Start
nshd_82_pse
STRICTLY CONFIDENTIAL
1982
NATIONAL SURVEY OF HEALTH AND DEVELOPMENT
(Medical Research Council)
Canynge Hall,

Interviewer's Name

Generic text
PRESENT STATE EXAMINATION
1. INTRODUCTION and 2. HEALTH, WORRYING, TENSION
Now I should like to get some idea of how you have been getting along in the past month, how your general health has been and how you have been feeling about things. Some of the things that I shall ask may not apply to you; I am just making sure that everything has been mentioned.

** Most people have some sort of worry or trouble from time to time. What sort of things do you worry about?

Long text
Means of exploration if subject gives inadequate information:
If subject's statement too brief: Can you tell me more about that?
If subject has no more to add: What else has been troubling you?
If statements are difficult to understand: Can you explain what you mean by ...?
If subject is vague: Could you give me an example of ...?

** What is it like when you worry?

0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What sort of state of mind do you get into?)
(Do unpleasant thoughts constantly go round and round in your mind?)
(Can you stop them by turning your attention to something else?)

** Have you had headaches or other aches or pains during the past month?

0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What kind?)

** Have you been getting exhausted and worn out during the day or evening even when you haven't been working very hard?

0
Not present
1
Only moderate form of symptom (tiredness) present, or intense form (exhaustion) for less than 50% of the time
2
Intense form of symptom present for more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked

** Have you had difficulty in relaxing during the past month?

0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do your muscles feel tensed up?)

** Have you been so fidgety and restless that you couldn't sit still?

0
Not present
1
Only moderate form of symptom (fidgety, restless) present, or intense form (pacing, can't sit down) for less than 50% of the time
2
Intense form of symptom (pacing, etc. )present for more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you have to keep pacing up and down?)

** Is your physical health good?

Generic text
(Does your body function normally?)

** Do you feel that you are physically ill in any way?

0
Feels physically very fit
1
No particular physical complaint, but does not say positively feels fit
2
Feels unwell, but not seriously incapacitated
3
Feels seriously incapacitated by physical illness
8
Examiner unsure , although question asked
9
Not applicable or not appropriate e.g. question not asked
(What is that like? How serious is it?)

** Do you tend to worry over your physical health?

0
Not present
1
Symptom present during past month, but not (2)
2
Subject constantly reverts to hypochondriacal preoccupations during interview
8
Examiner unsure although question asked
9
Not applicable, or not appropriate e.g. question not asked

** Do you often feel on edge, or keyed up, or mentally tense or strained?

0
Not present
1
Symptom definitely present during past month , but of moderate intensity, or intense less than 50% of the time
2
Intense form of symptom present for more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you generally suffer with your nerves?)
(Do you suffer from nervous exhaustion?)
3. AUTONOMIC ANXIETY
In this section, rate only subjective anxiety with autonomic accompaniments, either free floating or situational. Do not include worrying or nervous tension. Do not include anxiety due to e.g. persecutory delusions.
(CHECKLIST of autonomic accompaniments: Blushing, Butterflies in stomach, Choking, Difficulty in getting breath, Dizziness, Dry Mouth, Giddiness, Palpitations, Sweating, Trembling.)

** Have there been times lately when you have been very anxious or frightened?

0
Not present
1
Symptom definitely present, with autonomic accompaniment, during past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of the time
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
(What was this like?)
(Did your heart beat fast? - ask for other autonomic symptoms)
(How often in the past month?)

** Have you had the feeling that something terrible might happen?

0
Not present
1
Symptom definitely present, with autonomic accompaniment, during past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of the time
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(That some disaster might occur but you are not sure what? Like illness or death or ruination?)
(Have you been anxious about getting up in the morning because you are afraid to face the day?)
(What did it feel like?)

** Are there any special situations that make you anxious?

Generic text
IF NO EVIDENCE OF ANXIETY PROCEED TO NEXT **
(qc_11 == 0 || qc_11 == 9) && (qc_12 == 0|| qc_12 == 9)
Else

Have you had times when you felt shaky, or your heart pounded, or you felt sweaty, and you simply had to do something about it?

0
No panic attacks
1
1-4 panic attacks during past month
2
Panic attacks 5 times or more during past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What was it like?)
(What was happening at the time?)
(How often during the past month?)

Do you tend to get anxious in certain situations, such as travelling or being alone, or being in a lift or tube train?

0
Not present
1
Has not been in such situations during past month but aware that anxiety would have been present if the situation had occurred
2
Situation has occurred during past month and subject did feel anxious because of it
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What situations? How often in the past month?)
(CHECKLIST: make a note of each situation:
Crowds (shop, street, theatre, cinema, church)
Going out alone; being at home alone.
Enclosed spaces (hairdressers, phone booth, tunnel)
Open spaces, bridges
Traveiling (buses, cars, trains))

What about meeting people e.g. going into a crowded room, making conversation?

0
Not present
1
Has not been in such situations during past month but aware that anxiety would have been present if the situation had occurred
2
Situation has occurred during past month and subject did feel anxious because of it
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(CHECKLIST: make a note of each situation:
Speaking to an audience.
Eating, drinking or writing in front of other people.
Parties.)

Do you have any special fears, like some people are scared of feathers, or cats, or spiders, or birds?

0
Not present
1
Has not been in such situations during past month but aware that anxiety would have been present if the situation had occurred
2
Situation has occurred during past month and subject did feel anxious because of it
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(CHECKLIST: make a note of each situation:
Heights , thunderstorms, darkness, animals or insects of any kind, dentists, injections, blood, injury)

Do you avoid any of these situations (specify as appropriate) because you know you will get anxious?

0
No avoidance
1
Subject tends to avoid such situations whenever possible
2
Marked generalisation of avoidance has occurred during past month e.g. subject has not dared leave the house or has gone out only if accompanied
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(How much does it affect your life?)

Do you avoid any of these situations (specify as appropriate) because you know you will get anxious?

Generic text
4. THINKING, CONCENTRATION, INTERESTS

** Can you think clearly or is there any interference with your thoughts?

Generic text

** Do your thoughts tend to be muddled or slow?

0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Can you make up your mind about simple things quite easily?)
(Make decisions about everyday matters?)
IF NO INDICATION OF DELUSIONS CONNECTED WITH THINKING PROCESSES, PROCEED TO **
qc_15 == 0 || qc_15 == 9
Else

Are you in full control of your thoughts? Can people read your mind? Who? How? Is anything like hypnotism or telepathy going on? Are thoughts put into your head which are not your own? Do you feel under the control of some force or power other than yourself?

Generic text

IF DELUSIONS OF THOUGHT INSERTION ETC. (SYMPTOMS 55-59) MAY BE PRESENT,

1
Tick here

IF DELUSIONS OF CONTROL (SYMPTOM 71) MAY BE PRESENT,

1
Tick here

** What has your concentration been like recently?

0
Not present
1
Only moderate form of symptom present in past month ( e.g. can read a short article, can concentrate if tries hard) or intense less than 50% of the time
2
Symptom clinically intense (cannot attempt to read or concentrate) more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Can you read an article in the paper or watch a TV programme right through?)
(Do your thoughts drift off so that you don't take things in?)

** Do you tend to brood on things?

0
Not present
1
Symptom has caused moderate impairment to work or social relationships
2
Marked impairment
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(So much that you even neglect your work?)

** What about your interests, have they changed at all?

0
Not present
1
Symptom definitely present during past month but of moderate clinical severity or severe less than 50% of the time
2
Symptom clinically severe more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Have you lost interest in work, or hobbies or recreations?)
(Have you let your appearance go?)
5. DEPRESSED MOOD

** Do you keep reasonably cheerful or have you been very depressed or low-spirited recently?

Generic text

** Have you cried at all?

0
Not present
1
Only moderately depressed during past month , or deep depression for less than 50% of the time and tending to vary in intensity
2
Deeply depressed for more than 50% of the past month , and tending to be unvarying in intensity
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(When did you last really enjoy anything?)

** How do you see the future?

0
Not present
1
Hopelessness of moderate intensity but still has some degree of hope for the future (irrespective of time during month)
2
Intense form of symptom (patient has given up hope altogether)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Has life seemed quite hopeless?)
(Can you see any future?)
(Have you given up or does there still seem some reason for trying?
USE JUDGEMENT ABOUT WORDING THE FOLLOWING:

** Have you felt that life wasn't worth living?

0
Never deliberately considered suicide
1
Deliberately considered suicide (not just a fleeting thought) but made no attempt
2
Suicidal attempt but suicide's life never likely to be in serious danger, except unintentionally
3
Suicidal attempt apparently designed to end in death (i.e. accidental discovery or inefficient means)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Did you ever feel like ending it all?)
(What did you think you might do?)
(Did you actually try?)
(N.B. Examiner should judge clinically whether there was intent to end life or not. If in doubt, assume not.)

** Have you felt that life wasn't worth living?

Generic text
IF EVIDENCE OF BOTH DEPRESSION AND ANXIETY
(qc_11 == 1 || qc_11 == 2) && (qc_20 == 1 || qc_20 == 2)

Which seems worse, the depression or the anxiety? (use subject's own terms)

0
Anxiety primary
1
Anxiety and depression both present but seem independent of each other
2
Depression primary
8
Examiner unsure
9
Not applicable or not appropriate e.g. question not asked

Is the depression worse at any particular time of day?

0
No depression
1
Not specially marked in mornings
2
Specially marked in mornings
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
6. SELF AND OTHERS

** Have you wanted to stay away from other people?

0
Not present
1
Only passive form of symptom i.e. subject does not seek company but does not refuse it if offered, or, if active withdrawal, less than 50% of the month
2
Actively avoids company (refuses it if offered) ; actively withdrew in this way for more than 50% of the month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Why?)
(Have you been suspicious of their intentions? Of actual harm?)

** What is your opinion of yourself compared to other people?

0
Not present
1
Some inferiority, not amounting to feeling of worthlessness. If subject considers self to be worthless, this intense form of the symptom is present less than 50% of the time
2
Subject considers self to be completely worthless. Symptom present more than 50% of the month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you feel better, or not as good, or about the same as most?)
(Do you feel inferior or even worthless?)

** How confident do you feel in yourself?

0
Not present
1
Moderate lack of self-confidence, or intense lack for less than 50% of the month
2
Intense lack of self-confidence for more than 50% of the month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(For example, in talking to others, in managing with other people?)

** Are you self-conscious in public?

0
Not present
1
Marked self-consciousness only (irrespective of time during month)
2
Feels that people are criticising or laughing at self but can be reassured
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you get the feeling that other people are taking notice of you in the street or a bus or a restaurant?)
(Do they ever seem to laugh at you or talk about you critically?)
(Do you consider people really are looking at you, or is it perhaps the way you feel about it?)
IF NO EVIDENCE OF GUILT, OR OF DELUSIONS OF REFERENCE OR PERSECUTION, PROCEED TO NEXT **
IF EVIDENCE OF GUILT:

Do you have the feeling that you are being blamed for something or even accused? What about?

0
Not present
1
Subject feels blamed but not accused (irrespective of time during month)
2
Subject feels accused of some sin or misdemeanour; not delusional
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked

Do you tend to blame yourself at all?

0
Not present
1
Subject feels over guilty about some peccadillo (irrespective of time during month)
2
Subject feels to blame for everything that has gone wrong even when not his fault , but not that he has committed a serious crime or sin ; not delusional
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(If people are critical, do you think you deserve it?)

Do you feel you have committed a crime or sinned greatly or deserve punishment?

Generic text
(Have you felt you might contaminate or ruin other people?)

IF DEPRESSIVE DELUSIONS (SYMPTOMS 88, 91, 92) MAY BE PRESENT

1
Tick here
IF EVIDENCE OF DELUSIONS OF REFERENCE OR PERSECUTION

Do people seem to drop hints or say things with a double meaning? Do things seem specially arranged?

Generic text
(Do people follow you about?)
(Do you see any reference to yourself on TV or in the papers?)
(How do you explain it?)

IF DELUSIONS OF REFERENCE OR MISINTERPRETATION (SYMPTOMS 72 and 73) MAY BE PRESENT

1
Tick here

Is anyone trying to harm you?

Generic text
(How? Is there any organization behind it?)
(How do you explain it?)

IF DELUSIONS OF PERSECUTION (SYMPTOM 74) MAY BE PRESENT

1
Tick here
7. APPETITE, SLEEP, RETARDATION, LIBIDO

** What has your appetite been like recently?

0
No weight loss
1
Less than 7 lb.
2
7 lb. or more
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
(Have you lost any weight during the past 3 months?)

** Have you had any trouble getting off to sleep during the past month?

0
Not present
1
One hour or more delay (irrespective of sleeping tablets)
2
Two hours or more delay (irrespective of sleeping tablets) (In either case 10 or more nights during month)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(How long do you lie awake?)
(What happens if you take sleeping tablets?)
(How often does it happen?)

** Do you seem to be slowed down in your movements, or have too little energy recently? How much has it affected you?

0
Not present
1
Marked subjective listlessness and lack of energy
2
Marked retardation and underactivity (irrespective of time during month)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do things seem to be moving too fast for you?)
IF NO APPETITE OR SLEEP DISTURBANCE, AND NO DEPRESSION PROCEED TO NEXT **
IF SLEEP DISTURBANCE, OR DEPRESSION

Do you wake early in the morning?

0
Not present
1
One- two hours before ordinary time
2
Two hours or more before ordinary time (In either case, 10 or more nights during month)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Use discretion whether to ask this)

Has there been any change in your interest in sex?

0
Not present
1
Marked loss of interest and performance
2
Almost total loss of libido
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
Ask if appropriate:

Does the depression or tension get worse just before the start of the monthly period?

0
No definite exacerbation
1
Marked exacerbation
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
8. IRRITABILITY

** Have you been very much more irritable than usual recently?

0
Not present
1
Keeps irritation to self
2
Shows anger by shouting or quarrelling
3
Shows anger by hitting people, throwing or breaking things
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(How do you show it?)
(Do you keep it to yourself, or shout, or even hit people?)
9. EXPANSIVE MOOD AND IDEATION

** Have you sometimes felt particularly cheerful and on top of the world, without any reason?

0
Not present
1
Moderately expansive mood (euphoria with marked element of inappropriateness or excitement, whether recognised by subject or not), present during past month, and persistent for hours at a time. Do not include transient high spirits. Not necessarily described by subject
2
Intense form of symptom (elation or exaltation) definitely present during past month and persistent for hours at a time. Described by subject
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Too cheerful to be healthy?)
(How long does it last?)

** Have you felt particularly full of energy lately, or full of exciting ideas?

0
Not present
1
Subjective equivalent of flight of ideas. Images and ideas flash through the mind, each suggesting others, at a faster rate than usual. State persists for hours at a time
2
As (1) but accompanied by very high energy output and activity which does not seem to make subject tired at the time. Definitely occurred during past month and persisted for hours at a time
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
(Do things seem to go too slowly for you?)
(Do you need less sleep than usual?)
(Do you find yourself extremely active but not getting tired?)
(Have you developed new interests recently?)
IF NO EVIDENCE OF EXPANSIVE MOOD AND IDEATION, PROCEED TO NEXT **
IF EVIDENCE OF EXPANSIVE MOOD AND IDEATION
qc_31 == 1 || qc_31 == 2 || qc_31 == 8 || qc_32 == 1 || qc_32 == 2 || qc_32 == 8

Have you seemed super-efficient at work, or as though you had special powers or talents quite out of the ordinary?

0
Not present
1
Subjective feeling of superb health, exceptionally high intelligence, extraordinary abilities, etc. Persistent for hours at a time. Symptom occurred at some time during the month
2
Grandiose ideas have been translated into action during the month e.g. overspending, gambling, etc. under the influence of grandiose ideas and expansive affect. Do not include compulsive gambling unless clearly of this type
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Have you felt specially healthy?)
(Have you been buying any interesting things recently?)

Is there anything special about you?

Generic text
(Is there a special purpose or mission to your life?)
(Are you specially clever or inventive?)
(Are you a very prominent person?)
(How do you explain this?)

IF GRANDIOSE DELUSIONS (SYMPTOMS 75-77) MAY BE PRESENT

1
Tick here
10. OBSESSIONS
These symptoms are usually experienced as occurring against conscious resistance. (See definition in glossary)

** Do you find that you have to keep on checking things that you know you have already done?

0
Not present
1
Symptom of moderate intensity or if severe, present less than 50% of the time
2
Symptom present in severe degree for more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Like gas taps, doors, switches, etc.)
(Do you have to touch or count things many times or repeat the same action over and over again?)
(What happens when you try to stop?)

** Do you spend a lot of time on personal cleanliness, like washing over and over again even though you know you are clean? What about tidiness?

0
Not present
1
Symptom of moderate intensity or if severe, present less than 50% of the time
2
Symptom present in severe degree for more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you get worried by contamination with germs?)
(Do you have other rituals?)
(What happens when you try to stop?)

** Do you find it difficult to make decisions even about trivial things?

0
Not present
1
Symptom of moderate intensity or if severe, present less than 50% of the time
2
Symptom present in severe degree for more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you constantly have to question the meaning of the universe?)
(Do you get awful thoughts coming into your mind even when you try to keep them out?)
(What happens when you try to stop?)
11. DEPERSONALISATION AND DEREALISATION

** Have you had the feeling recently that things around you were unreal?)

0
Not present
1
Moderately intense form of symptom definitely occurred during past month, and persisted for hours at a time. Things appear colourless and artificial, people appear lifeless and seem to act rather than being themselves
2
Intense form of symptom occurred during month and persisted for hours at a time. e .g. whole world appears like a gigantic stage-set, with imitation instead of real objects and puppets instead of people
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(As though everything was an imitation of reality, like a stage set, with people acting instead of being themselves?)
(What is it like? How do you explain it?)

** Have you yourself felt unreal, that you were not a person, not in the living world?

0
Not present
1
Moderately intense form of the symptom definitely occurred during past month and persisted for hours at a time. Subject feels himself unreal, a sham, a shadow
2
Intense form of symptom definitely occurred during past month and persisted for hours at a time. Subject feels he is dead, not a person , living in a parallel existence, a hollow shell, even that he does not exist
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Or that you were outside yourself, looking at yourself from outside?)
(Or that you look unreal in the mirror?)
(Or that some part of your body did not belong to you?)
(How do you explain it?)
12. OTHER PERCEPTUAL DISTORTION, ETC.

** Does your imagination ever play tricks on you?

Generic text

** Do you get the feeling something odd is going on you can't explain?

Generic text

** Is there anything unusual about the way things look or sound or smell or taste?

Generic text
(Is your own appearance normal?)
(How do you explain it?)

IF PERCEPTUAL DISTORTION (SYMPTOMS 49-54) MAY BE PRESENT

1
Tick here
    • Do you ever seem to hear what seem to be voices when nobody is about?
Generic text
(When? What is it like?)
(What are the words? Is there more than one person?)
(How do you explain it?)

IF AUDITORY HALLUCINATIONS (SYMPTOMS 60-64) MAY BE PRESENT

1
Tick here

** Have you ever had a vision or seen things other people couldn't see?

Generic text
(When? What is that like?)
(How do you explain it?)

IF VISUAL HALLUCINATIONS (SYMPTOMS 64, 66, 67) MAY BE PRESENT

1
Tick here

IF YOU SUSPECT OTHER DELUSIONS MAY BE PRESENT

1
Tick here
16. SENSORIUM AND FACTORS AFFECTING, AND TREATMENT

** Have you had any lapses of memory recently?

Generic text

** Have there been any periods in which you completely forgot what happened?

0
Not present
1
Less than 12 hours
2
12-14 hours
3
More than 24 hours
8
Examiner unsure although questions asked
9
Not applicable or not appropriate e.g. question not asked
(What was it like?)
(How do you explain it?)
IF NO EVIDENCE OF POOR MEMORY, PROCEED TO **
IF ANY SUSPICION OF POOR MEMORY OR DISORIENTATION

May I ask one or two standard questions we ask of everybody?

0
Not present
1
Mild
2
Moderate
3
Severe
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
How old are you?
When is your birthday?
Can you tell me the year and the month?
What is the name of the Prime Minister?

** What medicines or drugs do you take?

Long text

** What medicines or drugs do you take?

0
Not present
1
Cannabis
2
Barbiturates, etc
3
LSD, amphetamines, etc
4
Heroin, cocaine, etc
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you take anything for your nerves or your mood?)
(Who prescribes them? Do you buy them over the counter?)
(What about other types of drugs, like cannabis?)

** May I ask about your drinking habits?

Generic text

** How much do you usually drink each day?

0
Not present
1
Agrees alcohol has been a problem but not 2
2
Any check list item applies
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Is alcohol in any way a problem for you?)
(In what way?)
(CHECKLIST: During the past month have you: Had family problems because of your drinking? Missed work because of drinking? Had morning shakes? Had blackouts for several hours? Heard voices or seen visions?)
Take subjects' previous replies into account when asking next 3 questions

** I have been asking about the last month; now may I ask if there has been any time in the past year when you have felt consistently sad and low spirited for a considerable period?

0
No
1
Yes
8
Examiner unsure
9
Not applicable
If 'Yes'
qc_52 == 2

(When was that? ... )

Generic text

** Has there been any time during the past year when you have felt anxious or fearful or nervous over a considerable period? (Such that you were prone to nervous sweating, trembling or 'butterflies' in the stomach?)

0
No
1
Yes
8
Examiner unsure
9
Not applicable
If 'Yes'
qc_53 == 2

(When was that? ... )

Generic text

** Has there been any time during the past year when you have felt full to overflowing of energy or exciting ideas for days at a stretch? (Such that you needed less sleep than usual?)

0
No
1
Yes
8
Examiner unsure
9
Not applicable
If 'Yes'
qc_54 == 2

(When was that? ... )

Generic text
RATE THE FOLLOWING IF SUFFICIENT INFORMATION HAS ALREADY EMERGED IF NOT, THEN ASK

** May I ask if you are seeing a doctor for your nerves?

Generic text
(Or specify any psychosomatic complaints?)
IF YES

** What kind of doctor is he?

0
No doctor
1
GP
2
Private doctor other than GP
3
Psychiatrist
4
Hospital out-patient (other than psychiatrist)
5
Other paramedical specialist or osteopath
6
Other - please specify
Other
(Your own GP, a private doctor, a psychiatrist, at hospital outpatients?)

** Have you seen a doctor in the past year for any nervous condition?

Generic text
If YES

what kind of doctor?

Generic text

When was that?

Generic text

** Are you attending for treatment, any person who is not medically qualified e.g. lay therapist, herbalist, acupuncturist, faith healer, Christian Scientist, church which forbids medical advice? Or have you done so in the past year?

Generic text

** Are you attending for treatment, any person who is not medically qualified e.g. lay therapist, herbalist, acupuncturist, faith healer, Christian Scientist, church which forbids medical advice? Or have you done so in the past year?

Long text
(When?)
(What were you complaining of at the time?)
Now return to Questionnaire A, page 18, question 73
End

nshd_82_pse

STRICTLY CONFIDENTIAL
NATIONAL SURVEY OF HEALTH AND DEVELOPMENT
(Medical Research Council)
Canynge Hall,
Interviewer's Name
Generic text
PRESENT STATE EXAMINATION

1. INTRODUCTION and 2. HEALTH, WORRYING, TENSION

Now I should like to get some idea of how you have been getting along in the past month, how your general health has been and how you have been feeling about things. Some of the things that I shall ask may not apply to you; I am just making sure that everything has been mentioned.
** Most people have some sort of worry or trouble from time to time. What sort of things do you worry about?
Long text
Means of exploration if subject gives inadequate information:
If subject's statement too brief: Can you tell me more about that?
If subject has no more to add: What else has been troubling you?
If statements are difficult to understand: Can you explain what you mean by ...?
If subject is vague: Could you give me an example of ...?
** What is it like when you worry?
0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What sort of state of mind do you get into?)
(Do unpleasant thoughts constantly go round and round in your mind?)
(Can you stop them by turning your attention to something else?)
** Have you had headaches or other aches or pains during the past month?
0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What kind?)
** Have you been getting exhausted and worn out during the day or evening even when you haven't been working very hard?
0
Not present
1
Only moderate form of symptom (tiredness) present, or intense form (exhaustion) for less than 50% of the time
2
Intense form of symptom present for more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
** Have you had difficulty in relaxing during the past month?
0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do your muscles feel tensed up?)
** Have you been so fidgety and restless that you couldn't sit still?
0
Not present
1
Only moderate form of symptom (fidgety, restless) present, or intense form (pacing, can't sit down) for less than 50% of the time
2
Intense form of symptom (pacing, etc. )present for more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you have to keep pacing up and down?)
** Is your physical health good?
Generic text
(Does your body function normally?)
** Do you feel that you are physically ill in any way?
0
Feels physically very fit
1
No particular physical complaint, but does not say positively feels fit
2
Feels unwell, but not seriously incapacitated
3
Feels seriously incapacitated by physical illness
8
Examiner unsure , although question asked
9
Not applicable or not appropriate e.g. question not asked
(What is that like? How serious is it?)
** Do you tend to worry over your physical health?
0
Not present
1
Symptom present during past month, but not (2)
2
Subject constantly reverts to hypochondriacal preoccupations during interview
8
Examiner unsure although question asked
9
Not applicable, or not appropriate e.g. question not asked
** Do you often feel on edge, or keyed up, or mentally tense or strained?
0
Not present
1
Symptom definitely present during past month , but of moderate intensity, or intense less than 50% of the time
2
Intense form of symptom present for more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you generally suffer with your nerves?)
(Do you suffer from nervous exhaustion?)

3. AUTONOMIC ANXIETY

In this section, rate only subjective anxiety with autonomic accompaniments, either free floating or situational. Do not include worrying or nervous tension. Do not include anxiety due to e.g. persecutory delusions.
(CHECKLIST of autonomic accompaniments: Blushing, Butterflies in stomach, Choking, Difficulty in getting breath, Dizziness, Dry Mouth, Giddiness, Palpitations, Sweating, Trembling.)
** Have there been times lately when you have been very anxious or frightened?
0
Not present
1
Symptom definitely present, with autonomic accompaniment, during past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of the time
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
(What was this like?)
(Did your heart beat fast? - ask for other autonomic symptoms)
(How often in the past month?)
** Have you had the feeling that something terrible might happen?
0
Not present
1
Symptom definitely present, with autonomic accompaniment, during past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of the time
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(That some disaster might occur but you are not sure what? Like illness or death or ruination?)
(Have you been anxious about getting up in the morning because you are afraid to face the day?)
(What did it feel like?)
** Are there any special situations that make you anxious?
Generic text
Have you had times when you felt shaky, or your heart pounded, or you felt sweaty, and you simply had to do something about it?
0
No panic attacks
1
1-4 panic attacks during past month
2
Panic attacks 5 times or more during past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What was it like?)
(What was happening at the time?)
(How often during the past month?)
Do you tend to get anxious in certain situations, such as travelling or being alone, or being in a lift or tube train?
0
Not present
1
Has not been in such situations during past month but aware that anxiety would have been present if the situation had occurred
2
Situation has occurred during past month and subject did feel anxious because of it
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(What situations? How often in the past month?)
(CHECKLIST: make a note of each situation:
Crowds (shop, street, theatre, cinema, church)
Going out alone; being at home alone.
Enclosed spaces (hairdressers, phone booth, tunnel)
Open spaces, bridges
Traveiling (buses, cars, trains))
What about meeting people e.g. going into a crowded room, making conversation?
0
Not present
1
Has not been in such situations during past month but aware that anxiety would have been present if the situation had occurred
2
Situation has occurred during past month and subject did feel anxious because of it
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(CHECKLIST: make a note of each situation:
Speaking to an audience.
Eating, drinking or writing in front of other people.
Parties.)
Do you have any special fears, like some people are scared of feathers, or cats, or spiders, or birds?
0
Not present
1
Has not been in such situations during past month but aware that anxiety would have been present if the situation had occurred
2
Situation has occurred during past month and subject did feel anxious because of it
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(CHECKLIST: make a note of each situation:
Heights , thunderstorms, darkness, animals or insects of any kind, dentists, injections, blood, injury)
Do you avoid any of these situations (specify as appropriate) because you know you will get anxious?
0
No avoidance
1
Subject tends to avoid such situations whenever possible
2
Marked generalisation of avoidance has occurred during past month e.g. subject has not dared leave the house or has gone out only if accompanied
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(How much does it affect your life?)
Do you avoid any of these situations (specify as appropriate) because you know you will get anxious?
Generic text

4. THINKING, CONCENTRATION, INTERESTS

** Can you think clearly or is there any interference with your thoughts?
Generic text
** Do your thoughts tend to be muddled or slow?
0
Not present
1
Symptom definitely present during the past month, but of moderate clinical intensity, or intense less than 50% of the time
2
Symptom clinically intense more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Can you make up your mind about simple things quite easily?)
(Make decisions about everyday matters?)
Are you in full control of your thoughts? Can people read your mind? Who? How? Is anything like hypnotism or telepathy going on? Are thoughts put into your head which are not your own? Do you feel under the control of some force or power other than yourself?
Generic text
IF DELUSIONS OF THOUGHT INSERTION ETC. (SYMPTOMS 55-59) MAY BE PRESENT,
1
Tick here
IF DELUSIONS OF CONTROL (SYMPTOM 71) MAY BE PRESENT,
1
Tick here
** What has your concentration been like recently?
0
Not present
1
Only moderate form of symptom present in past month ( e.g. can read a short article, can concentrate if tries hard) or intense less than 50% of the time
2
Symptom clinically intense (cannot attempt to read or concentrate) more than 50% of past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Can you read an article in the paper or watch a TV programme right through?)
(Do your thoughts drift off so that you don't take things in?)
** Do you tend to brood on things?
0
Not present
1
Symptom has caused moderate impairment to work or social relationships
2
Marked impairment
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(So much that you even neglect your work?)
** What about your interests, have they changed at all?
0
Not present
1
Symptom definitely present during past month but of moderate clinical severity or severe less than 50% of the time
2
Symptom clinically severe more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Have you lost interest in work, or hobbies or recreations?)
(Have you let your appearance go?)

5. DEPRESSED MOOD

** Do you keep reasonably cheerful or have you been very depressed or low-spirited recently?
Generic text
** Have you cried at all?
0
Not present
1
Only moderately depressed during past month , or deep depression for less than 50% of the time and tending to vary in intensity
2
Deeply depressed for more than 50% of the past month , and tending to be unvarying in intensity
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(When did you last really enjoy anything?)
** How do you see the future?
0
Not present
1
Hopelessness of moderate intensity but still has some degree of hope for the future (irrespective of time during month)
2
Intense form of symptom (patient has given up hope altogether)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Has life seemed quite hopeless?)
(Can you see any future?)
(Have you given up or does there still seem some reason for trying?
USE JUDGEMENT ABOUT WORDING THE FOLLOWING:
** Have you felt that life wasn't worth living?
0
Never deliberately considered suicide
1
Deliberately considered suicide (not just a fleeting thought) but made no attempt
2
Suicidal attempt but suicide's life never likely to be in serious danger, except unintentionally
3
Suicidal attempt apparently designed to end in death (i.e. accidental discovery or inefficient means)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Did you ever feel like ending it all?)
(What did you think you might do?)
(Did you actually try?)
(N.B. Examiner should judge clinically whether there was intent to end life or not. If in doubt, assume not.)
** Have you felt that life wasn't worth living?
Generic text
Which seems worse, the depression or the anxiety? (use subject's own terms)
0
Anxiety primary
1
Anxiety and depression both present but seem independent of each other
2
Depression primary
8
Examiner unsure
9
Not applicable or not appropriate e.g. question not asked
Is the depression worse at any particular time of day?
0
No depression
1
Not specially marked in mornings
2
Specially marked in mornings
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked

6. SELF AND OTHERS

** Have you wanted to stay away from other people?
0
Not present
1
Only passive form of symptom i.e. subject does not seek company but does not refuse it if offered, or, if active withdrawal, less than 50% of the month
2
Actively avoids company (refuses it if offered) ; actively withdrew in this way for more than 50% of the month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Why?)
(Have you been suspicious of their intentions? Of actual harm?)
** What is your opinion of yourself compared to other people?
0
Not present
1
Some inferiority, not amounting to feeling of worthlessness. If subject considers self to be worthless, this intense form of the symptom is present less than 50% of the time
2
Subject considers self to be completely worthless. Symptom present more than 50% of the month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you feel better, or not as good, or about the same as most?)
(Do you feel inferior or even worthless?)
** How confident do you feel in yourself?
0
Not present
1
Moderate lack of self-confidence, or intense lack for less than 50% of the month
2
Intense lack of self-confidence for more than 50% of the month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(For example, in talking to others, in managing with other people?)
** Are you self-conscious in public?
0
Not present
1
Marked self-consciousness only (irrespective of time during month)
2
Feels that people are criticising or laughing at self but can be reassured
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you get the feeling that other people are taking notice of you in the street or a bus or a restaurant?)
(Do they ever seem to laugh at you or talk about you critically?)
(Do you consider people really are looking at you, or is it perhaps the way you feel about it?)
IF NO EVIDENCE OF GUILT, OR OF DELUSIONS OF REFERENCE OR PERSECUTION, PROCEED TO NEXT **
Do you have the feeling that you are being blamed for something or even accused? What about?
0
Not present
1
Subject feels blamed but not accused (irrespective of time during month)
2
Subject feels accused of some sin or misdemeanour; not delusional
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
Do you tend to blame yourself at all?
0
Not present
1
Subject feels over guilty about some peccadillo (irrespective of time during month)
2
Subject feels to blame for everything that has gone wrong even when not his fault , but not that he has committed a serious crime or sin ; not delusional
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(If people are critical, do you think you deserve it?)
Do you feel you have committed a crime or sinned greatly or deserve punishment?
Generic text
(Have you felt you might contaminate or ruin other people?)
IF DEPRESSIVE DELUSIONS (SYMPTOMS 88, 91, 92) MAY BE PRESENT
1
Tick here
Do people seem to drop hints or say things with a double meaning? Do things seem specially arranged?
Generic text
(Do people follow you about?)
(Do you see any reference to yourself on TV or in the papers?)
(How do you explain it?)
IF DELUSIONS OF REFERENCE OR MISINTERPRETATION (SYMPTOMS 72 and 73) MAY BE PRESENT
1
Tick here
Is anyone trying to harm you?
Generic text
(How? Is there any organization behind it?)
(How do you explain it?)
IF DELUSIONS OF PERSECUTION (SYMPTOM 74) MAY BE PRESENT
1
Tick here

7. APPETITE, SLEEP, RETARDATION, LIBIDO

** What has your appetite been like recently?
0
No weight loss
1
Less than 7 lb.
2
7 lb. or more
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
(Have you lost any weight during the past 3 months?)
** Have you had any trouble getting off to sleep during the past month?
0
Not present
1
One hour or more delay (irrespective of sleeping tablets)
2
Two hours or more delay (irrespective of sleeping tablets) (In either case 10 or more nights during month)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(How long do you lie awake?)
(What happens if you take sleeping tablets?)
(How often does it happen?)
** Do you seem to be slowed down in your movements, or have too little energy recently? How much has it affected you?
0
Not present
1
Marked subjective listlessness and lack of energy
2
Marked retardation and underactivity (irrespective of time during month)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do things seem to be moving too fast for you?)
IF NO APPETITE OR SLEEP DISTURBANCE, AND NO DEPRESSION PROCEED TO NEXT **
Do you wake early in the morning?
0
Not present
1
One- two hours before ordinary time
2
Two hours or more before ordinary time (In either case, 10 or more nights during month)
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Use discretion whether to ask this)
Has there been any change in your interest in sex?
0
Not present
1
Marked loss of interest and performance
2
Almost total loss of libido
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
Ask if appropriate:
Does the depression or tension get worse just before the start of the monthly period?
0
No definite exacerbation
1
Marked exacerbation
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked

8. IRRITABILITY

** Have you been very much more irritable than usual recently?
0
Not present
1
Keeps irritation to self
2
Shows anger by shouting or quarrelling
3
Shows anger by hitting people, throwing or breaking things
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(How do you show it?)
(Do you keep it to yourself, or shout, or even hit people?)

9. EXPANSIVE MOOD AND IDEATION

** Have you sometimes felt particularly cheerful and on top of the world, without any reason?
0
Not present
1
Moderately expansive mood (euphoria with marked element of inappropriateness or excitement, whether recognised by subject or not), present during past month, and persistent for hours at a time. Do not include transient high spirits. Not necessarily described by subject
2
Intense form of symptom (elation or exaltation) definitely present during past month and persistent for hours at a time. Described by subject
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Too cheerful to be healthy?)
(How long does it last?)
** Have you felt particularly full of energy lately, or full of exciting ideas?
0
Not present
1
Subjective equivalent of flight of ideas. Images and ideas flash through the mind, each suggesting others, at a faster rate than usual. State persists for hours at a time
2
As (1) but accompanied by very high energy output and activity which does not seem to make subject tired at the time. Definitely occurred during past month and persisted for hours at a time
8
Examiner unsure although question asked
9
Not applicable or not appropriate e .g. question not asked
(Do things seem to go too slowly for you?)
(Do you need less sleep than usual?)
(Do you find yourself extremely active but not getting tired?)
(Have you developed new interests recently?)
IF NO EVIDENCE OF EXPANSIVE MOOD AND IDEATION, PROCEED TO NEXT **
Have you seemed super-efficient at work, or as though you had special powers or talents quite out of the ordinary?
0
Not present
1
Subjective feeling of superb health, exceptionally high intelligence, extraordinary abilities, etc. Persistent for hours at a time. Symptom occurred at some time during the month
2
Grandiose ideas have been translated into action during the month e.g. overspending, gambling, etc. under the influence of grandiose ideas and expansive affect. Do not include compulsive gambling unless clearly of this type
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Have you felt specially healthy?)
(Have you been buying any interesting things recently?)
Is there anything special about you?
Generic text
(Is there a special purpose or mission to your life?)
(Are you specially clever or inventive?)
(Are you a very prominent person?)
(How do you explain this?)
IF GRANDIOSE DELUSIONS (SYMPTOMS 75-77) MAY BE PRESENT
1
Tick here

10. OBSESSIONS

These symptoms are usually experienced as occurring against conscious resistance. (See definition in glossary)
** Do you find that you have to keep on checking things that you know you have already done?
0
Not present
1
Symptom of moderate intensity or if severe, present less than 50% of the time
2
Symptom present in severe degree for more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Like gas taps, doors, switches, etc.)
(Do you have to touch or count things many times or repeat the same action over and over again?)
(What happens when you try to stop?)
** Do you spend a lot of time on personal cleanliness, like washing over and over again even though you know you are clean? What about tidiness?
0
Not present
1
Symptom of moderate intensity or if severe, present less than 50% of the time
2
Symptom present in severe degree for more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you get worried by contamination with germs?)
(Do you have other rituals?)
(What happens when you try to stop?)
** Do you find it difficult to make decisions even about trivial things?
0
Not present
1
Symptom of moderate intensity or if severe, present less than 50% of the time
2
Symptom present in severe degree for more than 50% of the past month
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you constantly have to question the meaning of the universe?)
(Do you get awful thoughts coming into your mind even when you try to keep them out?)
(What happens when you try to stop?)

11. DEPERSONALISATION AND DEREALISATION

** Have you had the feeling recently that things around you were unreal?)
0
Not present
1
Moderately intense form of symptom definitely occurred during past month, and persisted for hours at a time. Things appear colourless and artificial, people appear lifeless and seem to act rather than being themselves
2
Intense form of symptom occurred during month and persisted for hours at a time. e .g. whole world appears like a gigantic stage-set, with imitation instead of real objects and puppets instead of people
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(As though everything was an imitation of reality, like a stage set, with people acting instead of being themselves?)
(What is it like? How do you explain it?)
** Have you yourself felt unreal, that you were not a person, not in the living world?
0
Not present
1
Moderately intense form of the symptom definitely occurred during past month and persisted for hours at a time. Subject feels himself unreal, a sham, a shadow
2
Intense form of symptom definitely occurred during past month and persisted for hours at a time. Subject feels he is dead, not a person , living in a parallel existence, a hollow shell, even that he does not exist
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Or that you were outside yourself, looking at yourself from outside?)
(Or that you look unreal in the mirror?)
(Or that some part of your body did not belong to you?)
(How do you explain it?)

12. OTHER PERCEPTUAL DISTORTION, ETC.

** Does your imagination ever play tricks on you?
Generic text
** Do you get the feeling something odd is going on you can't explain?
Generic text
** Is there anything unusual about the way things look or sound or smell or taste?
Generic text
(Is your own appearance normal?)
(How do you explain it?)
IF PERCEPTUAL DISTORTION (SYMPTOMS 49-54) MAY BE PRESENT
1
Tick here
* * Do you ever seem to hear what seem to be voices when nobody is about?
Generic text
(When? What is it like?)
(What are the words? Is there more than one person?)
(How do you explain it?)
IF AUDITORY HALLUCINATIONS (SYMPTOMS 60-64) MAY BE PRESENT
1
Tick here
** Have you ever had a vision or seen things other people couldn't see?
Generic text
(When? What is that like?)
(How do you explain it?)
IF VISUAL HALLUCINATIONS (SYMPTOMS 64, 66, 67) MAY BE PRESENT
1
Tick here
IF YOU SUSPECT OTHER DELUSIONS MAY BE PRESENT
1
Tick here

16. SENSORIUM AND FACTORS AFFECTING, AND TREATMENT

** Have you had any lapses of memory recently?
Generic text
** Have there been any periods in which you completely forgot what happened?
0
Not present
1
Less than 12 hours
2
12-14 hours
3
More than 24 hours
8
Examiner unsure although questions asked
9
Not applicable or not appropriate e.g. question not asked
(What was it like?)
(How do you explain it?)
IF NO EVIDENCE OF POOR MEMORY, PROCEED TO **
May I ask one or two standard questions we ask of everybody?
0
Not present
1
Mild
2
Moderate
3
Severe
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
How old are you?
When is your birthday?
Can you tell me the year and the month?
What is the name of the Prime Minister?
** What medicines or drugs do you take?
Long text
** What medicines or drugs do you take?
0
Not present
1
Cannabis
2
Barbiturates, etc
3
LSD, amphetamines, etc
4
Heroin, cocaine, etc
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Do you take anything for your nerves or your mood?)
(Who prescribes them? Do you buy them over the counter?)
(What about other types of drugs, like cannabis?)
** May I ask about your drinking habits?
Generic text
** How much do you usually drink each day?
0
Not present
1
Agrees alcohol has been a problem but not 2
2
Any check list item applies
8
Examiner unsure although question asked
9
Not applicable or not appropriate e.g. question not asked
(Is alcohol in any way a problem for you?)
(In what way?)
(CHECKLIST: During the past month have you: Had family problems because of your drinking? Missed work because of drinking? Had morning shakes? Had blackouts for several hours? Heard voices or seen visions?)
Take subjects' previous replies into account when asking next 3 questions
** I have been asking about the last month; now may I ask if there has been any time in the past year when you have felt consistently sad and low spirited for a considerable period?
0
No
1
Yes
8
Examiner unsure
9
Not applicable
(When was that? ... )
Generic text
** Has there been any time during the past year when you have felt anxious or fearful or nervous over a considerable period? (Such that you were prone to nervous sweating, trembling or 'butterflies' in the stomach?)
0
No
1
Yes
8
Examiner unsure
9
Not applicable
(When was that? ... )
Generic text
** Has there been any time during the past year when you have felt full to overflowing of energy or exciting ideas for days at a stretch? (Such that you needed less sleep than usual?)
0
No
1
Yes
8
Examiner unsure
9
Not applicable
(When was that? ... )
Generic text
** May I ask if you are seeing a doctor for your nerves?
Generic text
(Or specify any psychosomatic complaints?)
** What kind of doctor is he?
0
No doctor
1
GP
2
Private doctor other than GP
3
Psychiatrist
4
Hospital out-patient (other than psychiatrist)
5
Other paramedical specialist or osteopath
6
Other - please specify
Other
(Your own GP, a private doctor, a psychiatrist, at hospital outpatients?)
** Have you seen a doctor in the past year for any nervous condition?
Generic text
what kind of doctor?
Generic text
When was that?
Generic text
** Are you attending for treatment, any person who is not medically qualified e.g. lay therapist, herbalist, acupuncturist, faith healer, Christian Scientist, church which forbids medical advice? Or have you done so in the past year?
Generic text
** Are you attending for treatment, any person who is not medically qualified e.g. lay therapist, herbalist, acupuncturist, faith healer, Christian Scientist, church which forbids medical advice? Or have you done so in the past year?
Long text
(When?)
(What were you complaining of at the time?)
Now return to Questionnaire A, page 18, question 73
Name

1982 Present State Examination