes (KEY_PHRASE = behaving inappropriately)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07D

Were you a lot more interested in sex than usual, or did you want to have sexual encounters with people you wouldn't ordinarily be interested in?

1. Yes (KEY_PHRASE = having a lot more interest in sex than
usual)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07E

Did you try to do things that were impossible to do, like taking on large amounts of work?

1. Yes (KEY_PHRASE = trying to accomplish unrealistic goals)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07F

Did you talk a lot more than usual or feel a need to keep talking all the time?

1. Yes (KEY_PHRASE = talking a lot more than usual)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07G

Did you constantly keep changing your plans or activities?

1. Yes (KEY_PHRASE = constantly changing plans)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07H

Were you so easily distracted that any little interruption could get your thinking "off track"?

1. Yes (KEY_PHRASE = being easily distracted)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07I

Did your thoughts seem to jump from one thing to another or race through your head so fast that you couldn't keep track of them?

1. Yes (KEY_PHRASE = having thoughts racing in your mind)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07J

Did you sleep far less than usual and still not get tired or sleepy?

1. Yes (KEY_PHRASE = sleeping far less than usual)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07K

Did you get involved in foolish investments or schemes for making money?

1. Yes (KEY_PHRASE = getting involved in foolish schemes)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07L

Did you spend so much more money than usual that it caused you to have financial trouble?

1. Yes (KEY_PHRASE = getting into financial trouble)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07M

Were you interested in seeking pleasure in ways that you would usually consider risky, like having casual or unsafe sex, going on buying sprees or driving recklessly?

1. Yes (KEY_PHRASE = doing risky things)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07N

Did you have a greatly exaggerated sense of self-confidence or believe you could do things you really couldn't do?

1. Yes (KEY_PHRASE = having too much self-confidence)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q07O

Did you have the idea that you were actually someone else, or that you had a special connection with a famous person that you really didn't have?

1. Yes (KEY_PHRASE = believing you were someone else or
somehow connected to a famous person)
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q08

How many episodes lasting several days or longer have you ever had when you felt ^DT_EXIRR and also had some other problems we just mentioned?

Mania (MIA) - Question identifier:MIA_R09

You just mentioned that you had ^DT_ANEP when you were very ^DT_EXIRR and you were also ^DT_TEXT1E.

Mania (MIA) - Question identifier:MIA_Q09

How much did ^DT_THATEP ever interfere with either your work, your social life or your personal relationships?

1. Not at all
2. A little
3. Some
4. A lot
5. Extremely
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q09_1

During ^DT_THATEP, how often were you unable to carry out your normal daily activities?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q10A

Episodes of this sort sometimes occur as a result of a physical illness or injury or the use of medication, drugs or alcohol.

Do you think your ^DT_EPEVER occurred as the result of physical causes, medication, drugs or alcohol?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q10B

Do you think all of your episodes were the result of physical causes, medication, drugs, or alcohol?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q10C

What were the causes?

1. Exhaustion
2. Hyperventilation
3. Hypochondria
4. Menstrual cycle
5. Pregnancy / postpartum
6. Thyroid disease
7. Cancer
8. Overweight
9. Medication (excluding illicit drugs)
10. Illicit drugs
11. Alcohol
12. Chemical Imbalance / Serotonin Imbalance
13. Chronic pain
14. Caffeine
15. No specific diagnosis
16. Other - Specify
98. RF
99. DK

Mania (MIA) - Question identifier:MIA_Q19A

At any time in the past 12 months, did you have one of these episodes?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q19A_1

Did your episode occur at any time in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q19A_2

How recently was it?

1. During the past month
2. Between 1 and 6 months ago
3. More than 6 months ago
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q19B

How many episodes did you have in the past 12 months?

Mania (MIA) - Question identifier:MIA_Q19C

How many weeks in the past 12 months were you having ^DT_THISEP?

Mania (MIA) - Question identifier:MIA_Q19D

How old were you the last time you had one of these episodes?

Mania (MIA) - Question identifier:MIA_Q20A

During your life, how many episodes lasting a full week or longer have you ever had?

Mania (MIA) - Question identifier:MIA_Q21A

How many of these episodes were brought on by some stressful experience?

Mania (MIA) - Question identifier:MIA_Q21B

Was this episode brought on by some stressful experience or did it happen out of the blue?

1. Brought on by stress
2. Out of the blue
3. Don't remember
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q22A

How long was the longest episode you ever had?

Mania (MIA) - Question identifier:MIA_N22A

Was that in hours, days, weeks, months or years?

1. Hours
2. Days
3. Weeks
4. Months
5. Years

Mania (MIA) - Question identifier:MIA_Q24

Was your episode brought on by some stressful experience or did it happen out of the blue?

1. Brought on by stress
2. Out of the blue
3. Don't remember
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_R27

(Please refer to page 3 of the booklet.)

In the past 12 months, think about the period of time lasting one month or longer when your ^DT_EP2 of being very ^DT_EXIRR ^DT_WAS most severe. Please tell me, what number best describes how much your ^DT_EP2 interfered with each of the following activities. For each activity, please answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference".

Mania (MIA) - Question identifier:MIA_Q27A

In the past 12 months, how much did your ^DT_EP2 interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Mania (MIA) - Question identifier:MIA_Q27B_1

How much did your ^DT_EP2 interfere with your ability to attend school?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Mania (MIA) - Question identifier:MIA_Q27B_2

How much did ^DT_IT interfere with your ability to work at a job?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Mania (MIA) - Question identifier:MIA_Q27C

Again thinking about that period of time lasting one month or longer when your ^DT_EP2 ^DT_WAS most severe, how much did ^DT_IT interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 "very severe interference".)

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Mania (MIA) - Question identifier:MIA_Q27D

How much did ^DT_IT interfere with your social life?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Mania (MIA) - Question identifier:MIA_Q29

In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your ^DT_EP2 of being very ^DT_EXIRR?

Mania (MIA) - Question identifier:MIA_Q33

Did you ever in your life see, or talk on the telephone to, a medical doctor or other professional about your ^DT_EPISODE of being very ^DT_EXIRR? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q47

Did you receive professional treatment for your ^DT_EPISODE of being very ^DT_EXIRR at any time in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mania (MIA) - Question identifier:MIA_Q48

Were you ever hospitalized overnight for your ^DT_EPISODE of being very ^DT_EXIRR?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD)

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R01A

Earlier, you mentioned having a time in your life when you were "a worrier". The next questions are about that time. Please turn to page 6 of the booklet where we list several things which you could have been worried, nervous or anxious about during that time.

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R01B

Earlier, you mentioned having a time in your life when you were much more nervous or anxious than most other people. The next questions are about that time. Please turn to page 6 of the booklet where we list several things which you could have been nervous or anxious about during that time.

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R01C

Earlier, you mentioned having a period lasting 6 months or longer when you were anxious or worried most days. The next questions are about that time. Please turn to page 6 of the booklet where we list several things which you could have been anxious or worried about during that time.

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q01

Now, tell me which of these things were you ^DT_WORRIED about during that time?

1. Worrying about everything
2. Worrying about nothing in particular
3. Finances
4. Success at school or work
5. Social life
6. Love life
7. Relationships at school or work
8. Relationships with family
9. Physical appearance
10. Own physical health
11. Own mental health
12. Alcohol or drug use
13. Being away from home or apart from loved ones
14. The health or welfare of loved ones
15. Social phobias (e.g., meeting people)
16. Agoraphobia (e.g., leaving home alone)
17. Specific phobias (e.g., fears of bugs, heights or closed spaces)
18. Obsessions (e.g., worry about germs)
19. Compulsions (e.g., repetitive hand washing)
20. Crime / violence
21. Economy
22. Environment (e.g., global warming, pollution)
23. Moral decline of society (e.g. capitalism, decline of the family)
24. War / revolution
25. Other - Specify
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q02A

Is there anything else which you were ^DT_WORRIED about during that time?

1. Yes - Specify
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q02B

Is there anything else which you were ^DT_WORRIED about during that time?

1. Yes - Specify
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q03

Do you think your feelings of being ^DT_WORRIED were ever excessive, unreasonable, or a lot stronger than they should have been?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q04

How often did you find it difficult to control your ^DT_WORRY?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q04_1

How often were you so nervous or worried that you could not think about anything else, no matter how hard you tried?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q05

During your life, what is the longest period of months or years in a row when you were feeling ^DT_WORRIED most days?

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_N05_1

Was that in months or years?

1. Months
2. Years

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q05_3

Did you ever have a period that lasted 6 months or longer?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R09

Think of your worst period lasting 6 months or longer when you were ^DT_WORRIED. During that episode, tell me if you had any of the following problems.

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09A

Did you often feel restless, keyed up or on edge?

1. Yes (KEY_PHRASE = feeling restless or on edge)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09B

Did you often get tired easily?

1. Yes (KEY_PHRASE = feeling tired easily)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09C

Were you often more irritable than usual?

1. Yes (KEY_PHRASE = feeling more irritable than usual)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09D

Did you often have difficulty concentrating or keeping your mind on what you were doing?

1. Yes (KEY_PHRASE = having difficulty concentrating)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09E

Did you often have tense, sore or aching muscles?

1. Yes (KEY_PHRASE = having tense or aching muscles)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q09F

(During this worst episode lasting 6 months or longer,) did you often have trouble falling or staying asleep?

1. Yes (KEY_PHRASE = having difficulty falling or staying asleep)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10A

Did your heart often pound or race?

1. Yes (KEY_PHRASE = having your heart pound)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10B

Did you often sweat?

1. Yes (KEY_PHRASE = sweating)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10C

Did you often tremble or shake?

1. Yes (KEY_PHRASE = trembling)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10D

Did you often have a dry mouth?

1. Yes (KEY_PHRASE = having a dry mouth)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q10E

Were you sad or depressed most of the time?

1. Yes (KEY_PHRASE = feeling sad)
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13A

(During this episode lasting 6 months or longer,) did you often feel dizzy or lightheaded?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13B

Were you often short of breath?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13C

Did you often feel like you were choking?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13D

Did you often have pain or discomfort in your chest?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13E

Did you often have pain or discomfort in your stomach?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13F

(During this episode lasting 6 months or longer,) did you often have nausea?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13G

Did you often feel that you were unreal?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13H

Did you often feel that things around you were unreal?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13I

Were you often afraid that you might lose control or go crazy?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13J

Were you often afraid that you might pass out?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13K

(During this episode lasting 6 months or longer,) were you often afraid that you might die?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13L

Did you often have hot flushes or chills?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13M

Did you often have numbness or tingling sensations?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13N

Did you often feel like you had a lump in your throat?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q13O

Were you easily startled?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q15

How much emotional distress did you ever experience because you felt ^DT_WORRIED?

1. None
2. Mild
3. Moderate
4. Severe
5. Very severe
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q17

How much did your feelings of being ^DT_WORRIED ever interfere with either your work, your social life or your personal relationships?

1. Not at all
2. A little
3. Some
4. A lot
5. Extremely
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q17_1

How often were you unable to carry out your daily activities because you felt ^DT_WORRIED?

1. Often
2. Sometimes
3. Rarely
4. Never
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q18A

Feelings of being ^DT_WORRIED sometimes occur as a result of a physical illness or injury or the use of medication, drugs or alcohol. Do you think these feelings ever occurred as the result of physical causes, medication, drugs or alcohol?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q18B

Do you think your ^DT_WORRY was always the result of physical causes, medication, drugs, or alcohol?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q18C

What were the causes?

1. Exhaustion
2. Hyperventilation
3. Hypochondria
4. Menstrual cycle
5. Pregnancy / postpartum
6. Thyroid disease
7. Cancer
8. Overweight
9. Medication (excluding illicit drugs)
10. Illicit drugs
11. Alcohol
12. Chemical Imbalance / Serotonin Imbalance
13. Chronic pain
14. Caffeine
15. No specific diagnosis
16. Other - Specify
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R26

In the next questions, the word "episode" means a period lasting 6 months or longer when, nearly every day, you were ^DT_WORRIED, and you also had some of the other problems we just mentioned. The end of an episode is when you no longer have these feelings for a full month.

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q26D

During your life, how many episodes lasting 6 months or longer have you ever had when you felt ^DT_WORRIED?

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q27

During the past 12 months, did you have an episode of being ^DT_WORRIED that lasted at least six months or longer?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q27_1

How recently was it?

1. During the past month
2. Between 1 and 6 months ago
3. More than 6 months ago
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q27_2

How old were you ^DT_THESE?

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q31

How many of these episodes were brought on by some stressful experience?

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q32

Was this episode brought on by some stressful experience or did it happen out of the blue?

1. Brought on by stress
2. Out of the blue
3. Don't remember
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_R38

(Please refer to page 3 of the booklet.)

Think about the period of time lasting one month or longer when your feelings of being ^DT_WORRIED were most severe in the past 12 months. Please tell me what number best describes how much these feelings interfered with each of the following activities. For each activity, please answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference".

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38A

In the past 12 months, how much did your feelings of being ^DT_WORRIED interfere with your home responsibilities, like cleaning, shopping, and taking care of the house or apartment?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38B_1

How much did these feelings interfere with your ability to attend school?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38B_2

How much did these feelings interfere with your ability to work at a job?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38C

Again, thinking about the period of time that lasted one month or longer when your feelings of being ^DT_WORRIED were most severe, how much did these feelings interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference").

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q38D

How much did these feelings interfere with your social life?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q40

In the past 12 months, about how many days out of 365 were you totally unable to work or carry out your normal activities because of your feelings of being ^DT_WORRIED? (You may use any number between 0 and 365 to answer.)

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q44

Did you ever in your life see, or talk on the telephone to, a medical doctor or other professional about your feelings of being ^DT_WORRIED? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q58

During the past 12 months, did you receive professional treatment for being ^DT_WORRIED?

1. Yes
2. No
8. RF
9. DK

Generalized Anxiety Disorder (GAD) - Question identifier:GAD_Q59

Were you ever hospitalized overnight for being ^DT_WORRIED?

1. Yes
2. No
8. RF
9. DK

Smoking (SMK)

Smoking (SMK) - Question identifier:SMK_R1

The next questions are about smoking.

Smoking (SMK) - Question identifier:SMK_Q201A

In your lifetime, have you smoked a total of 100 or more cigarettes (about 4 packs)?

1. Yes
2. No
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q201B

Have you ever smoked a whole cigarette?

1. Yes
2. No
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q201C

At what age did you smoke your first whole cigarette?

Smoking (SMK) - Question identifier:SMK_Q202

At the present time, do you smoke cigarettes daily, occasionally or not at all?

1. Daily
2. Occasionally
3. Not at all
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q203

At what age did you begin to smoke cigarettes daily?

Smoking (SMK) - Question identifier:SMK_Q204

How many cigarettes do you smoke each day now?

Smoking (SMK) - Question identifier:SMK_Q205B

On the days that you do smoke, how many cigarettes do you usually smoke?

Smoking (SMK) - Question identifier:SMK_Q205C

In the past month, on how many days have you smoked 1 or more cigarettes?

Smoking (SMK) - Question identifier:SMK_Q205D

Have you ever smoked cigarettes daily?

1. Yes
2. No
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q206A

When did you stop smoking? Was it... ?

1. Less than one year ago
2. 1 year to less than 2 years ago
3. 2 years to less than 3 years ago
4. 3 or more years ago
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q206B

In what month did you stop?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
98. RF
99. DK

Smoking (SMK) - Question identifier:SMK_Q206C

How many years ago was it?

Smoking (SMK) - Question identifier:SMK_Q207

At what age did you begin to smoke (cigarettes) daily?

Smoking (SMK) - Question identifier:SMK_Q208

How many cigarettes did you usually smoke each day?

Smoking (SMK) - Question identifier:SMK_Q209A

When did you stop smoking daily? Was it... ?

1. Less than one year ago
2. 1 year to less than 2 years ago
3. 2 years to less than 3 years ago
4. 3 or more years ago
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q209B

In what month did you stop?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
98. RF
99. DK

Smoking (SMK) - Question identifier:SMK_Q209C

How many years ago was it?

Smoking (SMK) - Question identifier:SMK_Q210A

Was that when you completely quit smoking?

1. Yes
2. No
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q210B

When did you stop smoking completely? Was it... ?

1. Less than one year ago
2. 1 year to less than 2 years ago
3. 2 years to less than 3 years ago
4. 3 or more years ago
8. RF
9. DK

Smoking (SMK) - Question identifier:SMK_Q210C

In what month did you stop?

1. January
2. February
3. March
4. April
5. May
6. June
7. July
8. August
9. September
10. October
11. November
12. December
98. RF
99. DK

Smoking (SMK) - Question identifier:SMK_Q210D

How many years ago was it?

Alcohol Use, Abuse and Dependence (AUD)

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R01

Now, some questions about your alcohol consumption.

When we use the word "drink" it means:
- one bottle or can of beer or a glass of draft
- one glass of wine or a wine cooler (one whole bottle of wine counts as 5 drinks)
- one drink or cocktail with 1 and a 1/2 ounces of liquor

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q01

During the past 12 months, that is, from ^DT_YEARAGO to yesterday, have you had a drink of beer, wine, liquor or any other alcoholic beverage?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q02

Please refer to page 7 of the booklet.

During the past 12 months, how often did you drink alcoholic beverages?

1. Less than once a month
2. Once a month
3. 2 to 3 times a month
4. Once a week
5. 2 to 3 times a week
6. 4 to 6 times a week
7. Every day
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q03

Please refer to page 8 of the booklet.

How often in the past 12 months have you had 5 or more drinks on one occasion?

1. Never
2. Less than once a month
3. Once a month
4. 2 to 3 times a month
5. Once a week
6. More than once a week
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q04

Have you ever had a drink?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q05

Have you ever had 12 or more drinks in a year?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q06

On the days you drank in the past 12 months, about how many drinks did you usually have per day?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q08

Was there ever a year in your life when you drank more than you did in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q10

Please refer to page 7 of the booklet.

Think about the years in your life when you drank most. During those years, how often did you usually have at least one drink?

1. Less than once a month
2. Once a month
3. 2 to 3 times a month
4. Once a week
5. 2 to 3 times a week
6. 4 to 6 times a week
7. Every day
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q11

On the days you drank during those years, about how many drinks did you usually have per day?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R13

The next questions are about problems you may have had because of drinking at any time in your life.

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13A

First, was there ever a time in your life when your drinking or being hung over frequently interfered with your work or responsibilities at school, on a job, or at home?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13A_1

Was there ever a time in your life when your drinking caused arguments or other serious or repeated problems with your family, friends, neighbours, or co-workers?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13B

Did you continue to drink even though it caused problems with these people?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13C

Were there times in your life when you were often under the influence of alcohol in situations where you could get hurt, for example when riding a bicycle, driving, or operating a machine?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13D

Were you ever arrested or stopped by the police because of drunk driving or drunken behavior?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q13E

How many times were you arrested or stopped by the police due to drinking?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q16

You just reported that:
^DT_KEYPHRASEQ13E
^DT_KEYPHRASEQ13AE
^DT_KEYPHRASEQ13BE
^DT_KEYPHRASEQ13CE
^DT_KEYPHRASEQ13DE

How recently did you have ^DT_PROBLEM1 because of drinking?

1. In the past 30 days
2. 1 month to less than 6 months ago
3. 6 months to 12 months ago
4. More than 12 months ago
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q17

How old were you the last time (you had ^DT_PROBLEM1 because of drinking)?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R19

The next questions are about some other problems you may have had because of drinking.

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19A

Was there ever a time in your life when you often had such a strong desire to drink that you couldn't stop yourself from taking a drink or found it difficult to think of anything else?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19A_1

Did you ever need to drink a larger amount of alcohol to get an effect, or did you ever find that you could no longer get a "buzz" or a high on the amount you used to drink?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19B

Did you ever have times when you stopped, cut down, or went without drinking and then experienced withdrawal symptoms like fatigue, headaches, diarrhea, the shakes, or emotional problems?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19C

Did you ever have times when you took a drink to keep from having problems like these?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19D

Did you ever have times when you started drinking even though you promised yourself you wouldn't, or when you drank a lot more than you intended?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19E

Were there ever times when you drank more frequently or for more days in a row than you intended?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19F

Did you have times when you started drinking and became drunk when you didn't want to?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19G

Were there times when you tried to stop or cut down on your drinking and found that you were not able to do so?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19H

Did you ever have periods of several days or more when you spent so much time drinking or recovering from the effects of alcohol that you had little time for anything else?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19I

Did you ever have a time when you gave up or greatly reduced important activities because of your drinking, like sports, work, or seeing friends and family?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q19J

Did you ever continue to drink when you knew you had a serious physical or emotional problem that might have been caused by or made worse by drinking?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R22

^DT_INTRO22E.

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q23

Did you ever have three or more of these problems in the same 12-month period?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q25

How recently did you have ^DT_PROBLEM2?

1. In the past 30 days
2. 1 month to less than 6 months ago
3. 6 months to 12 months ago
4. More than 12 months ago
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q26

How old were you the last time you had any of these problems?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q29

Starting from the time you first began having ^DT_PROBLEM2, about how many different times did you ever make a serious attempt to quit drinking?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_R35

(Please refer to page 3 of the booklet.)

Think about the period of time that lasted one month or longer in the past 12 months when you were drinking the most. Please tell me what number best describes how much your drinking interfered with each of the following activities. For each activity, answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference."

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35A

In the past 12 months, how much did your drinking interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35B_1

How much did your drinking interfere with your ability to attend school?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35B_2

How much did your drinking interfere with your ability to work at a job?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35C

Again, thinking about that period lasting one month or longer during the past 12 months when you were drinking the most, how much did your drinking interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q35D

How much did your drinking interfere with your social life?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q36A

About how many days out of 365 in the past 12 months were you totally unable to work or carry out your normal activities because of your drinking?

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q39

Did you ever in your life see, or talk on the telephone to, a medical doctor or other professional about your use of alcohol? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q41

During the past 12 months, did you receive professional treatment for your use of alcohol?

1. Yes
2. No
8. RF
9. DK

Alcohol Use, Abuse and Dependence (AUD) - Question identifier:AUD_Q42

During your life, were you ever hospitalized overnight for your use of alcohol?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD)

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R01A

The next questions are about medicines that are often used nonmedically. By "used nonmedically" we mean:
- either used without the recommendation of a health professional,
- or used in greater amounts than your health professional told you to use them,
- or used for any reason other than what a health professional said you should use them for.

Again, I would like to remind you that everything you say will remain strictly confidential.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q01A

(Please refer to page 9 of the booklet.)

The first group is sedatives or tranquilizers, sometimes called "downers" or "nerve pills." These are medicines people sometimes use to help them stay calm and relaxed or to sleep. Examples include valium, rohypnol, and diazepam. Have you ever used a sedative or tranquilizer nonmedically?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q01B

Have you ever used a sedative or tranquilizer that a doctor prescribed for you?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q01C

Was your use ever so regular that you felt that you could not stop using the sedative or tranquilizer prescribed for you?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q01D

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q01E

(Please refer to page 10 of the booklet.)

How often (did you use a sedative or tranquilizer in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q02A

(Please refer to page 11 of the booklet.)

The second group of medicines is stimulants, sometimes called speed, ice, glass, crystal, crank, pep pills, or uppers. These are medicines that people sometimes use to stay awake, to improve their low mood, or to lose weight. Examples include dexamyl, methamphetamine, adderall, and ritalin. Have you ever used a stimulant nonmedically?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q02B

Have you ever used a stimulant that a doctor prescribed for you?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q02C

Was your use ever so regular that you felt that you could not stop using the stimulant prescribed for you?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q02D

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q02E

(Please refer to page 10 of the booklet.)

How often (did you use a stimulant in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q03A

(Please refer to page 12 of the booklet.)

The third group of medicines is analgesics. These are medicines that people usually take as pain killers. Examples include codeine, morphine, and percodan. Have you ever used a pain killer nonmedically?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q03B

Have you ever used a pain killer that a doctor prescribed for you?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q03C

Was your use ever so regular that you felt that you could not stop using the pain killer prescribed for you?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q03D

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q03E

(Please refer to page 10 of the booklet.)

How often (did you use a pain killer in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R04A

The next questions are about your experience with several other types of drugs.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04A

Have you ever used or tried marijuana or hashish?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04B

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04C

(Please refer to page 10 of the booklet.)

How often (did you use marijuana or hashish in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04D

Did you ever have a period where you used marijuana or hashish more than you did in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04E

(Please refer to page 10 of the booklet.)

Thinking of the year when you used marijuana or hashish most, how often did you use it?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04F

In your lifetime, how many times have you used marijuana or hashish?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q04G

Have you used marijuana or hashish more than 50 times in your lifetime?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q05A

Have you ever used or tried cocaine in any form, including powder, crack, free base, coca leaves, or paste?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q05B

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q05C

(Please refer to page 10 of the booklet.)

How often (did you use cocaine in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q06A

Have you ever used or tried club drugs such as ecstasy, ketamine or MDMA?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q06B

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q06C

(Please refer to page 10 of the booklet.)

How often (did you use club drugs in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q07A

Have you ever used or tried hallucinogens including LSD, mescaline, PCP, angel dust, mushrooms or peyote?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q07B

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q07C

(Please refer to page 10 of the booklet.)

How often (did you use hallucinogens in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q08A

Have you ever used or tried heroin or opium?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q08B

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q08C

(Please refer to page 10 of the booklet.)

How often (did you use heroin or opium in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q09A

Have you ever used any inhalants or solvents such as nitrous oxide, glue, paint or gasoline?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q09B

Have you used it in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q09C

(Please refer to page 10 of the booklet.)

How often (did you use inhalants or solvents in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q10A

Have you ever used any other illegal drug?

1. Yes, just once
2. Yes, more than once
3. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q10B

Have you used ^DT_OTHER in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q10C

(Please refer to page 10 of the booklet)

How often (did you use ^DT_OTHER in the past 12 months)?

1. Less than once a month
2. 1 to 3 times a month
3. Once a week
4. More than once a week
5. Every day
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R21

Earlier, you reported using marijuana or hashish. The next questions are about any problems you ever had because of your use of marijuana or hashish.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q21

Was there ever a time in your life when your use of marijuana or hashish frequently interfered with your work or responsibilities at school, on a job, or at home?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q22

Was there ever a time in your life when your use of marijuana or hashish caused arguments or other serious or repeated problems with your family, friends, neighbours, or co-workers?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q23

Did you continue to use marijuana or hashish even though it caused problems with these people?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q24

Were there times in your life when you were often under the influence of marijuana or hashish in situations where you could have gotten hurt, for example when riding a bicycle, driving, or operating a machine?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q25

Were you arrested or stopped by the police more than once because of driving under the influence of marijuana or hashish or because of your behaviour while you were under the influence of marijuana or hashish?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q28

Your use of marijuana or hashish:
^DT_KEYPHRASESB.

How recently did you have ^DT_THISPROBLEM1 because of using marijuana or hashish?

1. In the past 30 days
2. 1 month to less than 6 months ago
3. 6 months to 12 months ago
4. More than 12 months ago
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q29

How old were you the last time you had ^DT_THISPROBLEM1 because of marijuana or hashish?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R31

The next questions are about some other problems you may have had due to your use of marijuana or hashish.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q31

Was there ever a time in your life when you often had such a strong desire to use marijuana or hashish that you couldn't stop using or found it difficult to think of anything else?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q32

Did you ever need larger amounts of marijuana or hashish to get an effect, or did you ever find that you could no longer get high on the amount you used to use?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q33

Did you ever have times when you stopped, cut down or went without using marijuana or hashish and then experienced withdrawal symptoms?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q34

Did you ever have times when you used marijuana or hashish to keep from having problems like these?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q35

Did you ever have times when you used marijuana or hashish even though you planned not to or when you used a lot more than you intended?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q36

Were there ever times when you used marijuana or hashish more frequently or for more days in a row than you intended?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q37

Were there times when you tried to stop or cut down on your use of marijuana or hashish and found that you were not able to do so?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q38

Did you ever have several days or more when you spent so much time using or recovering from the effects of marijuana or hashish use that you had little time for anything else?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q39

Did you ever have a time when you gave up or greatly reduced important activities because of your marijuana or hashish use - like sports, work, or seeing friends and family?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q40

Did you ever continue to use marijuana or hashish when you knew you had a serious physical or emotional problem that might have been caused by or made worse by using marijuana or hashish?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R42

You reported that during the time you were using marijuana or hashish: ^DT_KEYPHRASESD.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q43

Did you ever have three or more of these problems in the same 12 month period during the time you were using marijuana or hashish?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q45

How recently did you have ^THISPROBLEM2 because of using marijuana or hashish?

1. In the past 30 days
2. 1 month to less than 6 months ago
3. 6 months to 12 months ago
4. More than 12 months ago
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q46

How old were you the last time you had any of these problems because of using marijuana or hashish?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R51

You reported using: ^DT_DRUGX.

The next questions are about any problems you ever had because of your use of ^DT_DRUGUSE.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q51

Was there ever a time in your life when your use of ^DT_DRUGUSE2 frequently interfered with your work or responsibilities at school, on a job, or at home?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q52

Was there ever a time in your life when your use of ^DT_DRUGUSE2 caused arguments or other serious or repeated problems with your family, friends, neighbours, or co-workers?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q53

Did you continue to use ^DT_DRUGUSE2 even though it caused problems with these people?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q54

Were there times in your life when you were often under the influence of ^DT_DRUGUSE2 in situations where you could have gotten hurt, for example when riding a bicycle, driving, or operating a machine?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q55

Were you arrested or stopped by the police more than once because of driving under the influence of ^DT_DRUGUSE2 or because of your behaviour while you were under the influence of ^DT_DRUGUSE2?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q58

Your use of ^DT_DRUGUSE:
^DT_KEYPHRASESB2.

How recently did you have ^DT_THISPROBLEM3 because of using ^DT_DRUGUSE2?

1. In the past 30 days
2. 1 month to less than 6 months ago
3. 6 months to 12 months ago
4. More than 12 months ago
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q59

How old were you the last time you had ^DT_THISPROBLEM3 because of ^DT_DRUGUSE2?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R61

You reported using: ^DT_DRUGX.

The next questions are about some other problems you may have had due to your use of ^DT_DRUGUSE.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q61

Was there ever a time in your life when you often had such a strong desire to use ^DT_DRUGUSE2 that you couldn't stop using or found it difficult to think of anything else?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q62

Did you ever need larger amounts of ^DT_DRUGUSE2 to get an effect, or did you ever find that you could no longer get high on the amount you used to use?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q63

Did you ever have times when you stopped, cut down or went without using ^DT_DRUGUSE2 and then experienced withdrawal symptoms?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q64

Did you ever have times when you used ^DT_DRUGUSE2 to keep from having problems like these?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q65

Did you ever have times when you used ^DT_DRUGUSE2 even though you planned not to or when you used a lot more than you intended?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q66

Were there ever times when you used ^DT_DRUGUSE2 more frequently or for more days in a row than you intended?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q67

Were there times when you tried to stop or cut down on your use of ^DT_DRUGUSE2 and found that you were not able to do so?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q68

Did you ever have several days or more when you spent so much time using or recovering from the effects of using ^DT_DRUGUSE2 that you had little time for anything else?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q69

Did you ever have a time when you gave up or greatly reduced important activities because of your use of ^DT_DRUGUSE2 - like sports, work, or seeing friends and family?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q70

Did you ever continue to use ^DT_DRUGUSE2 when you knew you had a serious physical or emotional problem that might have been caused by or made worse by using ^DT_DRUGUSE2?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R72

You reported that during the time you were using ^DT_DRUGUSE:
^DT_KEYPHRASESD2.

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q73

Did you ever have three or more of these problems in the same 12 month period during the time you were using ^DT_DRUGUSE?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q75

How recently did you have ^DT_THISPROBLEM4 because of using ^DT_DRUGUSE2?

1. In the past 30 days
2. 1 month to less than 6 months ago
3. 6 months to 12 months ago
4. More than 12 months ago
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q76

How old were you the last time you had any of these problems because of using ^DT_DRUGUSE2?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_R81

Please refer to page 3 of the booklet.

You earlier reported that during the past 12 months you used: ^DT_LIST12MOSUB.

Think about the period of time that lasted one month or longer in the past 12 months when you were using ^DT_ALL12MOSUB the most. Please tell me what number best describes how much your use of ^DT_ALL12MOSUB interfered with each of the following activities. For each activity, answer with a number between 0 and 10; 0 means "no interference" while 10 means "very severe interference."

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q81A

In the past 12 months, how much did your use of drugs interfere with your home responsibilities, like cleaning, shopping and taking care of the house or apartment?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q81B_1

How much did your use interfere with your ability to attend school?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q81B_2

How much did your use interfere with your ability to work at a job?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
11. Not applicable
98. RF
99. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q81C

Again, think about the period lasting one month or longer in the past 12 months when you were using ^DT_ALL12MOSUB the most. How much did your use of drugs interfere with your ability to form and maintain close relationships with other people? (Remember that 0 means "no interference" and 10 means "very severe interference".)

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q81D

How much did your use of drugs interfere with your social life?

0. No interference
1. |
2. |
3. |
4. |
5. |
6. |
7. |
8. |
9. V
10. Very severe interference
98. RF
99. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q83

About how many days out of 365 in the past 12 months were you totally unable to work or carry out your normal activities because of your using ^DT_ALL12MOSUB?

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q87

Now, think about all of the drugs you have used in your lifetime. Did you ever in your life see, or talk on the telephone to, a medical doctor or other professional about your drug use ^DT_INCMAR? (By other professional, we mean psychologists, psychiatrists, social workers, counsellors, spiritual advisors, homeopaths, acupuncturists, self-help groups or other health professionals.)

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q89

During the past 12 months, did you receive professional treatment for your drug use?

1. Yes
2. No
8. RF
9. DK

Substance Use, Abuse and Dependence (SUD) - Question identifier:SUD_Q90

During your life, were you ever hospitalized overnight for your drug use?

1. Yes
2. No
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS)

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_R01A

Please refer to page 13 of the booklet.

The following questions are about the difficulties people may have because of any short or long lasting health condition related to diseases or illnesses, injuries, mental or emotional problems and problems with alcohol or drugs.

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_R01B

When reporting any difficulties, please think about the average amount of: increased effort, discomfort or pain, slowness, or changes in the way you do the activity over the last 30 days.

You may feel that some of these questions do not apply to you, but it is important that we ask the same questions of everyone.

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q01

In the last 30 days, how much difficulty did you have in:

... standing for long periods such as 30 minutes?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q02

(In the last 30 days, how much difficulty did you have in:)

... taking care of your household responsibilities?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q03

(In the last 30 days, how much difficulty did you have in:)

... learning a new task, for example, learning how to get to a new place?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q04

In the last 30 days, how much of a problem did you have joining in community activities (for example, festivities, religious or other activities) in the same way as anyone else can?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
6. Not applicable
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q05

In the last 30 days, how much have you been emotionally affected by your health problems?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q06

In the last 30 days, how much difficulty did you have in:

... concentrating on doing something for 10 minutes?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q07

(In the last 30 days, how much difficulty did you have in:)

... walking a long distance such as a kilometre (or 0.6 miles)?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q08

(In the last 30 days, how much difficulty did you have in:)

... washing your whole body?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q09

(In the last 30 days, how much difficulty did you have in:)

... getting dressed?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q10

In the last 30 days, how much difficulty did you have in:

... dealing with people you do not know?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q11

(In the last 30 days, how much difficulty did you have in:)

... maintaining a friendship?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q12

(In the last 30 days, how much difficulty did you have in:)

... your day to day work or school activities?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme/Cannot do
6. Not applicable
8. RF
9. DK

WHO Disability Assessment Schedule 2.0 (DAS) - Question identifier:DAS_Q13

In the last 30 days, overall, how much did these difficulties interfere with your life?

1. None
2. Mild
3. Moderate
4. Severe
5. Extreme
8. RF
9. DK

Two-Week Disability (TWD)

Two-Week Disability (TWD) - Question identifier:TWD_R01

The next few questions ask about your health during the past 14 days. It is important for you to refer to the 14-day period from ^DTE2WKAGOE to ^DTEYSTRDAYE.

Two-Week Disability (TWD) - Question identifier:TWD_Q1

During that period, did you stay in bed at all because of illness or injury, including any nights spent as a patient in a hospital?

1. Yes
2. No
8. RF
9. DK

Two-Week Disability (TWD) - Question identifier:TWD_Q2

How many days did you stay in bed for all or most of the day?

Two-Week Disability (TWD) - Question identifier:TWD_Q3

^DT_DURING those 14 days, were there any days that you cut down on things you normally do because of illness or injury?

1. Yes
2. No
8. RF
9. DK

Two-Week Disability (TWD) - Question identifier:TWD_Q4

How many days did you cut down on things for all or most of the day?

Two-Week Disability (TWD) - Question identifier:TWD_Q5

^DT_DURING those 14 days, were there any days when it took extra effort to perform up to your usual level at work or at your other daily activities, because of illness or injury?

1. Yes
2. No
8. RF
9. DK

Two-Week Disability (TWD) - Question identifier:TWD_Q6

How many days required extra effort?

Mental Health Services (SR1)

Mental Health Services (SR1) - Question identifier:SR1_R001

Now I would like to ask you some questions about your contacts with health professionals as well as other people about problems with your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q001

During the past 12 months, were you hospitalized overnight or longer for problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q002

During the past 12 months, how many times were you hospitalized overnight or longer for these problems?

Mental Health Services (SR1) - Question identifier:SR1_Q003

How long did you stay in the hospital for these problems (during the past 12 months)?

Mental Health Services (SR1) - Question identifier:SR1_N003

Was that days, weeks, or months?

1. Days
2. Weeks
3. Months

Mental Health Services (SR1) - Question identifier:SR1_Q004

Please refer to page 14 of the booklet.

During the past 12 months, have you seen, or talked on the telephone to, any of the following people about problems with your emotions, mental health or use of alcohol or drugs?

1. Psychiatrist
2. Family doctor or general practitioner
3. Psychologist
4. Nurse
5. Social worker, counsellor, or psychotherapist
6. Family member
7. Friend
8. Co-worker, supervisor, or boss
9. Teacher or school principal
10. Other - Specify
11. None
98. RF
99. DK

Mental Health Services (SR1) - Question identifier:SR1_R010

You mentioned that you saw, or talked on the telephone to, a psychiatrist about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q010

Think of the psychiatrist you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this psychiatrist (about your problems with your emotions, mental health, or use of alcohol or drugs)?

Mental Health Services (SR1) - Question identifier:SR1_N010

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q011

(During the past 12 months,) about how long did each consultation with this psychiatrist last (in minutes)?

Mental Health Services (SR1) - Question identifier:SR1_Q012

In general, how much would you say the psychiatrist helped you (for your problems with your emotions, mental health, or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q013

Have you stopped seeing the psychiatrist?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q014

(Please refer to page 15 of the booklet.)

Why did you stop?

1. You felt better
2. You completed the recommended treatment
3. You thought it was not helping
4. You thought the problem would get better without more professional help
5. You couldn't afford to pay
6. You were too embarrassed to see the professional
7. You wanted to solve the problem without professional help
8. You had problems with things like transportation, childcare or your schedule
9. The service or program was no longer available
10. You were not comfortable with the professional's approach
11. Because of discrimination or unfair treatment
12. Other - Specify
98. RF
99. DK

Mental Health Services (SR1) - Question identifier:SR1_R020

You mentioned that you saw, or talked on the telephone to, a family doctor or general practitioner about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q020

Think of the family doctor or the general practitioner you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this family doctor or general practitioner about your problems with your emotions, mental health or use of alcohol or drugs?

Mental Health Services (SR1) - Question identifier:SR1_N020

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q021

(During the past 12 months,) about how long did each consultation with this family doctor or general practitioner last (in minutes) (for your problems with your emotions, mental health or use of alcohol or drugs) (in minutes)?

Mental Health Services (SR1) - Question identifier:SR1_Q022

In general, how much would you say this family doctor or general practitioner helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q023

Have you stopped talking to this family doctor or general practitioner about your problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q024

(Please refer to page 15 of the booklet.)

Why did you stop?

1. You felt better
2. You completed the recommended treatment
3. You thought it was not helping
4. You thought the problem would get better without more professional help
5. You couldn't afford to pay
6. You were too embarrassed to see the professional
7. You wanted to solve the problem without professional help
8. You had problems with things like transportation, childcare or your schedule
9. The service or program was no longer available
10. You were not comfortable with the professional's approach
11. Because of discrimination or unfair treatment
12. Other - Specify
98. RF
99. DK

Mental Health Services (SR1) - Question identifier:SR1_R030

You mentioned that you saw, or talked on the telephone to, a psychologist (about your emotions, mental health or use of alcohol or drugs)?

Mental Health Services (SR1) - Question identifier:SR1_Q030

Think of the psychologist you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this psychologist (about your problems with your emotions, mental health or use of alcohol or drugs)?

Mental Health Services (SR1) - Question identifier:SR1_N030

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q031

(During the past 12 months,) about how long did each consultation with this psychologist last (in minutes)?

Mental Health Services (SR1) - Question identifier:SR1_Q032

In general, how much would you say this psychologist helped you (for your problems with your emotions, mental health, or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q033

Have you stopped seeing this psychologist?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q034

(Please refer to page 15 of the booklet.)

Why did you stop?

1. You felt better
2. You completed the recommended treatment
3. You thought it was not helping
4. You thought the problem would get better without more professional help
5. You couldn't afford to pay
6. You were too embarrassed to see the professional
7. You wanted to solve the problem without professional help
8. You had problems with things like transportation, childcare or your schedule
9. The service or program was no longer available
10. You were not comfortable with the professional's approach
11. Because of discrimination or unfair treatment
12. Other - Specify
98. RF
99. DK

Mental Health Services (SR1) - Question identifier:SR1_R040

You mentioned that you saw, or talked on the telephone to, a nurse about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q040

Think of the nurse you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this nurse about your problems with your emotions, mental health or use of alcohol or drugs?

Mental Health Services (SR1) - Question identifier:SR1_N040

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q041

(During the past 12 months,) about how long did each consultation with this nurse last (for your problems with your emotions, mental health or use of alcohol or drugs)(in minutes)?

Mental Health Services (SR1) - Question identifier:SR1_Q042

In general, how much would you say this nurse helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q043

Have you stopped talking to this nurse about your problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q044

(Please refer to page 15 of the booklet.)

Why did you stop?

1. You felt better
2. You completed the recommended treatment
3. You thought it was not helping
4. You thought the problem would get better without more professional help
5. You couldn't afford to pay
6. You were too embarrassed to see the professional
7. You wanted to solve the problem without professional help
8. You had problems with things like transportation, childcare or your schedule
9. The service or program was no longer available
10. You were not comfortable with the professional's approach
11. Because of discrimination or unfair treatment
12. Other - Specify
98. RF
99. DK

Mental Health Services (SR1) - Question identifier:SR1_R050

You mentioned that you saw, or talked on the telephone to, a social worker, counsellor, (case worker,) or psychotherapist about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q050

Think of the social worker, counsellor, (case worker,) or psychotherapist you talked to the most often during the past 12 months.

How many times did you see, or talk to on the telephone to, this professional (about your problems with your emotions, mental health or use of alcohol or drugs)?

Mental Health Services (SR1) - Question identifier:SR1_N050

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q051

(During the past 12 months) about how long did each consultation with this professional last (in minutes)?

Mental Health Services (SR1) - Question identifier:SR1_Q052

In general, how much would you say this professional helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q053

Have you stopped talking to this professional about your problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q054

(Please refer to page 15 of the booklet.)

Why did you stop?

1. You felt better
2. You completed the recommended treatment
3. You thought it was not helping
4. You thought the problem would get better without more professional help
5. You couldn't afford to pay
6. You were too embarrassed to see the professional
7. You wanted to solve the problem without professional help
8. You had problems with things like transportation, childcare or your schedule
9. The service or program was no longer available
10. You were not comfortable with the professional's approach
11. Because of discrimination or unfair treatment
12. Other - Specify
98. RF
99. DK

Mental Health Services (SR1) - Question identifier:SR1_R060

You mentioned that you saw, or talked on the telephone to, a family member about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q060

Think of the family member you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this family member about your problems with your emotions, mental health or use of alcohol or drugs?

Mental Health Services (SR1) - Question identifier:SR1_N060

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q062

In general, how much would you say this family member helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_R070

You mentioned that you saw, or talked on the telephone to, a friend about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q070

Think of the friend you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this friend about your problems with your emotions, mental health or use of alcohol or drugs?

Mental Health Services (SR1) - Question identifier:SR1_N070

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q072

In general, how much would you say this friend helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_R080

You mentioned that you saw, or talked on the telephone to, a co-worker, supervisor or boss about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q080

Think of the co-worker, supervisor or boss you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this co-worker, supervisor or boss about your problems with your emotions, mental health or use of alcohol or drugs?

Mental Health Services (SR1) - Question identifier:SR1_N080

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q082

In general, how much would you say this co-worker, supervisor or boss helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_R090

You mentioned that you saw, or talked on the telephone to, a teacher or school principal about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q090

Think of the teacher or school principal you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this teacher or school principal about your problems with your emotions, mental health or use of alcohol or drugs?

Mental Health Services (SR1) - Question identifier:SR1_N090

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q092

In general, how much would you say this teacher or school principal helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_R100

You mentioned that you saw, or talked on the telephone to, other people about your emotions, mental health or use of alcohol or drugs.

Mental Health Services (SR1) - Question identifier:SR1_Q100

Think of the other person you talked to the most often during the past 12 months.

How many times did you see, or talk on the telephone to, this person (about your problems with your emotions, mental health or use of alcohol or drugs)?

Mental Health Services (SR1) - Question identifier:SR1_N100

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q102

In general, how much would you say this person helped you (for your problems with your emotions, mental health or use of alcohol or drugs)?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q110

During the past 12 months, did you receive help or services provided by your employer for problems with your emotions, mental health or use of alcohol or drugs, such as consultations with an Employee Assistance Program (EAP)?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q111

During the past 12 months, did you use the Internet to get information, help or support for problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q112

(Please refer to page 16 of the booklet.)

Did you use the Internet (for problems with your emotions, mental health or use of alcohol or drugs)...?

1. To learn about symptoms (e.g. get an online diagnosis)
2. To find out where you could get help
3. To discuss with others through forums, support groups or Internet social networks
4. To get online therapy (e.g. e-therapy, online counselling)
5. Other - Specify
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q113

During the past 12 months, (not counting internet support groups) did you go to a self-help group for help with problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q114

What type of self-help group did you go to?

1. Emotional or mental health (e.g. groups for eating disorders, bipolar disorder, bereavement, etc.)
2. Alcohol or drug use (e.g. Alcoholics Anonymous, Narcotics Anonymous, etc.)
3. Other - Specify
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q115

(During the past 12 months), how many times did you go to a meeting of a self-help group?

Mental Health Services (SR1) - Question identifier:SR1_N115

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q116

During the past 12 months, did you use a telephone helpline for problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q117

(During the past 12 months), how many times did you use a telephone helpline?

Mental Health Services (SR1) - Question identifier:SR1_N117

Was that per week, per month, or per year? If once per day, enter 7 times per week.

1. Per week
2. Per month
3. Per year

Mental Health Services (SR1) - Question identifier:SR1_Q118

During the past 12 months, was there ever a time when you felt that you needed help for your emotions, mental health or use of alcohol or drugs, but you didn't receive it?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_R119

The next question is about the money you spent over the past 12 months for services and products to help you with your problems with your emotions, mental health or use of alcohol or drugs. This includes all the money you and your family members paid "out-of-pocket" for visits, medications, tests and services associated with these problems.

Mental Health Services (SR1) - Question identifier:SR1_Q119

Not counting any costs that were covered by insurance, about how much money have you and your family spent on such services and products during the past 12 months?

Mental Health Services (SR1) - Question identifier:SR1_R120

Now I would like to ask about possible experiences you may have had with the health care system or social services.

Mental Health Services (SR1) - Question identifier:SR1_Q120

During the past 12 months, did you feel that any health professional or other service provider held negative opinions about you or treated you unfairly:

...because of your ethnicity, culture, race, skin colour, language or accent, religion or sexual orientation?

1. Yes
2. No
8. RF
9. DK

Mental Health Services (SR1) - Question identifier:SR1_Q121

(During the past 12 months, did you feel that any health professional or other service provider held negative opinions about you or treated you unfairly:)

...because of your past or current problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Medication Use (MED)

Medication Use (MED) - Question identifier:MED_R01

Now I'd like to ask a few questions about your use of medication, both prescription and over-the-counter.

Medication Use (MED) - Question identifier:MED_Q01

In the past 12 months, that is, from ^DV_DATE1YRE to yesterday, did you take any medication to help you with problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Medication Use (MED) - Question identifier:MED_Q02

Now, think about the last 2 days, that is, yesterday and the day before yesterday. During those 2 days, how many different medications did you take for problems with your emotions, mental health, or use of alcohol or drugs?

Medication Use (MED) - Question identifier:MED_R03

We will be collecting the names and drug identification numbers (DINs) of any medication you took over the last 2 days to help you with problems with your emotions, mental health or use of alcohol or drugs. It would help us record this information more quickly if you would go and get all the bottles and containers for these products.

Medication Use (MED) - Question identifier:MED_Q05

Do you have insurance that covers all or part of the cost of your prescription medication? Include any private, government or employee-paid insurance plans.

1. Yes
2. No
8. RF
9. DK

Medication Use (MED) - Question identifier:MED_Q06

Many people use other health products such as herbs, minerals or homeopathic products for problems with emotions, alcohol or drug use, energy, concentration, sleep or ability to deal with stress.

In the past 12 months, have you used any of these health products?

1. Yes
2. No
8. RF
9. DK

Drug Identification Numbers - sub block (DIN)

Drug Identification Numbers - sub block (DIN) - Question identifier:DIN_Q01N

Is a Drug Identification number (DIN) available for medication n?

1. Yes
2. No

Drug Identification Numbers - sub block (DIN) - Question identifier:DIN_Q02N

What is the DIN of medication n?

Drug Identification Numbers - sub block (DIN) - Question identifier:DIN_N03N

The name associated with DIN ^DIN_Q02n is ^DT_MEDNAME. Please confirm.

1. Yes
2. No

Drug Identification Numbers - sub block (DIN) - Question identifier:DIN_Q04N

What is the exact name of the medication that you took?

Perceived Need for Care (PNC)

Perceived Need for Care (PNC) - Question identifier:PNC_R01

The following questions deal with the different kinds of help you received, or thought you needed, for problems with your emotions, mental health or use of alcohol or drugs.

Perceived Need for Care (PNC) - Question identifier:PNC_Q01

(Please refer to page 17 of the booklet.)

During the past 12 months, did you receive the following kinds of help because of problems with your emotions, mental health or use of alcohol
or drugs?

1. Information about these problems, treatments or available services
2. Medication
3. Counselling, therapy, or help for problems with personal
relationships
4. Other - Specify
5. None
8. RF
9. DK

Perceived Need for Care (PNC) - Question identifier:PNC_Q02A

You mentioned that you received:

^DT_HELPX.

Do you think you got as much of ^DT_THISKIND1 of help as you needed (during the past 12 months)?

1. Yes
2. No
8. RF
9. DK

Perceived Need for Care (PNC) - Question identifier:PNC_Q02B

Which kind of help did you need more of (during the past 12 months)?

1. Information about these problems, treatments or available services
2. Medication
3. Counselling, therapy, or help for problems with personal
relationships
4. ^PNC_S01
8. RF
9. DK

Perceived Need for Care (PNC) - Question identifier:PNC_Q04A

You mentioned that you did not receive:

^DT_NOHELPX.

Do you think you needed ^DT_THISKIND2 of help (during the past 12 months)?

1. Yes
2. No
8. RF
9. DK

Perceived Need for Care (PNC) - Question identifier:PNC_Q04B

Which kind of help did you need (during the past 12 months)?

1. Information about these problems, treatments or available services
2. Medication
3. Counselling, therapy, or help for problems with personal
relationships
4. ^PNC_S01
8. RF
9. DK

Help Needed - sub block (PN1)

Help Needed - sub block (PN1) - Question identifier:PN1_Q01

(Please refer to page 18 of the booklet.)

Why didn't you get ^DT_NEEDHELP (during the past 12 months)?

1. You preferred to manage yourself
2. You didn't know how or where to get this kind of help
3. You haven't gotten around to it (e.g., too busy)
4. Your job interfered (e. g., workload, hours of work or no cooperation from supervisor)
5. Help was not readily available
6. You didn't have confidence in health care system or social services
7. You couldn't afford to pay
8. Insurance did not cover
9. You were afraid of what others would think of you
10. Language problems
11. ^PN1_Q01_item_11_E
12. Other - Specify
98. RF
99. DK

Help Needed - sub block (PN1) - Question identifier:PN1_Q02

(Please refer to page 19 of the booklet.)

Which of the following best describes why you preferred to manage yourself rather than seek help (during the past 12 months)?

1. You didn't think they knew how to help
2. You were uncomfortable talking about these problems
3. You relied on faith and spirituality
4. You relied on family and friends
5. You felt you'd be treated differently if people thought you had these problems
6. You didn't feel ready to seek help
7. You couldn't get this kind of help where you live
8. Other - Specify
98. RF
99. DK

Mental Health Experiences (MHE)

Mental Health Experiences (MHE) - Question identifier:MHE_R01

The following questions ask about your personal experiences with people who have had emotional or mental health problems. By this, we mean emotional or mental conditions that may need treatment from a health professional.

Mental Health Experiences (MHE) - Question identifier:MHE_Q01A

Have you ever worked or volunteered in a program that provides treatment services to people with emotional or mental health problems?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q01B

Was this in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q02A

To your knowledge, have you ever worked with someone who has been treated for an emotional or mental health problem?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q02B

Was this in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q03A

Has a close member of your family, such as a spouse, a parent, a child, a brother or a sister, ever received treatment for an emotional or mental health problem?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q03B

Was this in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q04A

Have any of your close friends ever been treated for an emotional or mental health problem?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q04B

Was this in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q05A

Have you ever received treatment for an emotional or mental health problem?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q05B

Was this in the past 12 months?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_Q06

During the past 12 months, did you feel that anyone held negative opinions about you or treated you unfairly because of your past or current emotional or mental health problem?

1. Yes
2. No
8. RF
9. DK

Mental Health Experiences (MHE) - Question identifier:MHE_R06A

Please refer to page 21 of the booklet.

Please tell me how this affected you. For each question, answer with a number between 0 and 10; where 0 means you have not been affected while 10 means you have been severely affected.

Mental Health Experiences (MHE) - Question identifier:MHE_Q06A

During the past 12 months, on a scale of 0 to 10, how much did these negative opinions or unfair treatment affect:

... your family relationships?

Mental Health Experiences (MHE) - Question identifier:MHE_Q06B

(During the past 12 months, on a scale of 0 to 10, how much did these negative opinions or unfair treatment affect:)

... your romantic life?

Mental Health Experiences (MHE) - Question identifier:MHE_Q06C

(During the past 12 months, on a scale of 0 to 10, how much did these negative opinions or unfair treatment affect:)

... your work or school life?

Mental Health Experiences (MHE) - Question identifier:MHE_Q06D

(During the past 12 months, on a scale of 0 to 10, how much did these negative opinions or unfair treatment affect:)

... your financial situation?

Mental Health Experiences (MHE) - Question identifier:MHE_Q06E

(During the past 12 months, on a scale of 0 to 10, how much did these negative opinions or unfair treatment affect:)

... your housing situation?

Mental Health Experiences (MHE) - Question identifier:MHE_Q06F

(During the past 12 months, on a scale of 0 to 10, how much did these negative opinions or unfair treatment affect:)

... your health care for physical health problems?

Family Mental Health Impact (FMI)

Family Mental Health Impact (FMI) - Question identifier:FMI_R01

The next few questions are about the problems of your family members. These include your spouse or partner, children, parents, parents-in-law, grandparents, brothers and sisters, cousins, aunts, uncles, nieces, or nephews.

Family Mental Health Impact (FMI) - Question identifier:FMI_Q01A

Do any of your family members have problems with their emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
3. Not applicable / No family members
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_Q01B

How many of your family members have problems with their emotions, mental health or use of alcohol or drugs?

1. One
2. Two
3. Three or more
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_Q02

The next questions are about how your life is affected by these problems of your family ^DT_MEMBER. Taking into consideration your time, energy, emotions, finances, and daily activities, would you say that ^DT_THEIR problems affect your life... ?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_R03

Please tell me if you do any of the following things for ^DT_PERSON because of these problems, over and above what you normally would do.

Family Mental Health Impact (FMI) - Question identifier:FMI_Q03A

Do you help ^DT_PERSON with practical things, like paperwork, getting around, housework, or taking medication?

1. Yes
2. No
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_Q03B

Do you spend more time keeping ^DT_PERSON company or giving emotional support, than you would if the problems didn't exist?

1. Yes
2. No
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_Q04

Do you spend any time doing other things related to ^DT_THEIR problems?

1. Yes
2. No
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_Q05

About how much time in an average week do you spend doing things related to ^DT_THEIR problems?

Family Mental Health Impact (FMI) - Question identifier:FMI_N05

Was that in minutes or hours?

1. Minutes
2. Hours

Family Mental Health Impact (FMI) - Question identifier:FMI_Q06

How much do ^DT_THEIR problems cause you embarrassment?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Family Mental Health Impact (FMI) - Question identifier:FMI_Q07

How much do ^DT_THEIR problems cause you to be worried, anxious, or depressed?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Social Provisions Scale 10 Items (SPS)

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_R01

(Please refer to page 22 of the booklet.)

The next questions are about your current relationships with friends, family members, co-workers, community members, and so on. Please indicate to what extent each statement describes your current relationships with other people.

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q01

There are people I can depend on to help me if I really need it.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q02

There are people who enjoy the same social activities I do.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q03

I have close relationships that provide me with a sense of emotional security and well-being.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q04

There is someone I could talk to about important decisions in my life.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q05

I have relationships where my competence and skill are recognized.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q06

There is a trustworthy person I could turn to for advice if I were having problems.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q07

I feel part of a group of people who share my attitudes and beliefs.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q08

I feel a strong emotional bond with at least one other person.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q09

There are people who admire my talents and abilities.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Social Provisions Scale 10 Items (SPS) - Question identifier:SPS_Q10

There are people I can count on in an emergency.

1. Strongly agree
2. Agree
3. Disagree
4. Strongly disagree
8. RF
9. DK

Negative Social Interactions (NSI)

Negative Social Interactions (NSI) - Question identifier:NSI_R01

The contact we have with others is not always pleasant. The next questions are about negative interaction with others.

Negative Social Interactions (NSI) - Question identifier:NSI_Q01

Are there persons with whom you are in regular contact that are detrimental to your well-being because they are a source of discomfort and stress?

1. Yes
2. No
8. RF
9. DK

Negative Social Interactions (NSI) - Question identifier:NSI_Q02

(Please refer to page 23 of the booklet.)

During the past month, how often have you felt that others made too many demands on you?

1. Never
2. Once in a while
3. Fairly often
4. Very often
8. RF
9. DK

Negative Social Interactions (NSI) - Question identifier:NSI_Q03

During the past month, how often have you felt that others were critical of you and things you did?

1. Never
2. Once in a while
3. Fairly often
4. Very often
8. RF
9. DK

Negative Social Interactions (NSI) - Question identifier:NSI_Q04

During the past month, how often have you felt that others did things that
were thoughtless or inconsiderate?

1. Never
2. Once in a while
3. Fairly often
4. Very often
8. RF
9. DK

Negative Social Interactions (NSI) - Question identifier:NSI_Q05

During the past month, how often have you felt that others acted angry or upset with you?

1. Never
2. Once in a while
3. Fairly often
4. Very often
8. RF
9. DK

Contact with Police (CWP)

Contact with Police (CWP) - Question identifier:CWP_R01

The following questions are about your contact with police.

Contact with Police (CWP) - Question identifier:CWP_Q01

During the past 12 months, did you come into contact with the police:

... for a public information session?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q02

(During the past 12 months, did you come into contact with the police:)

... for a traffic violation?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q03

(During the past 12 months, did you come into contact with the police:)

... as a victim of a crime?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q04

(During the past 12 months, did you come into contact with the police:)

... as a witness to a crime?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q05

During the past 12 months, did you come into contact with the police:

... by being arrested?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q06

(During the past 12 months, did you come into contact with the police:)

... for reasons related to problems with your emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q07

(During the past 12 months, did you come into contact with the police:)

... for reasons related to a family member's problems with their emotions, mental health or use of alcohol or drugs?

1. Yes
2. No
8. RF
9. DK

Contact with Police (CWP) - Question identifier:CWP_Q08

(During the past 12 months, did you come into contact with the police:)

... for any other reason?

1. Yes - Specify
2. No
8. RF
9. DK

Childhood Experiences (CEX)

Childhood Experiences (CEX) - Question identifier:CEX_R01

The next few questions are about things that may have happened to you before you were 16 in your school, in your neighbourhood, or in your family. Your responses are important whether or not you have had any of these experiences. Remember that all information provided is strictly confidential.

Childhood Experiences (CEX) - Question identifier:CEX_Q01

(Please refer to page 24 of the booklet.)

Before age 16, how many times did EXPERIENCE 1 happen to you?

INTERVIEWER: Experience 1 is "How many times did you see or hear any one of your parents, step-parents or guardians hit each other or another adult in your home? By adult, I mean anyone 18 years and over."

1. A (Never)
2. B (1 or 2 times)
3. C (3 to 5 times)
4. D (6 to 10 times)
5. E (More than 10 times)
8. RF
9. DK

Childhood Experiences (CEX) - Question identifier:CEX_Q02

(Please refer to page 25 of the booklet.)

Before age 16, how many times did EXPERIENCE 2 happen to you?

INTERVIEWER: Experience 2 is "How many times did an adult slap you on the face, head or ears or hit or spank you with something hard to hurt you?"

1. A (Never)
2. B (1 or 2 times)
3. C (3 to 5 times)
4. D (6 to 10 times)
5. E (More than 10 times)
8. RF
9. DK

Childhood Experiences (CEX) - Question identifier:CEX_Q03

(Please refer to page 26 of the booklet.)

Before age 16, how many times did EXPERIENCE 3 happen to you?

INTERVIEWER: Experience 3 is "How many times did an adult push, grab, shove or throw something at you to hurt you?"

1. A (Never)
2. B (1 or 2 times)
3. C (3 to 5 times)
4. D (6 to 10 times)
5. E (More than 10 times)
8. RF
9. DK

Childhood Experiences (CEX) - Question identifier:CEX_Q04

(Please refer to page 27 of the booklet.)

Before age 16, how many times did EXPERIENCE 4 happen to you?

INTERVIEWER: Experience 4 is "How many times did an adult kick, bite, punch, choke, burn you, or physically attack you in some way?"

1. A (Never)
2. B (1 or 2 times)
3. C (3 to 5 times)
4. D (6 to 10 times)
5. E (More than 10 times)
8. RF
9. DK

Childhood Experiences (CEX) - Question identifier:CEX_Q05

(Please refer to page 28 of the booklet.)

Before age 16, how many times did EXPERIENCE 5 happen to you?

INTERVIEWER: Experience 5 is "How many times did an adult force you or attempt to force you into any unwanted sexual activity, by threatening you, holding you down or hurting you in some way?"

1. A (Never)
2. B (1 or 2 times)
3. C (3 to 5 times)
4. D (6 to 10 times)
5. E (More than 10 times)
8. RF
9. DK

Childhood Experiences (CEX) - Question identifier:CEX_Q06

(Please refer to page 29 of the booklet.)

Before age 16, how many times did EXPERIENCE 6 happen to you?

INTERVIEWER: Experience 6 is "How many times did an adult touch you against your will in any sexual way? By this, I mean anything from unwanted touching or grabbing, to kissing or fondling."

1. A (Never)
2. B (1 or 2 times)
3. C (3 to 5 times)
4. D (6 to 10 times)
5. E (More than 10 times)
8. RF
9. DK

Childhood Experiences (CEX) - Question identifier:CEX_Q07

Before age 16, did you ever see or talk to anyone from a child protection organization about difficulties at home?

1. Yes
2. No
8. RF
9. DK

Spirituality (SPI)

Spirituality (SPI) - Question identifier:SPI_R01

The following questions are about your religious or spiritual beliefs.

Spirituality (SPI) - Question identifier:SPI_Q01

In general, how important are religious or spiritual beliefs in your daily life?

1. Very important
2. Somewhat important
3. Not very important
4. Not at all important
8. RF
9. DK

Spirituality (SPI) - Question identifier:SPI_Q02

To what extent do your religious or spiritual beliefs give you the strength to face everyday difficulties?

1. A lot
2. Some
3. A little
4. Not at all
8. RF
9. DK

Labour force (LF2)

Labour force (LF2) - Question identifier:LF2_R1

The next questions concern your activities in the last 7 days. By the last 7 days, I mean beginning [DV_DATE1WKE], and ending [DV_YSTEDAYE].

Labour force (LF2) - Question identifier:LF2_Q1

Last week, did you work at a job or a business? Please include part-time jobs, seasonal work, contract work, self-employment, baby-sitting and any other paid work, regardless of the number of hours worked.

1. Yes
2. No
3. Permanently unable to work
8. RF
9. DK

Labour force (LF2) - Question identifier:LF2_Q2

Last week, did you have a job or business from which you were absent?

1. Yes
2. No
8. RF
9. DK

Labour force (LF2) - Question identifier:LF2_Q3

Did you have more than one job or business last week?

1. Yes
2. No
8. RF
9. DK

Labour force (LF2) - Question identifier:LF2_Q4

In the past 4 weeks, did you do anything to find work?

1. Yes
2. No
8. RF
9. DK

Labour force (LF2) - Question identifier:LF2_R5

The next questions are about your current job or business.

Labour force (LF2) - Question identifier:LF2_Q31

Are you an employee or self-employed?

1. Employee
2. Self-employed
3. Working in a family business without pay
8. RF
9. DK

Labour force (LF2) - Question identifier:LF2_Q32

What is the name of your business?

Labour force (LF2) - Question identifier:LF2_Q33

For whom do you work?

Labour force (LF2) - Question identifier:LF2_Q34

What kind of business, industry or service is this?

Labour force (LF2) - Question identifier:LF2_Q35

What is your work or occupation?

Labour force (LF2) - Question identifier:LF2_Q36

In this work, what are your main activities?

Labour force (LF2) - Question identifier:LF2_Q37

About how many hours a week do you usually work at your job or business? If you usually work extra hours, paid or unpaid, please include these hours.

Labour force (LF2) - Question identifier:LF2_Q38

You indicated that you have more than one job.

About how many hours a week do you usually work at your other job(s)? If you usually work extra hours, paid or unpaid, please include these hours.

Work Stress (WST)

Work Stress (WST) - Question identifier:WST_R400

(Please refer to page 20 of the booklet.)

The next few questions are about your main job or business in the past 12 months. I'm going to read you a series of statements that might describe your job situation. Please tell me if you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree.

Work Stress (WST) - Question identifier:WST_Q401

Your job required that you learn new things.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q402

Your job required a high level of skill.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q403

Your job allowed you freedom to decide how you did your job.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q404

Your job required that you do things over and over.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q405

Your job was very hectic.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q406

You were free from conflicting demands that others made.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q407

Your job security was good.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q408

Your job required a lot of physical effort.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q409

You had a lot to say about what happened in your job.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q410

You were exposed to hostility or conflict from the people you worked with.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
6. Not applicable
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q411

Your supervisor was helpful in getting the job done.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
6. Not applicable
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q412

The people you worked with were helpful in getting the job done.

1. Strongly agree
2. Agree
3. Neither agree nor disagree
4. Disagree
5. Strongly disagree
6. Not applicable
8. RF
9. DK

Work Stress (WST) - Question identifier:WST_Q413

How satisfied were you with your job?

1. Very satisfied
2. Somewhat satisfied
3. Not too satisfied
4. Not at all satisfied
8. RF
9. DK

Income (INC)

Income (INC) - Question identifier:INC_R01

Although many health expenses are covered by health insurance, there is still a relationship between health and income. Please be assured that, like all other information you have provided, these answers will be kept strictly confidential.

Income (INC) - Question identifier:INC_Q01

(Please turn to page 30 of the booklet.)

Thinking about the total income for all household members, from which of the following sources did your household receive any income in the past 12 months?

1. Wages and salaries
2. Income from self-employment
3. Dividends and interest (e.g., on bonds, savings)
4. Employment insurance
5. Worker's compensation
6. Benefits from Canada or Quebec Pension Plan
7. Job related retirement pensions, superannuation and annuities
8. RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
9. Old Age Security and Guaranteed Income Supplement
10. Provincial or municipal social assistance or welfare
11. Child Tax Benefit
12. Child support
13. Alimony
14. Other (e.g., rental income, scholarships)
15. None
98. RF
99. DK

Income (INC) - Question identifier:INC_Q02

What was the main source of income?

1. Wages and salaries
2. Income from self-employment
3. Dividends and interest (e.g., on bonds, savings)
4. Employment insurance
5. Worker's compensation
6. Benefits from Canada or Quebec Pension Plan
7. Job related retirement pensions, superannuation and annuities
8. RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
9. Old Age Security and Guaranteed Income Supplement
10. Provincial or municipal social assistance or welfare
11. Child Tax Benefit
12. Child support
13. Alimony
14. Other (e.g., rental income, scholarships)
15. None
98. RF
99. DK

Income (INC) - Question identifier:INC_Q03

What is your best estimate of the total household income received by all household members, from all sources, before taxes and deductions, in the past 12 months?

Income (INC) - Question identifier:INC_Q05A

Can you estimate in which of the following groups your household income falls? Was the total household income in the past 12 months...?

1. Less than $50,000, including income loss
2. $50,000 and more
8. RF
9. DK

Income (INC) - Question identifier:INC_Q05B

Please stop me when I have read the category which applies to your household. Was it...?

1. Less than $5,000
2. $5,000 to less than $10,000
3. $10,000 to less than $15,000
4. $15,000 to less than $20,000
5. $20,000 to less than $30,000
6. $30,000 to less than $40,000
7. $40,000 to less than $50,000
8. RF
9. DK

Income (INC) - Question identifier:INC_Q05C

Please stop me when I have read the category which applies to your household. Was it...?

1. $50,000 to less than $60,000
2. $60,000 to less than $70,000
3. $70,000 to less than $80,000
4. $80,000 to less than $90,000
5. $90,000 to less than $100,000
6. $100,000 to less than $150,000
7. $150,000 and over
8. RF
9. DK

Income (INC) - Question identifier:INC_Q06

Thinking about your total personal income, from which of the following sources did you receive any income in the past 12 months?

1. Wages and salaries
2. Income from self-employment
3. Dividends and interest (e.g., on bonds, savings)
4. Employment insurance
5. Worker's compensation
6. Benefits from Canada or Quebec Pension Plan
7. Job related retirement pensions, superannuation and annuities
8. RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
9. Old Age Security and Guaranteed Income Supplement
10. Provincial or municipal social assistance or welfare
11. Child Tax Benefit
12. Child support
13. Alimony
14. Other (e.g., rental income, scholarships)
15. None
98. RF
99. DK

Income (INC) - Question identifier:INC_Q07

What was the main source of your personal income?

1. Wages and salaries
2. Income from self-employment
3. Dividends and interest (e.g., on bonds, savings)
4. Employment insurance
5. Worker's compensation
6. Benefits from Canada or Quebec Pension Plan
7. Job related retirement pensions, superannuation and annuities
8. RRSP/RRIF (Registered Retirement Savings Plan/Registered Retirement Income Fund)
9. Old Age Security and Guaranteed Income Supplement
10. Provincial or municipal social assistance or welfare
11. Child Tax Benefit
12. Child support
13. Alimony
14. Other (e.g., rental income, scholarships)
15. None
98. RF
99. DK

Income (INC) - Question identifier:INC_Q08A

What is your best estimate of your total personal income, before taxes and deductions, from all sources in the past 12 months?

Income (INC) - Question identifier:INC_Q08B

Can you estimate in which of the following groups your personal income falls? Was your total personal income in the past 12 months...?

1. Less than $30,000, including income loss
2. $30,000 and more
8. RF
9. DK

Income (INC) - Question identifier:INC_Q08C

Please stop me when I have read the category which applies to you. Was it...?

1. Less than $5,000
2. $5,000 to less than $10,000
3. $10,000 to less than $15,000
4. $15,000 to less than $20,000
5. $20,000 to less than $25,000
6. $25,000 to less than $30,000
8. RF
9. DK

Income (INC) - Question identifier:INC_Q08D

Please stop me when I have read the category which applies to you. Was it...?

1. $30,000 to less than $40,000
2. $40,000 to less than $50,000
3. $50,000 to less than $60,000
4. $60,000 to less than $70,000
5. $70,000 to less than $80,000
6. $80,000 to less than $90,000
7. $90,000 or more but less than $100,000
8. $100,000 and over
98. RF
99. DK

Income (INC) - Question identifier:INC_Q12

With your current household income, do you have any difficulty meeting basic expenses such as food, shelter and clothing?

1. Yes
2. No
8. RF
9. DK

Socio-demographic characteristics (SDC)

Socio-demographic characteristics (SDC) - Question identifier:SDC_R01

Now some general background questions which will help us compare the health of people in Canada.

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q01

In what country were you born?

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q02

Were you born a Canadian citizen?

1. Yes
2. No
8. RF
9. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q03

In what year did you first come to Canada to live?

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q04

To which ethnic or cultural groups did your ancestors belong? (For example: French, Scottish, Chinese, East Indian)

1. Canadian
2. French
3. English
4. German
5. Scottish
6. Irish
7. Italian
8. Ukrainian
9. Dutch (Netherlands)
10. Chinese
11. Jewish
12. Polish
13. Portuguese
14. South Asian (e.g. East Indian, Pakistani, Sri Lankan)
15. Norwegian
16. Welsh
17. Swedish
18. First Nations (North American Indian)
19. Métis
20. Inuit
21. Other - Specify
98. RF
99. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q05

Are you an Aboriginal person that is, First Nations, Métis or Inuit?
First Nations includes Status and Non-Status Indians.

1. Yes
2. No
8. RF
9. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q06

Are you First Nations, Métis or Inuit?

1. First Nations (North American Indian)
2. Métis
3. Inuit
8. RF
9. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q07

You may belong to one or more racial or cultural groups on the following list.

Are you...?

1. White
2. South Asian (e.g., East Indian, Pakistani, Sri Lankan)
3. Chinese
4. Black
5. Filipino
6. Latin American
7. Arab
8. Southeast Asian (e.g., Vietnamese, Cambodian, Malaysian, Laotian)
9. West Asian (e.g., Iranian, Afghan)
10. Korean
11. Japanese
12. Other - Specify
98. RF
99. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q08

Of English or French, which language(s) do you speak well enough to conduct a conversation? Is it...?

1. English only
2. French only
3. Both English and French
4. Neither English nor French
8. RF
9. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_R13

Now a question about the dwelling in which you live.

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q13

Is this dwelling...?

1. Owned by you or a member of this household, even if it is still being paid for
2. Rented, even if no cash rent is paid
8. RF
9. DK

Socio-demographic characteristics (SDC) - Question identifier:SDC_R14

Now one additional background question which will help us compare the health of people in Canada.

Socio-demographic characteristics (SDC) - Question identifier:SDC_Q14

Do you consider yourself to be...?

1. Heterosexual? (sexual relations with people of the opposite sex)
2. Homosexual, that is lesbian or gay? (sexual relations with people of your own sex)
3. Bisexual? (sexual relations with people of both sexes)
8. RF
9. DK

Education (EDU)

Education (EDU) - Question identifier:EDU_R01

The following questions are about education.

Education (EDU) - Question identifier:EDU_R07

Now I would like you to think about the rest of your household.

Education of the respondent (EDU1)

Education of the respondent (EDU1) - Question identifier:EDU1_Q01

What is the highest grade of elementary or high school you have ever completed?

1. Grade 8 or lower (Québec: Secondary II or lower)
2. Grade 9 - 10 (Québec: Secondary III or IV, Newfoundland and Labrador: 1st year secondary)
3. Grade 11 - 13 (Québec: Secondary V, Newfoundland and Labrador: 2nd to 3rd year of secondary)
8. RF
9. DK

Education of the respondent (EDU1) - Question identifier:EDU1_Q02

Did you complete a high school diploma or its equivalent?

1. Yes
2. No
8. RF
9. DK

Education of the respondent (EDU1) - Question identifier:EDU1_Q03

Have you received any other education that could be counted towards a certificate, diploma or degree from an educational institution?

1. Yes
2. No
8. RF
9. DK

Education of the respondent (EDU1) - Question identifier:EDU1_Q04

What is the highest certificate, diploma or degree that you have completed?

1. Less than high school diploma or its equivalent
2. High school diploma or a high school equivalency certificate
3. Trade Certificate or Diploma
4. College, cegep or other non-university certificate or diploma (other than trades certificates or diplomas)
5. University certificate or diploma below the bachelor's level
6. Bachelor's degree (e.g. B.A., B.Sc., LL.B.)
7. University certificate, diploma or degree above the bachelor's level
8. RF
9. DK

Education of the respondent (EDU1) - Question identifier:EDU1_Q05

Are you currently attending a school, college, cegep or university?

1. Yes
2. No
8. RF
9. DK

Education of the respondent (EDU1) - Question identifier:EDU1_Q06

Are you enrolled as...?

1. A full-time student
2. A part-time student
3. Both full-time and part-time student
8. RF
9. DK

Education of other household members (EDU2)

Education of other household members (EDU2) - Question identifier:EDU2_Q07

What is the highest grade of elementary or high school ^DT_NAME ever completed?

1. Grade 8 or lower (Québec: Secondary II or lower)
2. Grade 9 - 10 (Québec: Secondary III or IV, Newfoundland and Labrador: 1st year secondary)
3. Grade 11 - 13 (Québec: Secondary V, Newfoundland and Labrador: 2nd to 3rd year of secondary)
8. RF
9. DK

Education of other household members (EDU2) - Question identifier:EDU2_Q08

Did ^DT_SEX1 complete high school or its equivalent?

1. Yes
2. No
8. RF
9. DK

Education of other household members (EDU2) - Question identifier:EDU2_Q09

Has ^DT_SEX1 received any other education that could be counted towards a certificate, diploma or degree from an educational institution?

1. Yes
2. No
8. RF
9. DK

Education of other household members (EDU2) - Question identifier:EDU2_Q10

What is the highest certificate, diploma or degree ^DT_SEX1 has completed?

1. Less than high school diploma or its equivalent
2. High school diploma or a high school equivalency certificate
3. Trade Certificate or Diploma
4. College, cegep or other non-university certificate or diploma (other than trades certificates or diplomas)
5. University certificate or diploma below the bachelor's level
6. Bachelor's degree (e.g. B.A., B.Sc., LL.B.)
7. University certificate, diploma or degree above the bachelor's level
8. RF
9. DK

Administration information (ADM)

Administration information (ADM) - Question identifier:ADM_R01

^DT_STAT would like your permission to link information collected during this interview. This includes linking your survey information to your past and continuing use of health services such as visits to hospitals, clinics and doctor's offices.

Administration information (ADM) - Question identifier:ADM_Q01B

This linked information will be kept confidential and used only for statistical purposes. Do we have your permission?

1. Yes
2. No
8. RF
9. DK

Administration information (ADM) - Question identifier:ADM_Q03A

Having a provincial (or territorial) health number will assist us in linking to this other information.

Do you have ^DT_AN ^DT_PROVINCEE health number?

1. Yes
2. No
8. RF
9. DK

Administration information (ADM) - Question identifier:ADM_Q03B

For which province (or territory) is your health number?

10. Newfoundland and Labrador
11. Prince Edward Island
12. Nova Scotia
13. New Brunswick
24. Quebec
35. Ontario
46. Manitoba
47. Saskatchewan
48. Alberta
59. British Columbia
60. Yukon
61. Northwest Territories
62. Nunavut
88. Does not have a Canadian health number
98. RF
99. DK

Administration information (ADM) - Question identifier:ADM_R04AA

To avoid duplication of surveys, Statistics Canada has signed agreements with provincial ministries of health, Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.

Provincial ministries of health may make this information available to local health authorities, but names, addresses, telephone numbers and health numbers will not be provided.

Administration information (ADM) - Question identifier:ADM_R04AC

To avoid duplication of surveys, Statistics Canada has signed agreements with provincial ministries of health, the "Institut de la Statistique du Québec", Health Canada and the Public Health Agency of Canada to share the information that you provided on this survey.

The "Institut de la Statistique du Québec" and provincial ministries of health may make this information available to local health authorities, but names, addresses, telephone numbers and health numbers will not be provided.

Administration information (ADM) - Question identifier:ADM_Q04B

These organizations have agreed to keep your information confidential and use it only for statistical purposes.

Do you agree to share the information provided?

1. Yes
2. No
8. RF
9. DK

Administration information (ADM) - Question identifier:ADM_N09

Was this interview conducted on the telephone or in person?

1. On telephone
2. In person
3. Both

Administration information (ADM) - Question identifier:ADM_N10

Was the respondent alone when you asked this health questionnaire?

1. Yes
2. No
8. RF
9. DK

Administration information (ADM) - Question identifier:ADM_N11

Do you think that the answers of the respondent were affected by someone else being there?

1. Yes
2. No
8. RF
9. DK

Administration information (ADM) - Question identifier:ADM_N12

Record language of interview.

1. English
2. French
3. Chinese
4. Italian
5. Punjabi
6. Spanish
7. Portuguese
8. Polish
9. German
10. Vietnamese
11. Arabic
12. Tagalog (Filipino)
13. Greek
14. Tamil
15. Cree
16. Afghan
17. Cantonese
18. Hindi
19. Mandarin
20. Persian
21. Russian
22. Ukrainian
23. Urdu
24. Inuktitut
90. Other - Specify

Health Number Sub Block (HN)

Health Number Sub Block (HN) - Question identifier:HN_Q01

What is your health number?

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