A 15-Minute Psychiatric Assessment

Transcription

1 A 15-Minute Psychiatric Assessment The following questions have been adapted from several sources (see references) and are intended to screen for the following psychiatric conditions: MDE Alcohol Misuse Panic Disorder GAD ADHD Bulimia Nervosa Psychosis You will require approximately 10 minutes to complete the entire questionnaire. Please note that these questions are for the purpose of screening and are not comprehensive assessments of the listed conditions.

2 MDE (3 Questions) 1. During the past month have you often been bothered by feeling down, depressed or hopeless? Yes no 2. During the past month have you often been bothered by little interest or pleasure in doing things? Yes no (Scoring: Yes to questions 1 & 2 [sensitivity 96%, Specificity 78%]) 3. Is this something with which you would like help? No Yes Yes but not today (Scoring: Yes to question 3 increases specificity to 89%) Add psychosis questions if positive screen. Alcohol (5 Questions) Have any of the following happened to you in the last 6 months? 1. You drank alcohol even though a doctor suggested that you stop drinking because of a problem with your health? 2. You drank alcohol, were high from alcohol, or hung over while you were working, going to school, or taking care of children or other responsibilities?

3 3. You missed or were late for work, school, or other activities because you were drinking or hung over? 4. You had a problem getting along with other people while you were drinking? 5. You drove a car after having several drinks or after drinking too much? (Scoring: Yes to any questions suggests alcohol misuse) Panic Disorder (5 Questions) 1. In the past 6 months, did you ever have a spell or an attack when all of a sudden you felt frightened, anxious or very uneasy? yes no 2. In the past 6 months, did you ever have a spell or attack when for no reason your heart suddenly began to race, you felt faint, or you couldn t catch your breath? yes no IF YOU ANSWERED YES TO QUESTION #1 OR TO QUESTION #2, THEN CONTINUE WITH questions 3-5, OTHERWISE, STOP. (Scoring: Yes to question 1 or 2 [sensitivity 94%, specificity 59%]) 3. Did any of these spells or attacks ever happen in a situation when you were the center of attention? yes (If YES consider Social Phobia) (Scoring: No to question 3 [sensitivity 88%, specificity 70%])

4 4. How many times have you had a spell or attacks in the past month? (Check one.) 0 Once 2 to 3 times 4 to 10 times More than 10 times 5. In the past month, how worried have you been that spells or attacks might happen again? t at all worried Somewhat worried Very worried (Scoring: If patient answers Not at all worried then Panic Disorder is either in remission or panic attacks are related to other mental disorder) GAD (2 Questions) From PRIME MD Over the last 2weeks, how often have you been bothered by any of the following problems? (Scoring: combined score of 3 = high probability) Not at all 0 Several days 1 More than half the days 2 Nearly everyday 3 Feeling nervous, anxious or on edge Not being able to stop or control worrying

5 Bulimia Nervosa (3 Questions) Do you often feel that you can t control what or how much you eat? Do you often eat, within any 2-hour period, what most people would regard as an unusually large amount of food? If you checked YES to either above, Has this been as often, on average, as twice a week for the last 3 months? (Scoring: 2 positive responses = high probability) Psychosis (8 Questions) The next questions are about unusual things, like seeing visions or hearing voices that some people may not believe in. In fact these things may be quite common in certain situations. 1. Have you ever heard voices that other people could not hear? I don't mean having good hearing, but rather hearing things that other people said did not exist, like voices coming from inside your head talking to you or about you, or voices coming out of the air when there was no one around. Did you ever hear voices in this way? Yes 2. Have you ever felt that some mysterious force was inserting thoughts -- that were definitely not your own thoughts directly into your head? Yes

6 3. Have you ever felt that your thoughts were being read by other people or were being stolen out of your mind. Yes 4. Did you ever have a time when you felt that your mind was being taken over by others? Yes 5. Have you ever felt that someone or something was trying to communicate directly with you by sending special signs or signals? Some people experience this through the radio or television. Yes 6. Have you ever felt that there was a plot going on to harm you or to have people follow you that your family and friends did not believe was true? Yes 7. Do you have any special powers that most people lack? Yes 8. Has a doctor ever told you that you have schizophrenia? Yes (Scoring: Any yes response suggests high probability)

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8 References Arroll B, Goodyear-Smith F, Kerse N, et al. Effect of the addition of a help question to two screening questions on specificity for diagnosis of depression in general practice: diagnostic validity study. BMJ 2005; 331: 884 6A. Cooper L, et al. Validity of the Composite International Diagnostic Interview "CIDI# psychosis module in a psychiatric setting. Journal of Psychiatric Research 1998;: 32: Kessler RC, Adler L, Ames M, et al. The World Health Organization adult ADHD self-report scale (ASRS): a short screening scale for use in the general population. Psychol Med 2005; 35: Spitzer RL et al. Utility of a New Procedure for Diagnosing Mental Disorders in Primary Care: The PRIME-MD 1000 Study. JAMA 1994; 272(22): Steinpat MB, et al. Development of a Brief Diagnostic Screen for Panic Disorder in Primary Care. Psychosomatic Medicine 61: (1999)