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COSIG Assessment Training. M.I.N.I. MINI INTERNATIONAL NEUROPSYCHITRIC INTERVIEW. Major Depressive Episode Screening Questions. A1 Have you been consistently depressed or down, most of the day, nearly every day, for the past two weeks?

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M i n i l.jpg

M.I.N.I

MINI INTERNATIONAL NEUROPSYCHITRIC INTERVIEW


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Major Depressive EpisodeScreening Questions

A1 Have you been consistently depressed or down,

most of the day, nearly every day, for the past two

weeks?

A2 In the past two weeks, have you been much less

interested in most things or much less able to

enjoy the things you used to enjoy most of the

time?

If “YES” to either question, proceed to A3

If “NO” to both questions, skip to Section B, Dysthmia


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Major Depressive Episode (Continued)

A3 Over the past two weeks, when you felt

depressed or uninterested:

  • Was your appetite decreased or increased nearly every day? Did your weight increase without trying intentionally?

  • Did you have trouble sleeping nearly every night (difficulty falling asleep, waking up in the middle of the night, early morning wakening, or sleeping excessively)?


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Major Depressive Episode (Continued)

  • Did you talk or move more slowly than normal or were you fidgety, restless, or having trouble sitting still almost every day?

  • Did you feel tired or without energy almost every day?

  • Did you feel worthless or guilty almost every day?

  • Did you have difficulty concentrating or making decisions almost every day?

  • Did you repeatedly consider hurting yourself, feel suicidal, or wish that you were dead?


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Major Depressive Episode (Continued)

If 5 or more of the 7 symptoms are “YES” in A3 then the diagnosis of Major Depressive Episode, Current is made and proceed to A4

If less than 5 of the 7 symptoms are “YES” in A3 then skip to Section B, Dysthmia


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Major Depressive Episode, Recurrent

A4 During your lifetime, did you have other periods of two

weeks or more when you felt depressed or uninterested in

most things, and had most of the problems we just talked

about?

If “YES”, proceed to next question

If “NO”, proceed to Section D, Manic Episode

Did you ever have an interval of at least 2 months without

any depression and any loss of interest between 2 episodes of

depression?

If “YES”, Major Depressive Episode, Recurrent

diagnosis is made


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DysthmiaScreening Question

B1 Have you felt sad, low, or depressed most of

the time for the last two years?

If “YES” proceed to B2

If “NO” skip to Section D, Manic Episode


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Dysthmia (Continued)

B2 Was this period interrupted by your feeling

OK for two months or more?

If “YES” skip to Section D, Manic Episode

If “NO” proceed to B3


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Dysthmia (Continued)

B3 During this period of feeling depressed most

of the time:

  • Did your appetite change significantly?

  • Did you have trouble sleeping or sleep excessively?

  • Did you feel tired or without energy?

  • Did you lose self-confidence?

  • Did you have trouble concentrating or making decisions?

  • Did you feel hopeless?


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Dysthmia (Continued)

If two or more symptoms in B3 are “YES” proceed to B4

If less than 2 symptoms are “YES” in B3 skip to Section D, Manic Episode


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Dysthmia (Continued)

B4 Did the symptoms of depression cause you

significant distress or impair your ability to

function at work, socially or in some other

important way?

If “YES” Dysthmia diagnosis is made

If “NO” proceed to Section D, Manic Episode


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Manic and Hypomanic EpisodeScreening Questions

D1a Have you ever had a period when you were

feeling “up” or “high” or “hyper” or so full of

energy or full of yourself that you got into

trouble, or that other people thought you were

not your usual self? (Do not consider times

when you were intoxicated on drugs or alcohol.)

If “YES” ask:

D1b Are you currently feeling “up” or “high” or full

of energy?


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Manic and Hypomanic EpisodeScreening Questions

D2a Have you ever been persistently irritable, for

several days, so that you had arguments or

verbal or physical fights, or shouted at people

outside your family? Have you or others

noticed that you have been more irritable or

over reacted, compared to other people, even in

situations that you felt were justified?

If “Yes” ask:

D2b Are you currently feeling persistently irritable?


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Manic or Hypomanic Episode(Continued)

If D1b or D2b is “YES” proceed to D3 and explore only current episode

If D1b and D2b are “NO” proceed to D3 and explore the most problematic past episode

If D1a and D2a are both “NO” skip to Section E, Panic Disorder


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Manic and Hypomanic Episode(Continued)

D3 During the times when you felt high, full of

energy, or irritable did you:

  • Feel that you could do things others couldn’t do, or that you were an especially important person?

  • Need less sleep (for example, feel rested after only a few hours sleep)?

  • Talk too much without stopping, or so fast that people had difficulty understanding?

  • Have racing thoughts?


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Manic and Hypomanic Episode(Continued)

D3 During the times when you felt high, full of

energy, or irritable did you: (continued)

  • Become easily distracted so that any little interruption could distract you?

  • Become so active or physically restless that others were worried about you?

  • Want so much to engage in pleasurable activities that you ignored the risks or consequences (for example, spending sprees, reckless driving, or sexual indiscretions)?


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Manic and Hypomanic Episode(Continued)

If 3 or more of the D3 symptoms are “YES” (or 4 or more symptoms if D1a is “NO” when rating past episode or D1b is “NO” when rating current episode) then proceed to D4

If less than 3 symptoms are present, skip to Section E, Panic Disorder


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Manic or Hypomanic Episode(Continued)

D4 Did these symptoms last at least a week and

cause significant problems at home, at work,

socially, or at school, or were you hospitalized

for these problems?

If D4 is “NO” the diagnosis of Hypomanic Episode (Current or Past) is made

If D4 is “YES” the diagnosis of Manic Episode (Current or Past) is made


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Panic DisorderScreening Questions

E1a Have you, on more than one occasion, had

spells or attacks when you suddenly felt

anxious, frightened, uncomfortable or uneasy, even

in situations where most people would not feel that

way?

E1b Did the spells surge to a peak within 10 minutes of

starting?

If E1a and E1b are “YES” then proceed to E2


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Panic Disorder(Continued)

E2 At any time in the past, did any of those spells

or attacks come on unexpectedly or occur in

an unpredictable manner?

If E2 is “YES” proceed to E3

If E2 is “NO” skip to Section H, Obsessive Compulsive Disorder


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Panic Disorder(Continued)

E3 Have you ever had one such attack followed

by a month or more of persistent concern

about having another attack, or worries about

the consequences of the attack?


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Panic Disorder(Continued)

E4 During the worst spell that you can remember:

  • Did you have skipping, racing, or pounding of your heart?

  • Did you have sweating or clammy hands?

  • Were you trembling or shaking?

  • Did you have shortness of breath or difficulty breathing?

  • Did you have a choking sensation or lump in your throat?


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Panic Disorder(Continued)

E4 During the worst spell that you can remember:

  • Did you have chest pain, pressure, or discomfort?

  • Did you have nausea, stomach problems, or sudden diarrhea?

  • Did you feel dizzy, unsteady, lightheaded, or faint?

  • Did things around you feel strange, unreal, detached or unfamiliar, or did you feel outside of or detached from part or all of your body?


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Panic Disorder(Continued)

E4 During the worst spell that you can remember:

  • Did you fear that you were losing control or going crazy?

  • Did you fear that you were dying?

  • Did you have tingling or numbness in parts of your body?

  • Did you have hot flushes or chills?


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Panic Disorder(Continued)

If E3 is “YES” and 4 or more of the symptoms in E4 are “YES”, diagnosis of Panic Disorder, Lifetime is made and proceed to E7

E7 In the past month, did you have such attacks

repeatedly (2 or more) followed by persistent

concern about having another attack?

If E7 is “YES”, diagnosis of

Panic Disorder, Current is made


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Obsessive-Compulsive DisorderScreening Question

H1 In the past month, have you been bothered by

recurrent thoughts, impulses, or images that

were unwanted, distasteful, inappropriate,

intrusive, or distressing?

If H1 is “YES” proceed to H2

IF H1 is “NO” skip to H4


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Obsessive-Compulsive Disorder(Continued)

H2 Did they keep coming back into your mind

even when you tried to ignore or get rid of

them?

IF H2 is “YES” proceed to H3

If H2 is “NO” skip to H4


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Obsessive-Compulsive Disorder(Continued)

H3 Do you think that these obsessions are the

product of your own mind and that they are

not imposed from the outside?

If “YES” then criteria for “Obsessions” has

been met and proceed to H4


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Obsessive-Compulsive Disorder(Continued)

H4 In the past month, did you do something repeatedly

without being able to resist doing it, like washing or

cleaning excessively, counting or checking things

over and over, or repeating, collecting, arranging

things, or other superstitious rituals?

If “YES” then criteria for Compulsions has been met

and proceed to H5

If both H3 and H4 are “NO” skip to Section J, Alcohol Abuse and Dependence


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Obsessive-Compulsive Disorder(Continued)

H5 Did you recognize that either these obsessive

thoughts or these compulsive behaviors were

excessive or unreasonable?

If H5 is “YES” proceed to H6

If H5 is “NO” skip to Section J, Alcohol

Abuse and Dependence


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Obsessive-Compulsive Disorder(Continued)

H6 Did these obsessive thoughts and/or

compulsive behaviors significantly interfere

with your normal routine, occupational

functioning, usual social activities, or

relationships, or did they take more than one

hour a day?

If “YES” then diagnosis of Obsessive-Compulsive Disorder is made


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Posttraumatic Stress DisorderScreening Questions

I1 Have you ever experienced or witnessed or had

to deal with an extremely traumatic event that

included actual or threatened death or serious

injury to you or someone else?

If “YES” proceed to I2

If “NO” skip to Section J, Alcohol Abuse

and Dependence


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Posttraumatic Stress DisorderScreening Questions

I2 Did you respond with intense fear,

helplessness, or horror?

If “YES” proceed to I3

If “NO skip to section J, Alcohol Abuse

and Dependence


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Posttraumatic Stress Disorder

I3 During the past month, have you re-

experienced the event in a distressing way (such

as dreams, intense recollections, flashbacks, or

physical reactions)?

If “YES” proceed to I4

If “NO” skip to Section J, Alcohol Abuse

and Dependence


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Posttraumatic Stress Disorder(Continued)

I4 In the past month:

  • Have you avoided thinking about or talking about the event?

  • Have you avoided activities, places, or people that remind you of the event?

  • Have you had trouble recalling some important part of what happened?

  • Have you become much less interested in hobbies and social activities?


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Posttraumatic Stress Disorder(Continued)

I4 In the past month:

  • Have you felt detached or estranged from others?

  • Have you noticed that your feelings are numbed?

  • Have you felt that your life will be shortened or that you will die sooner than other people?

    If 3 or more of the 7 symptoms in I4 are

    “YES” proceed to I5

    If less than 3 symptoms are “YES” skip to Section J, Alcohol Abuse and Dependence


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Posttraumatic Stress Disorder(Continued)

I5 In the past month:

  • Have you had difficulty sleeping?

  • Were you especially irritable or did you have outbursts of anger?

  • Have difficulty concentrating?

  • Were you nervous or constantly on your guard?

  • Were you easily startled?

    If 2 or more symptoms in I5 are “YES” proceed to I6

    If less than 2 symptoms are “YES” skip to Section J


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Posttraumatic Stress Disorder(Continued)

I6 During the past month, have these problems

significantly interfered with your work or social

activities, or caused significant distress?

If “YES” diagnosis of Posttraumatic Stress Disorder is made

If “NO” proceed to Section J, Alcohol Abuse

and Dependence


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Alcohol Abuse and DependenceScreening Question

J1 In the past 12 months, have you had 3 or more

alcoholic drinks within a 3 hour period on 3 or

more occasions?

If “YES” proceed to J2

If “NO” skip to Section K, Psychoactive Substance Use Disorders


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Alcohol Abuse and Dependence(Continued)

J2 In the past 12 months:

  • Did you need to drink more in order to get the same effect that you got when you first started drinking?

  • When you cut down on drinking, did your hands shake, did you sweat or feel agitated? Did you drink to avoid these symptoms or to avoid being hung over, for example “the shakes,” sweating, or agitation? (If “YES” to either, code “YES”)


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Alcohol Abuse and Dependence(Continued)

J2 In the past 12 months:

  • During the times when you drank alcohol, did you end up drinking more than you planned when you started?

  • Have you tried to reduce or stop drinking alcohol but failed?

  • On the days that you drank, did you spend substantial time in obtaining alcohol, drinking, or recovering from the effects of alcohol?


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Alcohol Abuse and Dependence(Continued)

J2 In the past 12 months:

  • Did you spend less time working, enjoying hobbies, or being with others because of your drinking?

  • Have you continued to drink even though you knew that the drinking caused you health or emotional problems?


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Alcohol Abuse and Dependence(Continued)

If 3 or more questions in J2 are “YES” then diagnosis of Alcohol Dependence is made and skip to Section K, Psychoactive Substance

Use Disorders

If less than 3 questions in J2 are “YES” then proceed to J3 to assess for Alcohol Abuse


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Alcohol Abuse and Dependence(Continued)

J3 In the past 12 months:

  • Have you been intoxicated, high, or hung over more than once when you had other responsibilities at school, work, or at home? Did this cause any problems? (Code “YES” only if this caused problems.)

  • Were you intoxicated more than once in any situation where you were physically at risk, for example, driving a car, riding a motorbike, using machinery, etc.?


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Alcohol Abuse and Dependence(Continued)

J3 In the past 12 months:

  • Did you have legal problems more than once because of your drinking, for example, an arrest or disorderly conduct?

  • Did you continue to drink even though your drinking caused problems with your family or other people?


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Alcohol Abuse and Dependence(Continued)

If one or more questions in J3 are “YES” then diagnosis of Alcohol Abuse is made

If no questions in J3 are “YES” proceed to Section K, Psychoactive Substance Use Disorders


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Psychoactive Substance Use DisordersScreening Question

K1 Now I am going to show (or read) you a list

of street drugs or medications. In the past 12

months, did you take any of these drugs more

than once, to get high, to feel better, or to

change your mood?

If “YES” proceed to K2

If “NO” skip to Section L, Psychotic Disorders


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Psychoactive Substance Use Disorders(Continued)

K2 Considering your use of (specified drug), in the past

12 months:

  • Have you found that you needed to use more (specified drug) to get the same effect that you did when you first started taking it?

  • When you reduced or stopped using (specified drug), did you have withdrawal symptoms (aches, shaking, fever, weakness, diarrhea, nausea, sweating, heart pounding, difficulty sleeping, or feeling agitated, anxious, irritable, or depressed)? Did you use any drug(s) to keep yourself from getting sick (withdrawal symptoms) or so that you would feel better? (If “YES” to either, code “YES”)


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Psychoactive Substance Use Disorders(Continued)

K2 Considering your use of (specified drug), in the past

12 months:

  • Have you often found that when you used (specified drug), you ended up taking more than you thought you would?

  • Have you tried to reduce or stop taking (specified drug) but failed?

  • On the days that you used (specified drug), did you spend substantial time (> 2 hours), obtaining, using, or in recovering from the drug, or thinking about the drug?


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Psychoactive Substance Use Disorders(Continued)

K2 Considering your use of (specified drug), in

the past 12 months:

  • Did you spend less time working, enjoying hobbies, or being with family or friends because of your drug use?

  • Have you continued to use (specified drug) even though it caused you health or mental problems?


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Psychoactive Substance Use Disorders(Continued)

If 3 or more of the questions in K2 are

“YES” then diagnosis of Substance

Dependence is made

If less than 3 questions in K2 are “YES” proceed to K3 to assess Substance Abuse


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Psychoactive Substance Use Disorder(Continued)

K3 Considering your use of (specified drug), in the past

12 months:

  • Have you been intoxicated, high, or hung over from (specified drug) more than once, when you had other responsibilities at school, at work, or at home? Did this cause any problems? (Code “YES” only if this caused problems)

  • Have you been high or intoxicated from (specified drug) more than once in any situation where you were physically at risk (for exammple, driving a car, riding a motorbike, using machinery, boating, etc.)?


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Psychoactive Substance Use Disorder(Continued)

K3 Considering your use of (specified drug), in the past

12 months:

  • Did you have legal problems more than once because of your drug use, for example, an arrest or disorderly conduct?

  • Did you continue to use (specified drug) even though it cause problems with your family or other people?

    If one or more of the questions in K3 are “YES”

    then diagnosis of Substance Abuse is made


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Psychotic Disorders

  • There are no screening questions for the Psychotic Disorders section

  • Ask for an example of each question answered positively. Code “YES” only if the examples clearly show a distortion of thought or of perception or if they are not culturally appropriate.


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Psychotic Disorders(Continued)

  • Before coding, investigate whether delusions qualify as “bizarre.”

  • Delusions are “bizarre” if clearly implausible, absurd, not understandable, and cannot derive from ordinary life experience.

  • Hallucinations are coded “bizarre” if a voice comments on the person’s thoughts or behavior, or when two or more voices are conversing with each other.


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Psychotic Disorders(Continued)

Now I am going to ask you about unusual experiences that some people have:

L1 Have you ever believed that people were

spying on you, or that someone was plotting

against you, or trying to hurt you? (Note: Ask

for examples to rule out actual stalking.)

If “YES”: Do you currently believe these things?


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Psychotic Disorders(Continued)

L2 Have you ever believed that someone was

reading your mind or could hear your

thoughts, or that you could actually read

someone’s mind or hear what another person

was thinking?

If “YES”: Do you currently believe these things?


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Psychotic Disorders(Continued)

L3 Have you ever believed that someone or some

force outside yourself put thoughts in your

mind that were not your own, or made you act

in a way that was not your usual self? Have

you ever felt that you were possessed?

If “YES”: Do you currently believe these things?


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Psychotic Disorders(Continued)

L4 Have you ever believed that you were being

sent special messages through the TV, radio,

or newspaper, or that a person you did not

personally know was particularly interested in

you?

If “YES”: Do you currently believe these things?


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Psychotic Disorders(Continued)

L5 Have your relatives or friends ever considered any of

your beliefs strange or unusual?

Note: Ask for examples and only code “YES” if the

examples are clearly delusional ideas that were not

explored in questions L1-L4. For example, somatic or

religious delusions or delusions of grandiosity,

jealousy, guilt, ruin, destitution, etc.

If “YES”: Do they currently consider your beliefs as

strange?


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Psychotic Disorders(Continued)

L6 Have you ever heard things other people couldn’t

hear, such as voices?

Note: Hallucinations are scored “bizarre” only if patient

answers YES to the following:

If “YES”: Did you hear a voice commenting on your

thoughts or behavior or did you hear two or more

voices talking to each other?

If “YES”: Have you heard these things in the past month?


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Psychotic Disorders(Continued)

L7 Have you ever had visions when you were

awake or have you ever seen things other

people couldn’t see?

Note: Check to see if these are culturally

appropriate.

If “YES”: Have you seen these things in the past

month?


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Psychotic Disorders(Continued)

Clinician’s Judgment Items

L8 Is the patient currently exhibiting incoherence,

disorganized speech, or marked loosening of

associations?

L9 Is the patient currently exhibiting disorganized

or catatonic behavior?


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Psychotic Disorders(Continued)

Clinician’s Judgment Items

L10 Are negative symptoms of schizophrenia,

such as affective flattening, poverty of speech

(alogia) or an inability to initiate or persist in

goal-directed activities (avolition), prominent

during the interview?


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Psychotic Disorders(Continued)

If one or more of the questions from L1a to L7b

are “YES” or “YES – Bizarre” and also met criteria for Major Depressive Episode (Current or Recurrent) or Manic or Hypomanic Episode (Current or Past) then proceed to L11b


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Psychotic Disorders(Continued)

L11b You told me earlier that you had periods

when you felt (depressed/high/persistently

irritable).

Were the beliefs and experiences you just

described (symptoms coded “YES” from

L1a to L7a) restricted exclusively to times

when you were feeling depressed/high/

irritable?


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Psychotic Disorders(Continued0

If the patient ever had a period of at least 2 weeks of having these beliefs or experiences (psychotic symptoms) when they were not depressed, high or irritable, code “NO” on both Mood Disorder with Psychotic Features, Lifetime and Current and proceed to L13

If L11b is “YES” then diagnosis of Mood Disorder with Psychotic Features, Lifetime is made and proceed to L12


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Psychotic Disorders(Continued)

If one or more of the questions from L1b to L7b

are “YES” or “YES – Bizarre” and also met criteria for Major Depressive Episode, Current or Manic or Hypomanic Episode, Current then diagnosis of Mood Disorder with Psychotic Features, Current is made


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Psychotic Disorders(Continued)

L13 Are one or more of the L1b –L7b questions coded “YES – Bizarre”?

OR

Are 2 or more of the L1b-L7b questions coded “YES” (rather than “YES – Bizarre”)?

If “YES” then diagnosis of Psychotic

Disorder, Current is made


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Psychotic Disorders(Continued)

L14: Is L13 coded “YES” for Psychotic Disorder,

Current diagnosis

OR

Are one or more questions from L1a – L7a coded

“YES – Bizarre”

OR

Are 2 or more questions from L1a – L7a coded “YES”

(rather than “YES – Bizarre”)

AND

Did at least two of the psychotic symptoms occur during

the same time period?


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Psychotic Disorders(Continued)

If any of the conditions in L14 are met,

the diagnosis of Psychotic Disorder, Lifetime

is made and proceed to Section O, Generalized Anxiety Disorder


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Generalized Anxiety DisorderScreening Questions

O1 Have you worried excessively or been anxious

about several things over the past 6 months?

Are these worries present most days?

If “YES to both of these questions AND the patient’s anxiety is not restricted exclusively to, or better explained by any disorder prior to

this point, proceed to O2


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Generalized Anxiety Disorder(Continued)

O2 Do you find it difficult to control the worries

or do they interfere with your ability to focus

on what you are doing?

If “YES” proceed to O3

If “NO” interview is complete


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Generalized Anxiety Disorder(Continued)

O3 For the following items, code “NO” if the

symptoms are confined to features of any

disorders explored prior to this point.

When you were anxious over the past 6 months

did you, most of the time:

  • Feel restless, keyed up, or on edge?

  • Feel tense?

  • Feel tired, weak, or exhausted easily?


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Generalized Anxiety Disorder(Continued)

O3 When you were anxious over the past 6

months, did you, most of the time:

  • Have difficulty concentrating or find your mind going blank?

  • Feel irritable?

  • Have difficulty sleeping (difficulty falling asleep, waking up in the middle of the night, early morning wakening or sleeping excessively)?


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Generalized Anxiety Disorder(Continued)

If 3 or more of the symptoms in O3 are

coded “YES” then diagnosis of

Generalized Anxiety Disorder is made

If less than 3 symptoms are “YES” interview

is complete



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Brief Symptom Inventory

  • The BSI is a client self-report that measures psychological symptom severity on nine primary dimensions and three global severity indices.

  • The inventory contains 53 items and takes approximately 8-10 minutes to complete.

  • The BSI is used at intake to assess psychiatric symptom severity and to measure patient progress during treatment.


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BSI Administration

Instructions

The BSI test consists of a list of problems people sometimes have. Read each one carefully and circle the number of the response that best describes HOW MUCH THAT PROBLEM HAS DISTRESSED YOU OR BOTHERED YOU DURING THE PAST 7 DAYS, INCLUDING TODAY. Circle only one number for each problem. Do not skip any items. If you change your mind, draw an X through your original answer and then circle your new answer. Read the example before you begin. If you have any questions, please ask them now.



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BSI Primary Symptom Scales

  • Somatization (SOM): Reflects distress arising from perceptions of body dysfunction. Items focus on cardiovascular, gastrointestinal, respiratory complaints, and other somatic symptoms.

  • Obsessive-Compulsive (O-C): Focuses on thoughts, impulses, and actions that are experienced as unremitting and irresistible, as well as associated performance deficits.


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BSI Primary Symptom Scales

  • Interpersonal Sensitivity (I-S): Assesses feelings of personal inadequacy and inferiority, particularly in comparison to others.

  • Depression (DEP): Reflects a representative range of the indications of clinical depression, such as dysphoric mood and loss of interest.

  • Anxiety (ANX): Concerns general signs of nervousness, tension, fear, and panic attacks.


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BSI Primary Symptom Scales

  • Hostility (HOS): Measures thoughts, feelings and actions associated with chronic anger.

  • Phobic Anxiety (PHOB): Assesses persistent fear responses to certain stimuli that are irrational and disproportionate to the situation.

  • Paranoid Ideation (PAR): Concerns paranoid and disordered thinking, such as delusions, suspiciousness, and hostility.


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BSI Primary Symptom Scales

  • Psychoticism (PSY): Measures certain aspects of schizoid lifestyle, such as interpersonal withdrawal, alienation, and thought control.

  • Additional Items: There are four items that do not belong to a particular scale but are included because they possess clinical significance and contribute to the global severity measures.


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BSI Global Symptom Indices

  • Global Severity Index: Provides an overall severity index based on the average score of all item responses.

  • Positive Symptom Total: The total number of items with a positive or non-zero response.

  • Positive Symptom Distress Index: Provides a severity index based on the average score of all positive symptom items.








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Substance Abuse Treatment Scale(SATS)

The SATS is a brief clinician rating of the client’s stage of engagement in substance abuse treatment. The clinician rates the client’s level of engagement on an 8-point scale.


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Substance Abuse Treatment Scale

  • Pre-engagement

  • Engagement

  • Early Persuasion

  • Late Persuasion

  • Early Active Treatment

  • Late Active Treatment

  • Relapse Prevention

  • In Remission or Recovery



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Wrap-Around Services Assessment

This client-report assessment is designed

to assist in identifying service needs and monitor receipt of service types on a monthly basis.




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Client Evaluation of Self and Treatment (CEST)

The CEST survey consists of items that measure areas of client psychosocial functioning and perception of treatment. For this project, only the eight scales measuring the domains of treatment motivation and treatment process will be used.


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CEST Treatment Motivation Scales

This domain measures clients’ motivation for substance abuse treatment. Treatment motivation is a central factor in rehabilitating individuals with alcohol and drug problems because it is associated with retention and active participation in the treatment process.

Two scales contribute to the Treatment Motivation domain.


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CEST Treatment Motivation Scales

  • Desires Help:Reflects the degree to which clients recognize they have a substance abuse problem and desire help.

  • Ready for Treatment:Assesses the level of commitment clients have to participate in the current treatment program.


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CEST Treatment Motivation Scales

Problem recognition and commitment to the treatment process are related but distinct components determining treatment motivation. For example, clients may be able to identify that they have a substance abuse problem and need help but also be unwilling to commit to treatment at the current time.


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CEST Treatment Process Scales

This domain assesses elements of client engagement in treatment and quality of social network support. Client perceptions of treatment needs and participation, therapeutic relationship with counselors, and support for recovery in and outside of the treatment program are important factors in determining retention and treatment outcomes.

The Treatment Process domain is composed of six scales.


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CEST Treatment Process Scales

  • Needs More Treatment: Assesses the types of services that clients feel they need during treatment to address individual issues.

  • Satisfied with Treatment:Reflects client satisfaction with the quality of the treatment program.

  • Rapport with Counselors: Measures the degree of therapeutic alliance that clients have with counselors.


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CEST Treatment Process Scales

  • Participates in Treatment: Concerns clients’ perceptions of the extent to which they are participating in and benefiting from the treatment process.

  • Peer Support: Measures the amount of support that clients’ feel from other clients in the treatment program.

  • Social Support: Assesses the degree of support for recovery that clients’ feel from family and friends.


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CEST Treatment Process Scales

High scores on the Needs More Treatment, Satisfied with Treatment, Rapport with Counselors, and Participates in Treatment:

  • indicate greater levels of treatment engagement

  • suggest that clients are able to identify areas in need of treatment, feel comfortable with therapists, are actively participating in and benefiting from the treatment process, and

  • indicate clients are satisfied with the treatment experience.


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CEST Treatment Process Scales

High scores on the Peer Support and Social Support scales:

  • suggest that clients perceive other clients in the program and individuals in their external social network as a source of support in the recovery process

  • indicate that clients have established positive relationships with other clients and feel that family and friends are supportive of the treatment process and recovery



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Contact Information

Lori Mangrum, Ph.D.

Addiction Research Institute

University of Texas at Austin

lmangrum@mail.utexas.edu

(512) 232-0616