Have you ever experienced just for a few seconds or for days or months…
1. … that the outside world was strange and unreal?	No	Yes
2. … that you felt detached from your surroundings as if there were a veil between you and the outside world?	No	Yes
3. … that objects around you looked small or far away?	No	Yes
4. … the feeling that other people, objects, and the world around you were not real?	No	Yes
5. … a feeling as if you were looking at the world through a fog so that people and objects appeared unclear?	No	Yes
6. … of being in a familiar place but finding it unfamiliar and strange?	No	Yes
7. … the feeling that you were living in a dream?	No	Yes
8. … feeling strange as if you were cut off from the world?	No	Yes
9. … that familiar voices (including your own) sounded far away and unreal?	No	Yes