DePaul Symptom Questionnaire (DSQ-2)
Last reviewed
All 79 symptom questions, scored against four ME/CFS case definitions
The DSQ-2 is a self-report questionnaire developed by Leonard Jason and colleagues at DePaul University to assess the symptoms of myalgic encephalomyelitis / chronic fatigue syndrome (ME/CFS). It is the revised version of the original DePaul Symptom Questionnaire, with extra symptoms covering the newer case definitions. It is one of the standard research instruments in ME/CFS, and it is free to use.
This version asks all 79 DSQ-2 symptom questions in DePaul's wording. Each symptom is rated for how often you have had it and how severe it has been over the past six months. It then asks the questions about your illness that the case-definition rules need, and ten short questions from the RAND 36-Item Health Survey that measure how much your health limits you.
When you finish, your answers are checked against the four major ME/CFS case definitions using DePaul's published scoring rules: the IOM/NAM criteria (2015), the Canadian Consensus Criteria (2003), the ME International Consensus Criteria (2011), and Fukuda (1994). You also get a summary of eight symptom groups from the DSQ-2 validation study. It is designed for anyone with suspected ME/CFS, long COVID, post-viral fatigue, or overlapping conditions who wants a thorough, structured symptom record to take to an appointment.
It is long: about 100 answers in 12 short sections. Your answers are saved in your browser as you go, so you can pause and pick up where you left off. Nothing you enter leaves your device, and no sign-up or email is required. If you would like a quick screen first, the 4-question DSQ-Brief takes under two minutes, and the DSQ-PEM focuses on the post-exertional malaise pattern specifically.
Your DSQ-2 results
Case-definition screening
Whether your reported symptoms meet each of the four major ME/CFS case definitions, using DePaul's published scoring rules. This is a screen of self-reported symptoms, not a diagnosis.
Symptom profile
Average symptom score in each of the eight groups from the DSQ-2 validation study (0–100). This is this site's summary, not an official DSQ-2 score. The longer the bar, the more that system is affected.
Domain breakdown
Your results over time
Complete this again in a few weeks and the change will show here.
Symptom scores change slowly. A monthly retake is enough to see a trend.
Your results are stored only in this browser, on this device. Nothing is sent to us or to anyone else. They will be lost if you clear this site's data, use a private window, or switch browser or device. You can delete them at any time.
Understanding your DSQ-2 results
What the score measures
The DSQ-2 is a symptom questionnaire for ME/CFS developed at DePaul University by Leonard Jason and colleagues. It asks how often and how severely you have had each of 79 symptoms over the past six months, plus questions about how your illness began and how much it limits you. Its main use is checking reported symptoms against published ME/CFS case definitions. It is free to use.
This version asks all 79 symptom questions in DePaul's wording, the illness questions the scoring rules use, and ten questions from the RAND 36-Item Health Survey that give the three SF-36 scores the rules need. It leaves out the DSQ-2's other background questions, such as work and medical history.
DSQ-2 result interpretation
A symptom counts when it happens at least half the time and is at least moderate, a frequency and severity of 2 or more out of 4; for Fukuda, minor symptoms count at 1 or more. Each definition then needs its own combination of symptoms, illness length and loss of function, following DePaul's published scoring rules.
| Definition | Main requirements |
|---|---|
| IOM / NAM (2015) | Reduced functioning, fatigue for 6 months or more, post-exertional malaise, unrefreshing sleep, and cognitive problems or orthostatic intolerance |
| Canadian Consensus (2003) | As IOM, plus frequent fatigue, sleep problems, pain, two neurological or cognitive symptoms, and symptoms in two of the autonomic, neuroendocrine and immune areas |
| ME International Consensus (2011) | A 50% drop in activity, post-exertional exhaustion, and symptoms across neurological, immune or gut, and energy groups |
| Fukuda (1994) | Reduced functioning, fatigue for 6 months or more, and at least 4 of 8 symptoms, counted at a lower threshold |
The domain scores are this site's summary of the eight symptom groups found in the DSQ-2 validation study (Bedree et al. 2019): the average of each symptom's frequency and severity, scaled to 0 to 100. They are not official DSQ-2 scores, and no cut-offs exist for them.
What a change in score means
No minimal important change or cut-offs have been published for DSQ-2 scores. The questions cover the past six months, so results a month apart overlap heavily; look at the trend over several months. A change in which definitions you meet says more than small shifts in domain scores.
What it does not measure
No. Meeting a case definition on a self-report questionnaire is not a clinical diagnosis, which needs a clinician, an examination and tests to rule out other conditions with similar symptoms. Not meeting a definition here does not rule ME/CFS out either.
The DSQ-PEM looks at post-exertional malaise in more depth, and the FUNCAP records what everyday activities cost you. The post-exertional malaise explainer covers the symptom every definition here except Fukuda requires.
Taking this to your GP or consultant
Bring the date, which definitions you met and which criteria you missed, and the symptoms that met the threshold; copying your results as text captures these. In the UK, the NICE guideline (NICE NG206) uses its own criteria: fatigue worsened by activity, post-exertional malaise, unrefreshing or disturbed sleep and cognitive difficulties, suspected after 6 weeks and diagnosed after 3 months of assessment. The DSQ-2 does not score the NICE criteria, but your answers cover the same symptoms. See also preparing for a GP appointment.
Sources and licence
Based on: Jason LA, Sunnquist M. The development of the DePaul Symptom Questionnaire. Front Pediatr. 2018;6:330; and Bedree H, Sunnquist M, Jason LA. The DePaul Symptom Questionnaire-2: A Validation Study. Fatigue. 2019;7(3):166–179.
- Jason LA, Sunnquist M. The development of the DePaul Symptom Questionnaire: original, expanded, brief, and pediatric versions. Front Pediatr 2018;6:330, including Supplementary Data Sheet 2 (case-definition scoring rules). Article
- Bedree H, Sunnquist M, Jason LA. The DePaul Symptom Questionnaire-2: a validation study. Fatigue 2019;7(3):166–79. Full text
- RAND Corporation. 36-Item Short Form Survey: scoring instructions. RAND 36-Item Health Survey scoring
- National Institute for Health and Care Excellence. Myalgic encephalomyelitis (or encephalopathy)/chronic fatigue syndrome: diagnosis and management (NG206). 2021. Guideline