PSYCHOTIC DISORDERS AND MOOD DISORDERS WITH PSYCHOTIC FEATURES

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. 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 SCORED "BIZARRE" IF: A VOICE COMMENTS ON THE PERSON'S THOUGHTS OR BEHAVIOR, OR WHEN TWO OR MORE VOICES ARE CONVERSING WITH EACH OTHER.

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

L1 a Have you ever believed that people were spying on you, or that someone NO YES YES was plotting against you, or trying to hurt you?

NOTE: ASK FOR EXAMPLES TO RULE OUT ACTUAL STALKING.

b IF YES OR YES BIZARRE: do you currently believe these things? NO YES YES L6 L2 a Have you ever believed that someone was reading your mind or could hear NO YES YES

your thoughts, or that you could actually read someone’s mind or hear what another person was thinking?

b IF YES OR YES BIZARRE: do you currently believe these things? NO YES YES L6 L3 a Have you ever believed that someone or some force outside of yourself NO YES YES

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?

CLINICIAN: ASK FOR EXAMPLES AND DISCOUNT ANY THAT ARE NOT PSYCHOTIC.

b IF YES OR YES BIZARRE: do you currently believe these things? NO YES YES L6 L4 a Have you ever believed that you were being sent special messages through NO YES YES

the TV, radio, or newspaper, or that a person you did not personally know was particularly interested in you?

b IF YES OR YES BIZARRE: do you currently believe these things? NO YES YES L6 L5 a Have your relatives or friends ever considered any of your beliefs strange NO YES YES

or unusual?

INTERVIEWER: ASK FOR EXAMPLES. ONLY CODE YES IF THE EXAMPLES ARE CLEARLY

DELUSIONAL IDEAS NOT EXPLORED IN QUESTIONS L1 TO L4, FOR EXAMPLE, SOMATIC OR RELIGIOUS DELUSIONS OR DELUSIONS OF GRANDIOSITY, JEALOUSY, GUILT, RUIN OR DESTITIUTION, ETC.

b IF YES OR YES BIZARRE: do they currently consider your beliefs strange? NO YES YES L6 a Have you ever heard things other people couldn't hear, such as voices? NO YES

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 NO YES did you hear two or more voices talking to each other?

b IF YES OR YES BIZARRE TO L6a: have you heard these things in the past NO YES YES

month? 8b

HALLUCINATIONS ARE SCORED "BIZARRE" ONLY IF PATIENT ANSWERS YES TO THE FOLLOWING: Did you hear a voice commenting on your thoughts or behavior or

did you hear two or more voices talking to each other?

L7 a Have you ever had visions when you were awake or have you ever seen things NO YES other people couldn't see?

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CLINICIAN: CHECK TO SEE IF THESE ARE CULTURALLY INAPPROPRIATE.

b IF YES: have you seen these things in the past month? NO YES CLINICIAN'S JUDGMENT

L8 b IS THE PATIENT CURRENTLY EXHIBITING INCOHERENCE, NO YES DISORGANIZED SPEECH, OR MARKED LOOSENING OF ASSOCIATIONS?

L9 b IS THE PATIENT CURRENTLY EXHIBITING DISORGANIZED OR CATATONIC NO YES BEHAVIOR?

L10 b ARE NEGATIVE SYMPTOMS OF SCHIZOPHRENIA, E.G. SIGNIFICANT NO YES AFFECTIVE FLATTENING, POVERTY OF SPEECH (ALOGIA) OR AN

INABILITY TO INITIATE ORPERSIST IN GOAL-DIRECTED ACTIVITIES (AVOLITION), PROMINENT DURINGTHE INTERVIEW?

L11 a ARE 1 OR MORE « a » QUESTIONS FROM L1a TO L7a CODED YES OR YES BIZARRE

AND IS EITHER:

MAJOR DEPRESSIVE EPISODE, (CURRENT OR RECURRENT)

OR

MANIC OR HYPOMANIC EPISODE, (CURRENT OR PAST) CODED YES? NO YES L13 IF NO TO L11 a, CIRCLE NO IN BOTH ‘MOOD DISORDER WITH PSYCHOTIC FEATURES’ DIAGNOSTIC BOXES AND MOVE TO L13.

b You told me earlier that you had period(s) 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?

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/IRRITABLE, CODE NO TO THIS DISORDER.

IF THE ANSWER IS NO TO THIS DISORDER, ALSO CIRCLE NO TO L12 AND MOVE TO L13

L12 a ARE 1 OR MORE « b » QUESTIONS FROM L1b TO L7b CODED YES OR YES BIZARRE

AND IS EITHER:

MAJOR DEPRESSIVE EPISODE, (CURRENT)

OR

MANIC OR HYPOMANIC EPISODE, (CURRENT) CODED YES?

IF THE ANSWER IS YES TO THIS DISORDER (LIFETIME OR CURRENT), CIRCLE NO TO L13 AND L14 AND MOVE TO THE NEXT MODULE.

L13 ARE 1 OR MORE « b » QUESTIONS FROM L1b TO L6b, CODED YES BIZARRE?

OR

ARE 2 OR MORE « b » QUESTIONS FROM L1b TO L10b, CODED YES (RATHER THAN YES BIZARRE)?

NO YES

MOOD DISORDER WITH PSYCHOTIC FEATURES

LIFETIME

NO YES

MOOD DISORDER WITH PSYCHOTIC FEATURES CURRENT

NO YES PSYCHOTIC DISORDER CURRENT

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AND DID AT LEAST TWO OF THE PSYCHOTIC SYMPTOMS OCCUR DURING THE SAME 1 MONTH PERIOD?

L14 IS L13 CODED YES

OR

ARE 1 OR MORE « a » QUESTIONS FROM L1a TO L6a, CODED YES BIZARRE?

OR

ARE 2 OR MORE « a » QUESTIONS FROM L1a TO L7a, CODED YES (RATHER THAN YES BIZARRE)

AND DID AT LEAST TWO OF THE PSYCHOTIC SYMPTOMS OCCUR DURING THE SAME 1 MONTH PERIOD?

NO YES

PSYCHOTIC DISORDER LIFETIME

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In document Physical Violence (Page 171-174)