Neurotic Symptom Score (NSS) – A New Scoring System For Death Related Mental Health Research

Extent of the presence of symptoms related to the phenomenon of death is required to measure when someone wishes to evaluate this phenomenon’s impact. For that purpose, the research conducted in Bangladesh in the year 2003 on the impact and the variation of impact of the conception of death needed such measurement to evaluate the impact on the Muslims of Bangladesh. Thus symptoms described in the DSM-IV of the APA were taken in a checklist mainly from the sections that are related to adjustment problems, stress, and death. Number of symptoms present in a subject was assessed by the number of checkmarks given by the subject himself/herself on the checklist form containing the list of symptoms. This number was named as the Neurotic Symptom Score (NSS) for that subject. So simply, the self-declared number of the neurotic symptoms in a specific situation (stress of death) is the NSS for a specific subject.

The score can be ranging from zero to thirty-eight depending on the extent of presence of the following symptoms (for the last two weeks at least) –

1. Depressed mood

2. Diminished interest in all

3. Change of appetite with the change in body weight without any physical illness

4. Insomnia or hypersomnia

5. Fatigue or loss of energy

6. Feeling of worthlessness

7. Excessive or inappropriate guilt

8. Diminished ability to think

9. Diminished ability to concentrate

10. Indecisiveness

11. Recurrent thoughts of death

12. Suicidal ideation, plans, or attempts

13. Low self-esteem

14. Feeling of hopelessness

15. Palpitation

16. Sweating

17. Trembling

18. Shortness of breath or smothering sensation

19. Trouble swallowing

20. Chest pain or discomfort

21. Nausea or abdominal distress

22. Dizziness

23. Unsteady feeling or faintness

24. Depersonalization or derealization

25. Fear of going crazy

26. Fear of dying

27. Numbness or tingling sensation

28. Flashes or chills

29. Agoraphobia

30. Specific phobia

31. Avoidant behavior significantly interfering with social life

32. Obsessive thoughts

33. Compulsive activity

34. Excessive anxiety or worry, sometimes out of control

35. Restlessness

36. Irritability

37. Muscle tension or ache

38. Trouble falling or staying asleep

The checklist mentioning the above symptoms were provided to 150 Muslims of Bangladesh. After they check-marked and returned the form, the scores (number of check-marked symptoms) were tabulated and used for the research. Finally it yielded a good result that was also statistically significant. When the research was submitted to the supervising University’s academic board in Spain it was graded as an “excellent” research.