Male Questionnaire
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OUR SYSTEM DOES NOT RECOGNIZE YOU

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This section covers various unusual mental conditions and symptoms.

Q360

Is your short-term memory failing? Examples include forgetting what you were talking about or why you entered a room, or not being able to remember phone numbers before writing them down.
  • Don't know
  • No / average / a few times per year
  • Occasionally / moderately
  • Severely - I forget things often and quickly

Q361

Is your long-term memory failing? Do you find it hard to remember things that happened days, months or years ago?
  • No / don't know
  • Somewhat - it is hard to recall events accurately
  • Severely - it is hard to recall past events at all

Q362

Is Alzheimer's Disease affecting you?
  • No / don't know
  • There is good reason to believe I have it
  • Doctors think I might have it
  • I have been diagnosed with it

Q363

Is Senile Dementia (non-Alzheimer's type) affecting you?
  • No / don't know
  • There is good reason to believe I have it
  • Doctors think I might have it
  • I have been diagnosed with it

Q364

Do you suffer from seizures or convulsions?
  • No / don't know
  • Minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem

Q365

Do you suffer from mood swings, alternating from feeling overly happy/excited/irritable to sad/hopeless/depressed, then back again for no reason? There may be periods of 'normal' mood in between; moods can last minutes, hours, days, weeks or even months.
  • Don't know
  • No, my mood only changes if there is a good reason
  • Yes, occasional mood swings, barely noticeable
  • Yes, there is a definite pattern of mood swings
  • Yes, I have regular extreme mood swings

Q366

Do you suffer from episodes of confusion or disorientation?
  • Don't know
  • No
  • Occasionally
  • Often

Q367

Do you suffer from any form of learning disorder?
  • Don't know
  • No
  • Yes, minor
  • Yes, major

Q368

Do you have 'spacey' or unreal feelings?
  • No / don't know
  • Occasionally
  • Often

Q369

Do you suffer from hallucinations?
  • Don't know
  • No
  • Occasional minor hallucinations
  • Frequent minor hallucinations / occasional severe
  • Frequent severe hallucinations

Q370

Have you been diagnosed with or suspected of having Schizophrenia or schizophrenic tendencies?
  • No / never
  • It has been hinted at only
  • Yes, a significant problem, but in the past only
  • Yes, it is a chronic but minor problem
  • Yes, it is a chronic and serious problem

Q371

Have you had Obsessive-Compulsive Disorder / behavior (OCD)?
  • Never had it / don't know
  • Probably had it/minor episode(s) now resolved
  • Major episode(s) now resolved
  • Current minor problem
  • Current major problem