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Sheehan Disability Scale
Instructions: Circle a number on the line that best describes your situation.
WORK
Because of my problems, my work is impaired:
0 1 2 3 4 5 6 7 8 9 10
Not at all mildly moderately markedly very
SOCIAL LIFE/LEISURE ACTIVITIES
(e.g. with other people at parties, socializing, visiting, dating, outings, clubs & entertaining)
Because of my problems, my social/leisure is impaired:
0 1 2 3 4 5 6 7 8 9 10
Not at all mildly moderately markedly very
FAMILY LIFE/HOME RESPONSIBILITIES
(e.g. relating to family members, paying bills, managing home, shopping & cleaning)
Because of my problems, my family/home responsibilities are impaired:
0 1 2 3 4 5 6 7 8 9 10
Not at all mildly moderately markedly very
Below:
Circle the number to the left that corresponds to the statement
that best describes your disability
5 - Symptoms radically change or prevent normal work or social activities
4 - Symptoms interfere with normal work/social activities
but they are not prevented/radically changed
3 - Symptoms interfere with normal work/social activities in a minor way
2 - Symptoms are mild, but do not interfere with normal work/social activities
1 - No complaints, normal activity
Leon AC, et al, “Assessing Psychiatric Impairment in Primary Care with the Sheehan Disability Scale”. Int J Psychiatr Med, 1997; 27 (2): 93-105