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Psychosis Interview

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    WMHSCID2000 11/12/01 Overview 3

    EDUCATION AND WORK HISTORY

    How far did you get in school?(How much schooling have you had?)

    IF FAILED TO COMPLETE APROGRAM IN WHICH THEY WEREENROLLED: Why didnt you finish?

    YEARS OF EDUCATION:

    __________________________________________

    __________________________________________

    __________________________________________

    What kind of work do you do?(Do you work outside of your home?)

    Are you working now?

    IF YES: How long have you workedthere?

    IF LESS THAN 6 MONTHS: Whydid you leave your last job?

    Have you always done that kind ofwork?

    IF NO: Why is that? What kindof work have you done?

    How are you supporting yourselfNow?

    IF UNKNOWN: Has there ever been a periodof time when you were unable to work or go

    to school?

    IF YES: When? Why was that?

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

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    WMHSCID2000 11/12/01 Overview 4

    PAST PERIODS OF PSYCHOPATHOLOGY

    (THE LIFE CHART ON PAGE X OFOVERVIEW MAY BE USED TO DOCUMENTA COMPLICATED HISTORY OF

    PSYCHOPATHOLOGY AND TREATMENTOR OTHER LIFE EVENTS)

    Have you ever seen anybody for emotional orpsychiatric problems?

    IF YES: Could you tell me what that waslike (in your own words)?

    IF NO: Have you ever had emotional orpsychiatric problems that you didntdiscuss with a doctor or anyone like that?

    IF NO: Was there ever a time when you,or someone else, thought you should seesomeone because of the way you werefeeling or acting?

    Have you ever taken any medications (foremotional or psychological problems)?

    Can you tell me briefly what that was like?

    What about treatment for drugs or alcohol?

    ___________________________________________

    ___________________________________________

    ___________________________________________

    Treatment for emotional problems 1 NO

    with a physician or mental health 2 YESprofessional

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    P05

    Have you ever been in a hospital fortreatment of psychiatric or emotionalproblems?

    IF YES: What was that for? (How manytimes?)

    IF GIVES AN INADEQUATE ANSWER,CHALLENGE GENTLY:e.g., Wasnt there something else? Peopledont usually go to (psychiatric) hospitalsjust because they are tired or nervous.

    Number of previous hospitalizations 0(Do not include transfers) 1

    2345 (or

    more)

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    P06

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    WMHSCID2000 11/12/01 Overview 5

    Now, thinking back over just the past 12months, that is since MONTH YEAR, whenwere you the most upset?

    (Can you tell me briefly what that was

    like?)

    And when were you feeling the best you havefelt in the past 12 months?

    (What was that like?)

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    PSYCHOPATHOLOGY DURING THE PASTMONTH

    Now I would like to ask you about the pastmonth. How have things been going for you?

    Has anything happened that has beenespecially hard for you?

    How has your mood been?

    Do you take any medications or vitamins?

    ___________________________________________

    ___________________________________________

    ___________________________________________

    CURRENT SOCIAL FUNCTIONING

    How have you been spending your free time?

    Who do you spend time with?

    What do you worry about most?

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    WMHSCID2000 11/12/01 Overview 6

    SUBSTANCE ABUSE HISTORYHow much have you been drinking (alcohol)(in the past month)?

    When in your life were you drinking the most?How often? How much?

    How long did this period last?

    How many periods like this have you had?

    Have you been taking any drugs (in the pastmonth)?IF NECESSARY: Have you ever usedrecreational drugs?

    What recreational drugs have you used?When were you using most heavily?What were you using?How often were you using?How long did this period last?

    How many periods like this have you had?

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    SCREEN FOR HEAD INJURYHave you ever had an injury to your head,maybe in a fall, car accident, or fight?

    IF YES: Did you get knocked out? Do youknow how long you were unconscious?

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

    ___________________________________________

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    WMHSCID2000 3/5/03 Overview 7

    LIFE CHART

    Age (or date) Description (symptoms, triggering events) Treatment

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    _____ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    ______ ___________________________________________________ ______________

    IF R APPEARS UNABLE TO COMPLETE THE INTERVIEW DUE TO THE INTERFERENCE OF DEMENTIA OR OTHER

    ORGANIC FACTORS, PLEASE GO TO DEMENTIA SCREENING AT THE END OF THE INTERVIEW.

    IF R APPEARS TO BE UNDER THE INFLUENCE OF PSYCHOACTIVE SUBSTANCES OR INTOXICATED,

    DISCONTINUE THE INTERVIEW AND RESCHEDULE IT FOR ANOTHER TIME.

    GO TO SCREENING MODULE.

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    WMHSCID2000 3/5/03 Screening Module 1

    REVISED SCID SCREENINGMODULE(PSYCHOTIC DISORDERS)

    Now I want to ask you some more

    specific questions about problemsyou may have had.

    CIDI SC 21

    + You said in the earlier interviewthat you have had ...

    ? Did you ever have...

    - SKIP

    ... a period lasting several daysor longer when most of the dayyou felt sad, empty, ordepressed.

    1 2NO Yes

    SC03

    CIDI SC 22

    + You said in the earlier interviewthat you have had ...

    ? Did you ever have...

    - SKIP

    ... a period lasting several daysor longer when most of the dayyou were very discouragedabout how things were going inyour life.

    1 2NO Yes

    SC04

    CIDI SC 23

    + You said in the earlier interviewthat you have had ...

    ? Did you ever have...

    - SKIP

    ... a period lasting several daysor longer when you lost interestin most things you usually enjoylike work, hobbies, and personalrelationships.

    1 2NO Yes

    SC05

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    WMHSCID2000 3/5/03 Screening Module 2

    CIDI SC 24

    + You said in the earlier interviewthat you have had ...

    ? Did you ever have...

    - SKIP

    Some people have periodslasting several days or longer

    when they feel much moreexcited and full of energy thanusual. Their minds go too fast.They talk a lot. They are veryrestless or unable to sit still andthey sometimes do things thatare unusual for them, such asdriving too fast or spending toomuch money.

    a period like this lastingseveral days or longer?

    1 2NO Yes

    SC20

    CIDI SC 25a

    + You said in the earlier interviewthat you have had ...

    ? Did you ever have...

    - SKIP

    a period lasting several daysor longer when most of the timeyou were so irritable that youeither started arguments,

    shouted at people, or hitpeople?

    1 2NO Yes

    SC21

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    WMHSCID2000 3/5/03 Psychosis 1

    s

    INSTRUCTIONS TO INTERVIEWERS

    1. COMPLETE THE PSYCHOTIC SYMPTOMS MODULE.

    2. UPON COMPLETING THE PSYCHOTIC SYMPTOMS MODULE, IF THERE IS NO EVIDENCE OFPSYCHOSIS (THERE ARE NO ITEMS CODED 3 IN B. PSYCHOTIC AND ASSOCIATEDSYMPTOMS)END THE INTERVIEW.

    3. IF THE PERSON IS POSITIVE FOR PSYCHOTIC SYMPTOMS (ONE OR MORE ITEMS ARECODED 3 IN B. PSYCHOTIC AND ASSOCIATED SYMPTOMS)AND THE PERSON HAS SCREENED IN FOR DEPRESSIVE OR MANIC SYMPTOMS,COMPLETE THE MOOD DISORDER MODULE AND THEN COMPLETE THE C. DIFFERENTIALDIAGNOSES MODULE

    4. IF THE PERSON IS POSITIVE FOR PSYCHOTIC SYMPTOMS (ONE OR MORE ITEMS ARECODED 3 IN B. PSYCHOTIC AND ASSOCIATED SYMPTOMS)AND THE PERSON HAS NOT SCREENED IN FOR DEPRESSIVE OR MANIC SYMPTOMS,COMPLETE THE C. DIFFERENTIAL DIAGNOSES MODULE

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    WMHSCID2000 3/5/03 Psychosis 2

    *PSYCHOTIC AND ASSOCIATED SYMPTOMS*

    THIS MODULE IS FOR CODING PSYCHOTIC AND ASSOCIATED SXS THAT HAVE BEEN PRESENT ATANY POINT IN RESPONDENTS LIFE

    FOR EACH PSYCHOTIC SYMPTOM CODED 3, DESCRIBE THE ACTUAL CONTENT AND INDICATETHE PERIOD OF TIME DURING WHICH THE SYMPTOM WAS PRESENT.

    IF ALREADY HAS ACKNOWLEDGEDPSYCHOTIC SYMPTOMS: Youve toldme about (PSYCHOTIC SYMPTOMS).Now Id like to ask you about otherexperiences like that.

    IF NO ACKNOWLEDGEMENT OFPSYCHOTIC SYMPTOMS SO FAR:Now Id like to ask you about unusualexperiences (or ideas) which peoplesometimes have.

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    WMHSCID2000 3/5/03 Psychosis 3

    *DELUSIONS*

    DELUSIONSFalse personal beliefs based on incorrectinference about external reality and firmlysustained in spite of what constitutes

    incontrovertible and obvious proof or evidence tothe contrary.

    The belief is not one ordinarily accepted by othermembers of the persons culture or subculture.

    Code overvalued ideas (unreasonable andsustained beliefs that are maintained with lessthan delusional intensity) as 2.

    CIDI PS 1e

    + You said in the earlierinterview that you have had atime when you believed...

    ? Did you ever have a timewhen you believed ...

    - SKIP

    ... that some strange force was trying tocommunicate directly with you by sendingspecial signs or signals that you couldunderstand but that no one else couldunderstand. Sometimes this happens byspecial signs coming through the radio ortelevision.

    1 2NO Yes

    B001

    Could you give me an example of a time when this happened?

    Can you tell me more about what happened?

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    WMHSCID2000 3/5/03 Psychosis 4

    IF NECESSARY:Has it ever seemed like people weretalking about you or taking special notice ofyou?

    IF YES: Were you convinced theywere talking about you or did you thinkit might have been your imagination?

    What about receiving special messagesfrom the TV, radio or newspaper, or fromthe way things were arranged around you?

    Delusions of reference, i.e.events, objects, or otherpeople in the individualsimmediate environment have

    a particular or unusualsignificance.

    DESCRIBE:

    1 2 3 _ 8 9 B002

    CIDI PS 1f

    + You said in the earlier interviewthat you have had a time whenyou believed...

    ? Did you ever have a time whenyou believed ...

    - SKIP

    ... that there was an unjust plotgoing on to harm you or to havepeople follow you that yourfamily and friends did notbelieve was true?

    1 2NO Yes

    B003

    Could you give me an example of a time when this happened?

    Can you tell me more about what happened?

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    WMHSCID2000 3/5/03 Psychosis 5

    IF NECESSARY:What about anyone going out of their wayto give you a hard time, or trying to hurtyou?

    Persecutory delusions,i.e., the individual (orhis/her group) is beingattacked, harassed,

    cheated, persecuted, orconspired against.

    DESCRIBE:

    1 2 3 _ 8 9 B004

    Did you ever feel that you were especiallyimportant in some way, or that you hadspecial powers to do things that otherpeople could not do?

    Grandiose delusion, i.e.,content involvesexaggerated power,knowledge or importance,or a special relationship toa deity or famous person

    DESCRIBE:

    1 2 3 _ 8 9 B005

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    WMHSCID2000 3/5/03 Psychosis 6

    Did you ever feel that something was verywrong with you physically even thoughyour doctor said nothing was wrong ... like

    you had cancer or some other terribledisease?

    Have you ever been convinced thatsomething was very wrong with the way apart or parts of your body looked?

    (Did you ever feel that something strangewas happening to parts of your body?)

    Somatic delusion, i.e.,content involves changeor disturbance in body

    appearance orfunctioning.

    DESCRIBE:

    1 2 3 _ 8 9 B006

    Did you ever have any unusual religiousexperiences?

    (Did you ever feel that you had committeda crime or done something terrible forwhich you should be punished?)

    Other delusionsCheck if:___ religious delusions___ delusions of guilt___ jealous delusions___ erotomanicdelusions

    DESCRIBE:

    1 2 3 _ 8 9 B007

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    WMHSCID2000 3/5/03 Psychosis 7

    CIDI PS 1c

    + You said in the earlier interviewthat you have had a time whenyou experienced ...

    ? Did you ever have a time whenyou experienced ...

    - SKIP

    ... mind control. That is either

    (1) Believing that some

    mysterious force was insertingmany different strange thoughts-- that were definitely not yourown thoughts -- directly into yourhead by means of x-rays or laserbeams or other methods.

    (2) Or, believing that your ownthoughts were being stolen outof your mind by some strangeforce.

    1 2

    NO Yes

    B008

    CIDI PS 1d

    + You said in the earlier interviewthat you have had a time ...

    ? Did you ever have a time ...

    - SKIP

    ... when you felt that your mindwas being taken over by strangeforces?

    For example, feeling that yourmind was being taken over bystrange forces with laser beamsor other methods that weremaking you do things you didnot choose to do.

    1 2NO Yes

    B009

    Could you give me an example of a time when this happened?

    Can you tell me more about what happened?

    IF NECESSARY:

    Did you ever feel that someone or

    something outside yourself wascontrolling your thoughts or actionsagainst your will?

    (Did you ever feel that certainthoughts that were not your ownwere put into your head?)

    (What about taken out of yourhead?)

    Delusion of being controlled,i.e., feelings, impulses, thoughts

    or actions are experienced asbeing under the control of someexternal force.

    Check if:___ thought insertion___ thought withdrawal

    DESCRIBE:

    1 2 3 _ 8 9 B010

    B011B012

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    WMHSCID2000 3/5/03 Psychosis 8

    Did you ever feel as if your thoughtswere being broadcast out loud so thatother people could actually hear whatyou were thinking?

    Did you ever believe that someonecould read your mind?

    How do you explain [CONTENT OFDELUSION]?

    Thought broadcasting, i.e., thedelusion that ones thoughts areaudible to others.

    DESCRIBE:

    1 2 3 _ 8 9 B013

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    WMHSCID2000 3/5/03 Psychosis 9

    *AUDITORY HALLUCINATIONS*

    CIDI PS 1b

    + You said in the earlier interviewthat you have heard ...

    ? Did you ever hear ...

    - SKIP

    ... voices that other people couldnot hear. (I dont mean havinggood hearing, but rather) hearing

    things that other people said didnot exist, like strange voicescoming from inside your headtalking to you or about you, orvoices coming out of the air whenthere was no one around?

    1 2NO Yes

    B014

    Could you give me an example of a time when this happened?

    Can you tell me more about what happened?

    HALLUCINATIONS (PSYCHOTIC)A sensory perception that has thecompelling sense of reality of a trueperception but occurs withoutexternal stimulation of the relevantsensory organ. (ON SCID ITEMS,CODE 2 FOR HALLUCINATIONS

    THAT ARE SO TRANSIENT ASTO BE WITHOUT DIAGNOSTICSIGNIFICANCE.)

    IF NECESSARY:Did you ever hear things that otherpeople couldnt, such as noises, orthe voices of people whispering ortalking? (Were you awake at thetime?)

    IF YES: What did you hear?How often did you hear it?

    Auditory hallucinations when fullyawake, heard either inside oroutside of the head.

    DESCRIBE:

    1 2 3 _ 8 9 B015

    IF VOICES: Did theycomment on what you weredoing or thinking?

    A voice keeping up a runningcommentary on the individualsbehavior or thoughts as theyoccur

    1 2 3 _ 8 9 B016

    How many voices did youhear?Were they talking to each

    other?

    Two or more voices conversingwith each other

    1 2 3 _ 8 9 B017

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    WMHSCID2000 3/5/03 Psychosis 10

    *VISUAL HALLUCINATIONS*

    CIDI PS 1a

    + You said in the earlier interview that

    you have seen

    ? Did you ever see ...

    - SKIP

    ... a vision that other people

    could not see?

    1 2

    NO Yes B018

    Could you give me an example of a time when this happened?

    Can you tell me more about what happened?

    IF NECESSARY:Did you ever have visions or see thingsthat other people couldnt see? (Wereyou awake at the time?)

    NOTE: DISTINGUISH FROM ANILLUSION, I.E., A MISPERCEPTIONOF A REAL EXTERNAL STIMULUS

    Visual hallucinations

    DESCRIBE:

    1 2 3 _ 8 9 B019

    What about strange sensations in yourbody or on your skin?

    Tactile hallucinations, e.g.,electricity

    DESCRIBE:

    1 2 3 _ 8 9 B020

    What about smelling or tasting thingsthat other people couldnt smell ortaste?For example, tasting something thatwas not in your mouth?

    Other hallucinations, e.g.gustatory, olfactory

    Check if:

    ___ gustatory

    ___ olfactory

    DESCRIBE:

    1 2 3 _ 8 9 B021

    B031

    B032

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    WMHSCID2000 3/5/03 Psychosis 11

    *OTHER SYMPTOMS* OTHER SYMPTOMS

    IF NO SUGGESTION THAT THERE HAVE EVER BEEN PSYCHOTIC SYMPTOMS,CHECK HERE ___ AND SKIP TO NEXT MODULE

    B022

    Grossly inappropriate affect:Affect that is clearly discordantwith the content of speech orideation, e.g., smiling whilediscussing being persecuted.

    DESCRIBE:

    1 2 3 _ 8 9 B023

    Disorganized speech:Frequent derailment(loosening of associations) orincoherence; derailment is apattern of speech in which theideas slip off the track ontoanother that is completelyunrelated or only obliquelyrelated. The person may shiftthe topic idiosyncratically fromone frame of reference toanother and things may besaid in juxtaposition that lack ameaningful relationship.Incoherence is speech that isessentially incomprehensibleto others because words orphrases are joined togetherwithout a logical or meaningfulconnection.

    DESCRIBE:

    1 2 3 _ 8 9 B024

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    WMHSCID2000 3/5/03 Psychosis 12

    *NEGATIVE SYMPTOMS* NEGATIVE SYMPTOMS

    FOR ANY NEGATIVE SYMPTOMS CODED 3, DETERMINE WHETHER THESYMPTOM IS DEFINITELY PRIMARY OR WHETHER IT IS POSSIBLY ORDEFINITELY SECONDARY, I.E., RELATED TO ANOTHER MENTAL

    DISORDER (E.G. DEPRESSION), A SUBSTANCE OR A GENERAL MEDICALCONDITION (E.G., MEDICATION-INDUCED AKINESIA), OR TO APSYCHOTIC SYMPTOM (E.G., COMMAND HALLUCINATIONS NOT TOMOVE).

    IF UNKNOWN: How do you spendyour time?

    Avolition: An inability toinitiate and persist in goal-directed activities. Whensevere enough to beconsidered pathological,avolition is pervasive andprevents the person from

    completing may different typesof activities (e.g., work,intellectual pursuits, self-care).

    1 2 3 _ 8 9 B025

    Alogia: Impoverishment inthinking that is inferred fromobserving speech andlanguage behavior. Theremay be restriction in theamount of spontaneousspeech and brief and concretereplies to questions (Poverty ofspeech). Sometimes thespeech is adequate in amountbut conveys little informationbecause it is overconcrete,overabstract, repetitive, orstereotyped (poverty ofcontent).

    1 2 3 _ 8 9 B026

    Affective flattening: Absence

    or near absence of signs ofaffective expression.

    1 2 3 _ 8 9 B027

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    WMHSCID2000 3/5/03 Psychosis 13

    NOTE TO INTERVIEWERS:

    IF: THERE ARE NO ITEMS CODED 3 IN B. PSYCHOTIC ANDASSOCIATED SYMPTOMS, CHECK HERE ___ AND END THEINTERVIEW.

    B028

    IF: THE PERSON IS POSITIVE FOR PSYCHOTIC SYMPTOMS (ONE OR MOREITEMS ARE CODED 3 IN B. PSYCHOTIC AND ASSOCIATED SYMPTOMS)

    AND THE PERSON HAS SCREENED IN FOR DEPRESSIVE OR MANICSYMPTOMS,

    COMPLETE THE MOOD DISORDER MODULE AND THEN COMPLETE THEC. DIFFERENTIAL DIAGNOSES MODULE

    B029

    IF: THE PERSON IS POSITIVE FOR PSYCHOTIC SYMPTOMS (ONE OR MOREITEMS ARE CODED 3 IN B. PSYCHOTIC AND ASSOCIATED SYMPTOMS)

    AND THE PERSON HAS NOT SCREENED IN FOR DEPRESSIVE OR MANICSYMPTOMS,

    COMPLETE THE C. DIFFERENTIAL DIAGNOSES MODULE

    B030

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    WMHSCID2000-1 3/5/03 Depression A. 1

    A. DEPRESSION

    WHEN RATING THE FOLLOWING ITEMS, REMEMBER YOU MUST HAVE ENOUGH INFORMATION FROM THE

    RESPONDENT TO ALLOW YOU TO JUDGE WHETHER MDE CRITERIA ARE PRESENT. IT IS NOT ENOUGH TO BASE

    THIS ON A YES OR NO ANSWER FROM THE RESPONDENT. DO NOT RATE PRESENT IF INSUFFICIENT EVIDENCE.

    RATE 9 (INADEQUATE INFORMATION).

    Now I am going to ask you some more questions about your mood.

    IF NECESSARY:Has there ever been a period of timewhen you were feeling (depressed ordown/OTHER PHRASE ABOVE) most of

    the day nearly every day? (What was thatlike?)

    IF YES: How long did it last? (Aslong as two weeks?)

    When was that?

    A. The following symptoms must havebeen present during the same two-week period and represent a changefrom previous functioning:

    (1) depressed mood most of theday, nearly every day, as indicated eitherby subjective report (e.g., feels sad or

    empty) or observation made by others(e.g., appears tearful).

    DESCRIBE, VERBATIM IF

    POSSIBLE:_________________________

    __________________________________

    ________________________

    _______________________________

    1 2 3 _ 8 9A001

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    WMHSCID2000-1 3/5/03 Depression A. 2

    INSTRUCTIONS TO INTERVIEWERS:

    IF THE PERSON HAS MET CRITERIA FOR DEPRESSED MOOD:

    REFERRING TO THE SPECIFIC PSYCHOTIC SYMPTOMS THE PERSON ENDORSEDEARLIER, ASK THE RESPONDENT WHETHER THEY HAVE HAD THESE MOOD

    SYMPTOMS DURING A TIME WHEN THEY WERE HAVING THE PSYCHOTICSYMPOTMS.

    INDICATE:____ YES____ NO

    A) IF YES: MAKE SURE THE PERSON MET THE MOOD CRITERIA DURING THATSPECIFIC TIME (I.E. MOST OF THE DAY, NEARLY EVERY DAY, FOR TWO ORMORE WEEKS).AND: IF POSSIBLE: FOCUS ON THE TWO-WEEK PERIOD WHEN PSYCHOTICSYMPTOMS AND DEPRESSIVE MOOD SYMPTOMS CO-OCCURRED IN ASKINGREMAINING ITEMS.

    IF TIME PERIOD IS ASSOCIATED WITH BEREAVEMENT, INQUIRE ABOUTADDITIONAL TIMES OF CO-OCCURING DEPRESSION AND PSYCHOTICSYMPTOMS

    B) IF NO: GO ON TO THE MANIA SECTION (P. A10)

    IF THE PERSON HAS NOT MET CRITERIA FOR DEPRESSED MOOD:

    GO ON TO THE MANIA SECTION (P.A10)

    A096

    A097

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    WMHSCID2000-1 3/5/03 Depression A. 3

    . . . what about losinginterest or pleasure in things you usuallyenjoyed?

    IF YES: Was it nearly every day?How long did it last? (As long as

    two weeks?)

    (2) markedly diminished interest orpleasure in all, or almost all, activitiesmost of the day, nearly every day (asindicated either by subjective account orobservation made by others).

    DESCRIBE,VERBATIM IF

    POSSIBLE:________________________

    _________________________________

    ________________________

    _________________________________

    ______________________________

    1 2 3 _ 8 9 A003

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    WMHSCID2000-1 3/5/03 Depression A. 4

    IDENTIFY THIS TWO WEEKPERIOD WITH APPROPRIATEANCHORING EVENT:

    ______________________

    During this (TWO WEEK PERIOD) . . .

    . . did you lose or gain anyweight? (How much?) (Were you tryingto lose weight?)

    IF NO: How was your appetite?(What about compared to your usualappetite?) (Did you have to forceyourself to eat?) (Did you Eat[less/more] than usual?) (Was thatnearly every day?)

    (3) significant weight loss when notdieting, or weight gain (e.g., a change ofmore than 5% of body weight in a month)or decrease or increase in appetite nearlyevery day.

    Check if:

    ____ weight loss or decreasedappetite

    ____ weight gain or increasedappetite

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    ___

    1 2 3 _ 8 9 A004

    A005

    A006

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    WMHSCID2000-1 3/5/03 Depression A. 5

    . . how were you sleeping?(Did you have trouble falling asleep,trouble staying asleep, waking frequently,waking too early, OR sleeping too much?How many hours a night compared tousual? Was that nearly every night?)

    (4) insomnia or hypersomnia nearly everyday

    Check if:

    ____ insomnia

    ____ hypersomnia

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    ________________

    1 2 3 _ 8 9 A007

    A008

    A009

    . . were you talking ormoving more slowly than is normal foryou? (Was it so bad that other peoplenoticed it? What did they notice?Was that nearly every day?)

    What about the opposite

    . Were you so fidgety orrestless that you were unable to sitstill? (Was it so bad that other peoplenoticed it? What did they notice?Was that nearly every day?

    (5) psychomotor retardation or agitationnearly every day (observable by others,not merely subjective feelings ofrestlessness or being slowed down)

    NOTE: CONSIDER BEHAVIORDURING THE INTERVIEW

    Check if:

    ____ psychomotor retardation

    ____ psychomotor agitation

    DESCRIBE:______________________________

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    1 2 3 _ 8 9 A010

    A011

    A012

    . . what was your energy like?(Tired all the time? Nearly every day?)

    (6) fatigue or loss of energy nearly everyday

    DESCRIBE:______________________________

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    1 2 3 _ 8 9 A013

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    WMHSCID2000-1 3/5/03 Depression A. 6

    During this time . . .

    . . how did you feel aboutyourself/how do you value yourself as aperson? (Worthless?) (Nearly everyday?)

    IF NOT: What about feeling guiltyabout things you had done or notdone? (Nearly every day?)

    (7) feelings of worthlessness or excessiveor inappropriate guilt (which may bedelusional) nearly every day (not merelyself-reproach or guilt about being sick)

    NOTE: CODE 1 OR 2 IF ONLY

    LOW SELF-ESTEEM.

    Check if:

    ____ worthlessness

    ____ inappropriate guilt

    DESCRIBE:

    ______________________________

    ____________________________________________________________

    ______________________________

    __________________________________

    1 2 3 _ 8 9 A014

    A015

    A016

    . . did you have troublethinking or concentrating? (What kinds ofthings did it interfere with?) (Nearly everyday?) (What about forgetting things orlosing things?)

    IF NO: Was it hard to makedecisions about everyday things?(Nearly every day?)

    (8) diminished ability to think orconcentrate, or indecisiveness, nearlyevery day (either by subjective account oras observed by others)

    Check if:____ diminished ability to think

    ____ indecisiveness

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    1 2 3 _ 8 9 A017

    A018

    A019

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    WMHSCID2000-1 3/5/03 Depression A.7

    . . were things so bad thatyou were thinking a lot about death or thatyou would be better off dead? Whatabout thinking of hurting yourself?

    IF YES: Did you do anything tohurt yourself?

    (9) recurrent thoughts of death (not justfear of dying), recurrent suicidal ideationwithout a specific plan, or a suicideattempt or a specific plan for committingsuicide

    NOTE: CODE 1 FOR SELF-

    MUTILATION W/O SUICIDALINTENT

    Check if:

    ___ thoughts of own death

    ___ suicidal ideation

    ___ specific plan

    ___ suicide attempt

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    1 2 3 _ 8 9 A020

    A021

    A022

    A023

    A024

    IF UNCLEAR: Has (DEPRESSIVEEPISODE/OWN WORDS) made ithard for you to do your work, takecare of things at home, or get alongwith other people?

    C. The symptoms cause clinicallysignificant distress or impairment insocial, occupational, or other importantareas of functioning

    NOTE ASPECTS OF IMPAIRMENT :

    _________________________________

    _________________________________

    ________________________

    NOTE: DSM-IV criterion B (i.e., does notmeet criteria for a Mixed Episode) hasbeen omitted from the SCID.

    1 2 3 _ 8 9 A025

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    WMHSCID2000-1 3/5/03 Depression A.8

    Just before this began, were youphysically ill?

    IF YES: What did the doctor say?

    (Were there any other changes in yourphysical health?)

    Just before this began, were you usingany medications?

    IF YES: Was there any change inthe amount you were using?

    Just before this began, were you drinkingor using any street drugs?

    D. The symptoms are not due to the directphysiological effects of a substance (e.g.,a drug of abuse, medication) or to ageneral medical condition.

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    ______________________________

    1 3 _ 9 A026

    Etiological substances include:alcohol, amphetamines, cocaine,hallucinogens, inhalants, opioids,phencyclidine, sedatives, hypnotics,anxiolytics. Medications includeantihypertensives, oral contraceptives,corticosteroids, anabolic steroids,anticancer agents, analgesics,anticholinergics, cardiac medications.

    Etiological general medical conditionsinclude: degenerative neurologicalillnesses (e.g., Parkinsons disease),cerebro-vascular disease (e.g., stroke),metabolic conditions (e.g., Vitamin B-12deficiency), endocrine conditions (e.g.,hyper- and hypo- thyroidism); viral orother infections (e.g., hepatitis,mononucleosis, HIV), and certain cancers(e.g., carcinoma of the pancreas).

    Etiological organic mental disordersinclude: dementias, delirium, organicamnesia syndrome, other mentaldisorders due to brain damage anddysfunction, and personality andbehavioral disorders due to braindisease, damage and dysfunction.

    IF THERE IS ANY INDICATION THAT THE

    DEPRESSION MAY BE SECONDARY (I.E., ADIRECT PHYSIO-LOGICAL CONSEQUENCE

    OF A GMC OR SUBSTANCE), GO TO *GMC/

    SUBSTANCE,* A. 21 , AND RETURN TO

    MAKE A RATING OF 1OR 3.

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    WMHSCID2000-1 3/5/03 Depression A. 9

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    31

    (Did this begin soon after someoneclose to you died?)

    E. The symptoms are not betteraccounted for by Bereavement, i.e.,after the loss of a loved one, thesymptoms persist for longer than 2months or are characterized bymarked functional impairment, morbid

    preoccupation with worthlessness,suicidal ideation, psychotic symptoms,or psycho motor retardation

    1 3 _ 9 A082

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    WMHSCID2000-1 3/5/03 Mania A. 10

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    32

    *MANIC EPISODE* MANIC EPISODE CRITERIA

    IF NECESSARY:Has there ever been a period of timewhen you were feeling so good,

    high, excited, or hyper that otherpeople thought you were not yournormal self or you were so hyper thatyou got into trouble? (Did anyonesay you were manic?) (Was thatmore than just feeling good?)

    IF NO: What about a period oftime when you were so irritablethat you found yourself shouting atpeople or starting fights orarguments?

    (Did you find yourself yelling atpeople you didnt really know?)

    What was it (/that) like?

    A. A distinct period ofabnormally and persistentlyelevated, expansive, or irritablemood

    Check if:

    ___ elevated, expansivemood

    ___ irritable mood

    1 2 3 _ 8 9 A083

    A098

    A099

    How long did that last? (As long asone week?) (Did you have to go intoa hospital?)

    ... lasting at least one week (orany duration if hospitalization isnecessary)

    1 2 3 _ 8 9 A084

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    WMHSCID2000-1 3/5/03 Mania A. 11

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    33

    INSTRUCTIONS TO INTERVIEWERS:

    IF THE PERSON HAS MET CRITERIA FOR MANIC MOOD:

    REFERRING TO THE SPECIFIC PSYCHOTIC SYMPTOMS THE PERSON ENDORSEDEARLIER, ASK THE RESPONDENT WHETHER THEY HAVE HAD THESE MOODSYMPTOMS DURING A TIME WHEN THEY WERE HAVING THE PSYCHOTIC

    SYMPOTMS.

    INDICATE:____ YES____ NO

    A) IF YES: MAKE SURE THE PERSON MET THE MOOD CRITERIA DURING THATSPECIFIC TIME (A DISTINCT MOOD FOR AT LEAST A WEEK, ORHOSPITALIZATION WAS NECESSARY).AND: IF POSSIBLE: FOCUS ON THE ONE-WEEK PERIOD WHEN PSYCHOTICSYMPTOMS AND MANIC MOOD SYMPTOMS CO-OCCURRED IN ASKINGREMAINING ITEMS.

    B) IF NO: GO ON TO COMPLETE C. DIFFERENTIAL DIAGNOSES

    IF THE PERSON HAS NOT MET CRITERIA FOR MANIC MOOD:

    GO ON TO COMPLETE C. DIFFERENTIAL DIAGNOSES

    A100

    A101

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    WMHSCID2000-1 3/5/03 Mania A. 12

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    34

    FOCUS ON THE WORST PERIOD.

    IF UNCLEAR: During (episode),when were you the most (OWNWORDS FOR MANIA)?

    During that time ...

    B. During the period of mooddisturbance, three (or more) ofthe following symptoms havepersisted (four if the mood isonly irritable) and have beenpresent to a significant degree:

    ... how did you feel about yourself?

    (Did you feel more self-confident thanusual?) (Did you feel like you hadany special powers or abilities?)

    (1) inflated self-esteem orgrandiosity

    1 2 3 _ 8 9 A085

    did you need less sleep thanusual?

    IF YES: Did you still feel rested?

    (2) decreased need for sleep(e.g., feels rested after onlythree hours of sleep)

    1 2 3 _ 8 9 A086

    ... were you much more talkative than

    usual? (Did people have troublestopping you or understanding you?Did people have trouble getting aword in edgewise?)

    (3) more talkative than usual

    or pressure to keep talking

    1 2 3 _ 8 9 A087

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    WMHSCID2000-1 3/5/03 Mania A. 13

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    35

    ... were your thoughts racing throughyour head?

    (4) flight of ideas orsubjective experience thatthoughts are racing

    1 2 3 _ 8 9 A088

    ... were you so easily distracted bythings around you that you hadtrouble concentrating or staying onone track?

    (5) distractibility (i.e.,attention too easily drawn tounimportant or irrelevantexternal stimuli)

    1 2 3 _ 8 9 A089

    ... how did you spend your time?(Work, friends, hobbies?) (Were youso active that your friends or familywere concerned about you?)

    IF NO INCREASED ACTIVITY:Were you physically restless?(How bad was it?)

    (6) increase in goal-directedactivity (either socially, atwork or school, or sexuality)or psychomotor agitation

    Check if:

    ___ increase in activity

    ___ psychomotor agitation

    1 2 3 _ 8 9 A090

    During that time ...

    ... did you do anything that couldhave caused trouble for you or yourfamily? (Buying things you didntneed?) (Anything sexual that wasunusual for you?) (Reckless driving?)

    (7) excessive involvement inpleasurable activities whichhave a high potential forpainful consequences (e.g.,engaging in unrestrainedbuying sprees, sexualindiscretions, or foolishbusiness investments)

    1 2 3 _ 8 9A091

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    WMHSCID2000-1 3/5/03 Mania A. 14

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    36

    AT LEAST THREE B SXSARE CODED 3 (FOUR IFMOOD ONLY IRRITABLE).

    Note: DSM-IV criterion C (i.e.,

    does not meet criteria for aMixed Episode) has beenomitted from the SCID.

    1 2 3 _ 8 9 A092

    IF NOT KNOWN: At that time, didyou have serious problems at home,or at work (school) because you(were/had) (SYMPTOMS) or did youhave to go into a hospital?

    (D) the mood disturbance issufficiently severe to causemarked impairment inoccupational functioning or inusual social activities orrelationships with others, or tonecessitate hospitalization toprevent harm to self or others,

    or there are psychotic features.

    DESCRIBE:

    _________________________

    1 2 3 _ 8 9 A093

    _________________________

    _________________________

    _________________________

    _________________________

    Just before this began, were youtaking any medications?

    IF YES: Any change in theamount you were taking?

    Just before this began, were youdrinking or using any street drugs?

    E. The symptoms are not dueto the direct physiologicaleffects of a substance (i.e., adrug of abuse, medication)

    1 2 3 _ 8 9 A094

    Just before this began, were youphysically ill?

    IF YES: What did the doctor say?

    ... or to a general medicalcondition

    1 2 3 _ 8 9 A095

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    WMHSCID2000-1 3/5/03 Mania A. 15

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    37

    IF THERE IS ANYINDICATION THAT MANIAMAY BE SECONDARY, I.E., ADIRECT PHYSIOLOGICALCONSEQUENCE OF A GMCOR SUBSTANCE, GO TO

    *GMS/SUBSTANCE.* A. 17,AND RETURN HERE TOMAKE A RATING OF 1 OR3.

    NOTE: MANIC-LIKEEPISODES THAT ARECLEARLY CAUSED BYSOMATIC ANTIDEPRESSANTTREATMENT (E.G.,MEDICATION,ECT, LIGHTTHERAPY) SHOULD NOT

    COUNT TOWARD ADIAGNOSIS OF BIPOLAR IDISORDER BUT A RECONSIDERED SUBSTANCE-INDUCED MOODDISORDERS, ??.

    Etiological general medicalconditions include:degenerative neurologicalillnesses (e.g., Huntingtonsdisease, multiple sclerosis),cerebrovascular disease (e.g.,stroke), metabolic conditions(e.g., Vitamin B-12 deficiency,Wilsons disease), endocrineconditions (e.g.,hyperthyroidism), viral or otherinfections, and certain cancers(e.g., cerebral neoplasms).

    Etiological substances include:

    alcohol, amphetamines,cocaine, hallucinogens,inhalants, opiods,phencyclidine, sedatives,hypnotics, and anxiolytics.Medications includepsychotropic medications (e.g.,antidepressants),corticosteroids, anabolicsteroids, isoniazid,antiparkinson medication (e.g.,levadopa), and

    sympathomimetics/decongestants

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    WMHSCID2000-1 3/5/03 GMC/Substance A. 16

    *GMC/SUBSTANCE CAUSING MOOD SYMPTOMS*

    MOOD DISORDER DUE TO AGENERAL MEDICAL CONDITION

    MOOD DISORDER DUE TO A GENERALMEDICAL CONDITION CRITERIA

    IF SYMPTOMS NOT TEMPORALLY ASSOCIATED WITH A GENERAL MEDICAL CONDITION,CHECK HERE ___ AND GO TO *SUBSTANCE-INDUCED MOOD DISORDER,* A. 19. A069

    CODE BASED ON INFORMATIONALREADY OBTAINED

    A. A prominent and persistentdisturbance in mood predominates in theclinical picture and is characterized byeither (or both) of the following:

    (1) depressed mood or markedlydiminished interest or pleasure inall, or almost all, activities

    (2) elevated, expansive, orirritable mood

    1 2 3 _ 8 9

    1 2 3 _ 8 9

    A070

    A071

    Do you think your (MOOD SXS) were inany way related to your (COMORBIDGENERAL MEDICAL CONDITION) ?

    IF YES: Tell me how.

    (Did the [MOOD SXS] start or get muchworse only after [COMORBID GENERALMEDICAL CONDITION] began?)

    B./C. There is evidence from the history,physical examination, or laboratoryfindings that the disturbance is the directphysiological consequence of a generalmedical condition and the disturbance isnot better accounted for by anothermental disorder (e.g., AdjustmentDisorder With Depressed Mood, inresponse to the stress of having a generalmedical condition).

    1 2 3 _ 8 9 A072

    IF YES AND GMC HASRESOLVED: Did the (MOODSXS) get better once the(COMORBID GENERALMEDICAL CONDITION) gotbetter?

    THE FOLLOWING FACTORS SHOULDBE CONSIDERED AND SUPPORT THECONCLUSION THAT THE GMC ISETIOLOGIC TO THE MOODSYMPTOMS:

    1) THERE IS EVIDENCE FROM THELITERATURE OF A WELL-ESTAB-LISHED ASSOCIATION BETWEEN THEGMC AND MOOD SYMPTOMS.

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    GO TO

    *SUB-

    STANCE

    INDUCED*

    A. 19

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    38

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    WMHSCID2000-1 3/5/03 GMC/Substance A. 17

    2) THERE IS A CLOSE TEMPORALRELATIONSHIP BETWEEN THECOURSE OF THE MOOD SYMPTOMSAND THE COURSE OF THE GENERALMEDICAL CONDITION.

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    3) THE MOOD SYMPTOMS ARECHARACTERIZED BY UNUSUALPRESENTING FEATURES (E.G., LATEAGE AT ONSET).

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    4) THE ABSENCE OF ALTER-NATIVEEXPLANATIONS (E.G., MOODSYMPTOMS AS A PSYCHOLOGICALREACTION TO THE GMC).

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    IF UNCLEAR: How much did (MOODSYMPTOMS) interfere with your life?

    E. The symptoms cause clinicallysignificant distress or impairment insocial, occupational, or other importantareas of functioning

    1 2 3 _ 8 9 A073

    GO TO

    *SUB-

    STANCE

    INDUCED*A19

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate information

    39

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    WMHSCID2000-1 3/5/03 GMC/Substance A. 18

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition

    9=inadequateinformation 40

    D. The disturbance does not occurexclusively during the course of Delirium.

    1 3 _ 9 A074

    DELERIUMDUE TO A

    GMC

    MOOD

    DIS-

    ORDER

    DUE TO

    A GMC

    RETURN TO M.D.E., A1

    RETURN TO MANIA A10

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    WMHSCID2000-1 3/5/03 GMC/Substance A. 19

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

    information 41

    *SUBSTANCE-INDUCED MOODDISORDER*

    SUBSTANCE-INDUCED MOODDISORDER CRITERIA

    IF SYMPTOMS NOT TEMPORALLY ASSOCIATED WITHSUBSTANCE, CHECK HERE ___ AND RETURN TO EPISODEBEING EVALUATED.

    A075

    CODE BASED ON INFORMATIONALREADY OBTAINED.

    A. A prominent andpersistent disturbancein mood predominates inthe clinical picture and is

    characterized by one (or both) of thefollowing:

    (1) depressed mood or markedlydiminished interest or pleasure inall, or almost all, activities

    1 2 3 _ 8 9 A076

    (2) elevated, expansive orirritable mood

    1 2 3 _ 8 9 A077

    IF NOT KNOWN: When did the (MOODSYMPTOMS) begin? Were you alreadyusing (SUBSTANCE) or had you juststopped or cut down your use?

    B. There is evidence from the history,physical examination or laboratoryfindings that either (1) the symptoms in Adeveloped during or within a month ofsubstance intoxication or withdrawal, or(2) medication use is etiologically relatedto the disturbance

    1 2 3 _ 8 9 A078

    Do you think your (MOOD SXS) are in

    any way related to your (SUBSTANCEUSE)?

    IF YES: Tell me how.

    ASK ANY OF THE FOLLOWINGQUESTIONS AS NEEDED TO RULEOUT A NON-SUBSANCE-INDUCEDETIOLOGY

    C. The disturbance is not better

    accounted for by a Mood Disorder that isnot substance-induced. Evidence that thesymptoms are better accounted for by aMood Disorder that is not substance-induced might include:

    1 2 3 _ 8 9 A079

    IF UNKNOWN: Which came first, the(SUBSTANCE USE) or the (MOODSYMPTOMS)?

    1) the mood symptoms precedethe onset of the Substance Abuseor Dependence (or medication

    use)

    EPISODE BEING EVALUATED:

    MDE A. 1

    MANIA A. 10

    NOT SUBSTANCE

    INDUCED. RETURN

    TO EPISODE BEING

    EVALUATED

    NOT SUBSTANCE

    INDUCED. RETURN

    TO EPISODE BEING

    EVALUATED

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    WMHSCID2000-1 3/5/03 GMC/Substance A. 20

    a substantial period of time (e.g.,

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

    information 42

    IF UNKNOWN: Have you had a periodof time when you stopped using(SUBSTANCE)?

    IF YES: After you stopped using(SUBSTANCE) did the (MOODSXS) get better?

    2) the mood symptoms persist for

    about a month) after the cessationof acute withdrawal or severeintoxication

    IF UNKNOWN: How much of(SUBSTANCE) were you using when youbegan to have (MOOD SYMPTOMS)?

    3) the mood symptoms aresubstantially in excess of whatwould be expected given the type,duration or amount of thesubstance used

    IF UNKNOWN: Have you had any otherepisodes of (MOOD SYMPTOMS)?

    IF YES: How many? Were youusing (SUBSTANCES) at thosetimes?

    4) there is evidence suggestingthe existence of an independentnon-substance-induced MoodDisorder (e.g. , a history ofrecurrent Major DepressiveEpisodes)

    IF UNKNOWN: How much did (MOODSYMPTOMS) interfere with your life?

    E. The symptoms cause clinicallysignificant distress or impairment insocial, occupational, or other importantareas of functioning.

    1 2 3 _ 8 9 A080

    D. The disturbance does not occurexclusively during the course of Delirium.

    1 3 _ 9 A081

    SUBSTANCE

    INDUCEDDELERIUM

    SUBSTANCE

    INDUCEDMOOD

    DISORDER

    RETURN TO

    EPISODE

    BEING

    EVALUATE

    RETURN TO EPISODE BEING EVALUATED.

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 1

    C. DIFFERENTIAL DIAGNOSIS OF PSYCHOTIC DISORDERS

    NOTE: BOTH PRIMARY PSYCHOTIC SYMPTOMS AND PSYCHOTIC SYMPTOMS THAT ARESUBSTANCE-INDUCED OR DUE TO A GENERAL MEDICAL CONDITION MAY BE PRESENT

    IN THE SAME INDIVIDUAL AT THE SAME TIME. THIS MAY REQUIRE MULTIPLE PASSESTHROUGH THE ALGORITHMS IN THIS MODULE.

    IF: ALL PSYCHOTIC SYMPTOMS IN MODULE B. ARE DUE TO A SUBSTANCE OR AGENERAL MEDICAL CONDITION, GO TO *GMC/SUBSTANCE*, C13

    IF: THERE ARE NO ITEMS CODED 3 IN B. PSYCHOTIC AND ASSOCIATED SYMPTOMS,CHECK HERE ___ AND END THE INTERVIEW.

    C002

    IF A MAJOR DEPRESSIVE ORMANIC EPISODE HAS EVER BEENPRESENT: Has there been a timewhen you had (PSYCHOTIC SXS)and you were not(DEPRESSED/MANIC)?

    Psychotic symptoms occur attimes other than during MajorDepressive, Manic, or Mixedepisodes.

    NOTE: CODE 3 IF NOMAJOR DEPRESSIVE,MANIC, OR MIXEDEPISODES OR IF SOMEPSYCHOTIC SYMPTOMSOCCUR OUTSIDE OFMOOD EPISODES. CODE

    1 ONLY IF PSYCHOTICSXS OCCUR EXCLUSIVELYDURING MOOD EPISODES.

    1 2 3 _ 8 9 C003

    PSYCHOTIC

    MOOD

    DISORDER.

    Obtain information

    on the course of

    illness and then

    end the interview

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

    information 43

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 2

    *SCHIZOPHRENIA* SCHIZOPRHENIA CRITERIA

    CHECK FOR PRESENCE OFACTIVE PHASE SYMPTOMS

    [NOTE: CRITERIA ARE INDIFFERENT ORDER THAN INDSM-IV.]

    REFER TO ITEMS CODED 3 INTHE PSYCHOTIC ANDASSOCIATED SYMPTOMSMODULE.

    A. Two (or more) of the followingeach present for a significantportion of time during a onemonth period (or less ifsuccessfully treated):

    (1) Delusions

    (2) Hallucinations

    (3) disorganized speech(e.g., frequent derailmentor incoherence).

    (4) Grossly disorganizedor catatonic behavior

    (5) Negative symptoms,i.e., affective flattening,alogia or avolition

    [Note: Only one A symptom isrequired if delusions are bizarreor hallucinations consist of avoice keeping up a runningcommentary on the personsbehavior or thoughts, or two ormore voices conversing with eachother.]

    1 2 3 _ 8 9 C004

    GO TO

    *DELUSIONAL

    DISORDER,*

    C.8

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

    information 44

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 3

    IF UNCLEAR: Has there ever been atime when you had (SXS FROMACTIVE PHASE) at the same timethat you were (down / high / irritable /OWN WORDS)?

    D. Schizoaffective disorder andMood Disorder with PsychoticFeatures have been ruled outbecause either:

    (1) No Major Depressive, Manic,or Mixed episodes haveoccurred concurrently withthe active phase symptoms(i.e., the A symptoms listedabove).

    NOTE: CODE 3 IF NEVER ANYMAJOR DEPRESSIVE ORMANIC EPISODES OR IF ALLMAJOR DEPRESSIVE ANDMANIC EPISODES OCCURRED

    DURING THE PRODROMOL ORRESIDUAL PHASE. CODE 1IF ANY MOOD EPISODESOVERLAP WITH PSYCHOTICSYMPTOMS.

    NOTE: BECAUSE OF THEDIFFICULTY INDISTINGUISHING THEPRODROMAL AND RESIDUALSYMPTOMS OFSCHIZOPHRENIA FROM A

    MAJOR DEPRESSIVESYNDROME, THE RATERSHOULD RECONSIDER ANYPREVIOUSLY CODED MAJORDEPRESSIVE EPISODE TO BESURE IT IS UNEQUIVOCAL.

    1 2 3 _ 8 9 C005

    IF UNCLEAR: How much of the timethat you have had (SXS FROMACTIVE AND RESIDUAL PHASES)

    would you say you have also been(depressed / high / irritable / OWNWORDS)?

    2) The total duration of moodepisodes [occurring duringthe disturbance] has been

    brief relative to the totalduration of the active andresidual phases.

    NOTE: CODE 1 IF SYMPTOMSMEETING CRITERIA FOR AMAJOR DEPRESSIVE, MANIC,OR MIXED EPISODE HAVEBEEN PRESENT FOR ASUBSTANTIAL PORTION OFTHE TOTAL DURATION OF THEACTIVE AND RESIDUAL

    PHASES

    1 2 3 _ 8 9 C006

    GO TO

    *SCHIZO-

    AFFECTIVE

    DISORDER,*

    C. 7

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

    information 45

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 5

    NOW MAKE A DIFFERENTIALDIAGNOSIS BETWEENSCHIZOPHRENIA ANDSCHIZOPHRENIFORM DISORDER

    IF UNCLEAR: Between(MULTIPLE EPISODES)were you back to yournormal self? How long dideach episode last?

    C. Continuous signs of thedisturbance persist for at leastsix months. This six-monthperiod must include at least one

    month of symptoms that meetcriterion A (i.e., active phasesymptoms), and may includeperiods of prodromal or residualsymptoms. During theseprodromal or residual periods,the signs of the disturbance maybe manifested by only negativesxs (i.e., affective flattening,alogia, avolition) or two or moresymptoms listed in criterion Apresent in an attenuated form

    (e.g., odd beliefs, unusualperceptual experiences).

    1 2 3 _ 8 9 C007

    IF NOT ALREADY KNOWN: Whenyou (HAD A CRITERION SXS),were you (working, having a sociallife, taking care of yourself)?

    B. For a significant portion of thetime since the onset of thedisturbance, one or more majorareas of functioning such aswork, interpersonal relations orself-care is markedly below thelevel achieved prior to the onset

    (or when the onset is inchildhood or adolescence, failureto achieve expected level ofinterpersonal, academic oroccupational achievement).

    1 2 3 _ 8 9 C008

    GO TO

    PSYCHOTIC

    DISORDER

    NOS,*

    C. 12

    GO TOSCHIZO

    PHRENI -

    FORM

    DISORDER

    C6

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 5

    IF NOT KNOWN: Were you takingany drugs or medicines during thistime?

    IF NOT KNOWN: Were you

    physically ill at this time?

    E. the disturbance is not due to thedirect physiological effects of asubstance (e.g., a drug of abuse,a medication) or to a generalmedical condition (Go to C5.)

    1 3 9 C009

    IF THERE IS ANY INDICATION THATTHE PSYCHOTIC SXS MAY BESECONDARY, I.E., A DIRECTPHYSIOLOGICALCONSEQUENCE OF A GMC OR

    SUBSTANCE GO TO*GMC/SUBSTANCE*, C13

    Etiological general medicalconditions include: neurological

    conditions (e.g., neoplasms,cerebrovascular disease,Huntingtons disease, epilepsy,auditory nerve injury, deafness,migraine, central nervous systeminfections); endocrine conditions(e.g. hyper- and hypothyroidism,hyper- and hypoparathyroidism,hypocortisolism); metabolicconditions (e.g., hypoxia, hypercarbia, hypoglycemia); fluid orelectrolyte imbalances; hepatic or

    renal diseases; and autoimmunedisorders with central nervoussystem involvement (e.g.,systemic lupus erythematosis).

    Etiological substances include:alcohol, amphetamine, cannabis,cocaine, hallucinogens, inhalants,opioids (meperidine),phencyclidine, sedatives,hypnotics, anxiolytics, and otheror unknown substances.

    DUE TO SUB-

    STANCE OR

    GMC; IF THERE

    ARE OTHERPERIODS OF

    PSYCHOTIC SXS

    NOT DUE TO A

    SUBSTANCE OR

    GMC RETURN

    TO C. 1;OTHERWISE ENDINTERVIEW

    SCHIZO-PHRENIA

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 6

    *SCHIZOPHRENIFORMDISORDER*

    SCHIZOPHRENIFORM DISORDER CRITERIA

    SCHIZOPHRENIA HAS BEENRULED OUT BECAUSE THE

    DURATION IS LESS THAN SIXMONTHS.

    IF NOT KNOWN: How long did(PSYCHOTIC SXS) last?

    B. An episode of the disorder(including prodromal, active

    and residual phases) lasts atleast one month but less thansix months.

    1 2 3 _ 8 9C010

    IF NOT KNOWN: Were you takingany drugs or medications during thistime?

    IF NOT KNOWN: Were youphysically ill at this time?

    C. The disturbance is not due tothe direct physiological effectsof a substance (e.g., a drug ofabsue, medication) or to a

    general medical

    1 3 _ 9C011

    IF THERE IS ANY INDICATION THATTHE PSYCHOTIC SXS MAY BESECONDARY, I.E., A DIRECTPHYSIOLOGICALCONSEQUENCE OF A GMC OR

    SUBSTANCE GO TO*GMC/SUBSTANCE*, C13

    REFER TO LIST (see previous

    page) OF GENERAL MEDICALCONDITIONS ANDSUBSTANCES, C5

    GO TO

    BRIEF

    PSYCHOTIC

    DISORDER

    C. 10

    IF OTHER PERIODS

    OF PSYCHOTIC

    SXS NOT DUE TO

    A SUB-STANCE OR

    GMC RETURN TO

    C.1: OTHERWISEEND INTERVIEW

    SCHIZO-

    PHRENI-FORM

    DIS-

    ORDER

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C. 7

    *SCHIZOAFFECTIVE DISORDER* SCHIZOAFFECTIVE DISORDER CRITERIA

    SCHIZOPHRENIA ANDSCHIZOPHRENIFORM DISORDERHAVE BEEN RULED OUT

    BECAUSE OF PROMINENT MOODSYMPTOMS. CONSIDER ADIAGNOSIS OFSCHIZOAFFECTIVE DISORDER.

    A. An uninterrupted period ofillness during which, at sometime, there is either a Major

    Depressive Episode (which mustinclude A(1) depressed mood), aManic or a Mixed episodeconcurrent with symptoms thatmeet criterion A forSchizophrenia .

    Note: The Major DepressiveEpisode must include criterionA(1): depressed mood.

    1 2 3 _ 8 9C012

    IF NOT ALREADY KNOWN: Have

    there been any times when you had(PSYCHOTIC SXS) when you werenot (MANIC OR DEPRESSED)?

    B. During the same period of

    illness, there have beendelusions or hallucinations forat least two weeks in theabsence of prominent moodsymptoms.

    1 2 3 _ 8 9

    C013

    C. Symptoms that meet criteriafor a mood episode are presentfor a substantial portion of thetotal duration of the active andresidual periods of the illness

    1 2 3 _ 8 9C014

    IF NOT KNOWN: Were you takingany drugs or medicines during thistime?

    IF NOT KNOWN: Were youphysically ill at this time?

    (What did the doctor say?)

    D. The disturbance is not due tothe direct physiological effects ofa substance (e.g., a drug ofabuse, a medication) or to ageneral medical condition.

    Describe:

    1 3 _ 9C015

    IF THERE IS ANY INDICATION THATTHE PSYCHOTIC SXS MAY BESECONDARY, I.E., A DIRECTPHYSIOLOGICALCONSEQUENCE OF A GMC OR

    SUBSTANCE GO TO*GMC/SUBSTANCE*, C13

    REFER TO LIST OF GENERALMEDICAL CONDITIONS ANDSUBSTANCES, C5

    GO TO

    *PSYCHOTIC

    DISORDER

    NOS* C. 12

    PSYCHOTIC

    MOOD DIS-

    ORDER --

    END

    INTERVIEW.

    SCHIZO

    AFFECTIVE

    DISORDER

    DUE TO SUBSTANCE

    OR GMC; IF OTHER

    PERIODS OF

    PSYCHOTIC SXS NOT

    DUE TO A

    SUBSTANCE OR GMC

    RETURN TO C. 1;

    OTHERWISE END

    INTERVIEW

    GO TO

    *PSYCHOTIC

    DISORDER

    NOS,*

    C. 12

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C. 8

    *DELUSIONAL DISORDER* DELUSIONAL DISORDER CRITERIA

    SCHIZOPHRENIA,SCHIZOPHRENIFORM, AND

    SCHIZOAFFECTIVE DISORDERHAVE BEEN RULED OUT

    NOTE: THE ORDER OF THECRITERIA BELOW DIFFERS

    FROM THAT IN DSM-IV.

    IF UNCLEAR: Has there ever been atime when you have been(DELUSIONAL) at the same time thatyou were (depressed / high / irritable/ OWN WORDS)?

    D. (1) There are no MajorDepressive, Manic, or Mixedepisodes have occurredconcurrently with delusions.

    NOTE: CODE 3 IF THEREHAVE NEVER BEEN ANYMAJOR DEPRESSIVE, MANICOR MIXED EPISODES OR IF

    ALL MOOD EPISODESOCCURRED AT TIMES OTHERTHAN DURING DELUSIONALPERIODS. CODE 1 IF THEREHAS BEEN A PERIOD OFOVERLAP WITH DELUSIONS

    1 2 3 _ 8 9 C016

    IF UNCLEAR: How much of the timethat you have had (DELUSIONS)would you say you have also been(depressed / high / irritable / OWN

    WORDS)?

    D. (2) The total duration of allmood episodes occurringconcurrently with delusions hasbeen brief relative to the duration

    of the delusional periods.

    NOTE: CODE 1 IF SYMPTOMSMEETING CRITERIA FOR AMOOD EPISODE AREPRESENT OFR ASUBSTANTIAL PORTION OFTHE TOTAL DURATION OF THEDISTURBANCE.

    1 2 3 _ 8 9 C017

    IF UNCLEAR: Have you had(DELUSIONS) only at times whenyou were (depressed / high / irritable/ OWN WORDS)?

    Psychotic symptoms occurexclusively during MajorDepressive, Manic, and Mixedepisodes.

    1 2 3 _ 8 9 C018

    CONTINUE

    ON NEXT

    PAGE

    CONTINUE

    ON NEXTPAGE

    PSYCHOTIC

    MOOD

    DISORDER

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 9

    A. Nonbizarre delusions (i.e.,involving situations that occur inreal life, such as being followed,poisoned, infected, loved at adistance, having a disease, or

    being deceived by ones spouseor love) of at least one monthsduration.

    1 2 3 _ 8 9 C019

    B. Has never met criterion A forSchizophrenia. Note: Tactile andolfactory hallucinations may bepresent in delusional Disorder ifthey are related to the delusionaltheme.

    NOTE: CODE 3 IF OTHER

    ACTIVE PHASE SYMPOTMS OFSCHIOZPHRENIA (E.G.,HALLUCINATIONS) ARE NOTSIGNIFICANT (I.E., LAST LESSTHAN ONE MONTH)

    1 2 3 _ 8 9 C020

    C. Apart from the impact of thedelusion(s) or its ramifications,functioning is not markedlyimpaired and behavior is notobviously odd or bizarre.

    1 2 3 _ 8 9 C021

    IF NOT KNOWN: Were you takingany drugs or medicines during thistime?

    IF NOT KNOWN: Were youphysically ill at this time?

    (What did the doctor say?)

    E. The disturbance is not due tothe direct physiological effects ofa substance (e.g., a drug ofabuse, a medication) or to ageneral medical condition.

    Describe:

    1 3 _ 9 C046

    IF THERE IS ANY INDICATION THATTHE DELUSIONS MAY BESECONDARY, I.E., A DIRECTPHYSIOLOGICALCONSEQUENCE OF A GMC OR

    SUBSTANCE GO TO*GMC/SUBSTANCE*, C13

    REFER TO LIST OF GENERALMEDICAL CONDITIONS ANDSUBSTANCES, C5

    GO TO

    *BRIEF

    PSYCHOTICDISORDER*

    C. 10

    GO TO

    *PSYCHOTIC

    DISORDERNOS,*C. 12

    GO TO

    *PSYCHOTIC

    DISORDER

    NOS,* C. 12

    DELUSIONAL

    DISORDER

    DUE TO GMC/SUB; IF

    OTHER PERIODS OF

    PSYCHOTIC SXS NOT

    DUE TO A SUBSTANCE

    OR GMC RETURN TO

    C. 1; OTHERWISE END

    INTERVIEW

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 10

    *BRIEF PSYCHOTIC DISORDER* BRIEF PSYCHOTIC DISORDER CRITERIA

    A. Presence of one (or more) ofthe following symptoms:

    (1) delusions

    (2) hallucinations

    (3) disorganized speech(e.g., frequentderailment orincoherence).

    (4) grossly disorganizedor catatonic behavior

    1 2 3 _ 8 9 C022

    IF NOT KNOWN: Were you takingany drugs or medicines during thistime?

    IF NOT KNOWN: Were youphysically ill at this time?

    (What did the doctor say?)

    C. (2) The disturbance is not dueto the direct physiological effectsof a substance (e.g., a drug ofabuse, a medication) or to ageneral medical condition.

    Describe:

    1 3 _ 9 C023

    IF THERE IS ANY INDICATION THATTHE DELUSIONS MAY BE

    SECONDARY, I.E., A DIRECTPHYSIOLOGICALCONSEQUENCE OF A GMC OR

    SUBSTANCE GO TO*GMC/SUBSTANCE*, C13

    REFER TO LIST OF GENERALMEDICAL CONDITIONS ANDSUBSTANCES, C5

    DUE TO GMC/SUB

    IF OTHER PERIODS

    OF PSYCHOTIC SXS

    NOT DUE TO A SUB-

    STANCE OR GMCRETURN TO C. 1;

    OTHERWISE GO TO

    END OF INTERVIEW

    GO TO*PSYCHOTIC

    DISORDERNOS*C. 12

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 11

    B. Duration of an episode if thedisturbance is at least one day,but less than one month, with aneventual full return to premorbidlevel of functioning.

    1 2 3 _ 8 9C024

    C. (1) Not better accounted forby a Mood disorder (i.e., no fullmood episode is present)

    NOTE: CODE 3 IF NO MOODEPISODES.

    1 2 3 _ 8 9C025

    Symptoms occur shortly after andapparently in response to eventsthat, singly or together, would bemarkedly stressful to almostanyone in similar circumstancesin the persons culture.

    DESCRIBE STRESSOR:

    1 2 3 _ 8 9C026

    NOTE: CHECK HERE IF ONSETWITHIN 4 WEEKSPOSTPARTUM

    ______ C027

    BRIEF

    PSYCHOTIC

    DISORDER

    GO TO

    *PSYCHOTIC

    DISORDER

    NOS*C. 12

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses 12

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

    information 54

    *PSYCHOTIC DISORDER NOS* PSYCHOTIC DISORDER NOS

    NOTE: If psychotic symptoms havebeen present but are notdiagnostically significant, code 1

    (i.e., do not diagnose PsychoticDisorder NOS), for example recurrenthallucinations of name being called.

    This category should be used todiagnose psychoticsymptomatology (i.e., delusions,

    hallucinations, disorganizedspeech, grossly disorganized orcatatonic behavior) about whichthere is inadequate information tomake a specific diagnosis, or aboutwhich there is contradictoryinformation, or disorders withpsychotic symptoms that do notmeet the criteria for any specificpsychotic disorder defined above.

    1 2 3 _ 8 9C028

    Indicate type:

    1 Postpartum psychosis that doesnot meet criteria for Mooddisorder with PsychoticFeatures, Brief PsychoticDisorder, Psychotic disorderdue to a GMC, or a substance-Induced psychotic disorder.

    2 Psychotic symptoms that havelasted for less than one monthbut have not yet remitted sothat the criteria for BriefPsychotic disorder are not met.

    3 Persistent auditoryhallucinations in the absence ofany other features.

    4 Persistent nonbizarre delusionswith periods of overlappingmood episodes that have beenrepresent for a substantial

    portion of the delusionaldisturbance.

    5 Situations in which the clinicianhas concluded that a psychoticdisorder is present but is unableto determine whether it isprimary, due to a generalmedical condition, orsubstance-induced.

    6 Other (describe):

    C029

    C030

    C031

    C032

    C033

    C034

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C13

    *GMC/SUBSTANCE CAUSING PSYCHOTIC SYMPTOMS*

    PSYCHOTIC DISORDER DUE TO AGENERAL MEDICAL CONDITION

    PSYCHOTIC DISORDER DUE TO A GENERALMEDICAL CONDITION CRITERIA

    IF SYMPTOMS NOT TEMPORALLY ASSOCIATED WITH A GENERAL MEDICAL CONDITION,

    CHECK HERE ___ AND GO TO *SUBSTANCE-INDUCED PSYCHOTIC DISORDER,* C 16. C035

    CODE BASED ON INFORMATIONALREADY OBTAINED

    A. Prominent hallucinations or delusions 1 2 3 _ 8 9 C036

    Do you think your (DELUSIONS /HALLUCINATIONS) were in any wayrelated to your (COMORBID GENERALMEDICAL CONDITION) ?

    IF YES: Tell me how.

    (Did the [DELUSIONS /HALLUCINATIONS] start or get muchworse only after [COMORBID GENERALMEDICAL CONDITION] began?)

    B./C. There is evidence from the history,physical examination, or laboratoryfindings that the disturbance is the directphysiological consequence of a generalmedical condition and the disturbance isnot better accounted for by anothermental disorder

    1 2 3 _ 8 9 C037

    IF YES AND GMC HASRESOLVED: Did the (DELUSIONS /HALLUCINATIONS) get better oncethe (COMORBID GENERALMEDICAL CONDITION) gotbetter?

    THE FOLLOWING FACTORS SHOULDBE CONSIDERED AND SUPPORT THECONCLUSION THAT THE GMC ISETIOLOGIC TO THE PSYCHOTICSYMPTOMS:

    1) THERE IS EVIDENCE FROM THELITERATURE OF A WELL-ESTAB-LISHED ASSOCIATION BETWEEN THEGMC AND PSYCHOTIC SYMPTOMS.

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    GO TO

    *SUBSTANCE

    INDUCED*

    C 16

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C14

    2) THERE IS A CLOSE TEMPORALRELATIONSHIP BETWEEN THECOURSE OF THE PSYCHOTIC SYMP-TOMS AND THE COURSE OF THEGENERAL MEDICAL CONDITION.

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    3) THE PSYCHOTIC SYMPTOMS ARECHARACTERIZED BY UNUSUALPRESENTING FEATURES (E.G., LATEAGE AT ONSET).

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    4) THE ABSENCE OF ALTER-NATIVEEXPLANATIONS (E.G., PSYCHOTICSYMPTOMS AS A PSYCHOLOGICAL

    REACTION TO THE GMC).

    DESCRIBE:

    ______________________________

    ______________________________

    ______________________________

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C15

    IF UNCLEAR: How much did(PSYCHOTIC SYMPTOMS) interferewith your life?

    E. The symptoms cause clinicallysignificant distress or impairment insocial, occupational, or other importantareas of functioning

    1 2 3 _ 8 9 C038

    GO TO

    *SUB-STANCE

    INDUCED*

    C 16

    D. The disturbance does not occurexclusively during the course of Delirium.

    1 3 _ 9 C039

    DELERIUM

    DUE TO A

    GMC

    PSYCHO

    TIC DIS-

    ORDER

    DUE TO

    A GMC

    CONTINUE ON NEXT PAGE

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C 16

    *SUBSTANCE-INDUCED PSYCHOTICDISORDER*

    SUBSTANCE-INDUCED PSYCHOTICDISORDER CRITERIA

    IF SYMPTOMS NOT TEMPORALLY ASSOCIATED WITHSUBSTANCE, CHECK HERE ___ AND RETURN TO EPISODEBEING EVALUATED.

    C040

    CODE BASED ON INFORMATIONALREADY OBTAINED.

    A. Prominent hallucinations or delusionsNote: Do not include hallucinations if theperson has insight that they aresubstance-induced.

    1 2 3 _ 8 9 C041

    IF NOT KNOWN: When did the(DELUSIONS / HALLUCINATIONSSYMPTOMS) begin? Were you alreadyusing (SUBSTANCE) or had you juststopped or cut down your use?

    B. There is evidence from the history,physical examination or laboratoryfindings that either (1) the symptoms in Adeveloped during or within a month ofsubstance intoxication or withdrawal, or(2) medication use is etiologically related

    to the disturbance

    1 2 3 _ 8 9 C042

    Do you think your (DELUSIONS /HALLUCINATIONS) are in any wayrelated to your (SUBSTANCE USE)?

    IF YES: Tell me how.

    ASK ANY OF THE FOLLOWINGQUESTIONS AS NEEDED TO RULEOUT A NON-SUBSANCE-INDUCEDETIOLOGY

    C. The disturbance is not betteraccounted for by a Psychotic Disorderthat is not substance-induced. Evidencethat the symptoms are better accountedfor by a Psychotic Disorder that is notsubstance-induced might include:

    1 2 3 _ 8 9 C043

    IF UNKNOWN: Which came first, the(SUBSTANCE USE) or the (PSYCHOTICSYMPTOMS)?

    1) the psychotic symptoms precedethe onset of the Substance Abuseor Dependence (or medicationuse)

    NOT SUBSTANCE

    INDUCED. RETURN

    TO EPISODE BEING

    EVALUATED

    NOT SUBSTANCE

    INDUCED. RETURN

    TO EPISODE BEING

    EVALUATED

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000-1 3/5/03 Differential Diagnoses C17

    IF UNKNOWN: Have you had a periodof time when you stopped using(SUBSTANCE)?

    IF YES: After you stopped using(SUBSTANCE) did the (DELUSIONS /HALLUCINATIONS) get better or

    were you still having DELUSIONS /HALLUCINATIONS?

    2) the psychotic symptoms persist fora substantial period of time (e.g.,about a month) after the cessationof acute withdrawal or severeintoxication

    IF UNKNOWN: How much of(SUBSTANCE) were you using when youbegan to have (DELUSIONS /HALLUCINATIONS)?

    3) the psychotic symptoms aresubstantially in excess of whatwould be expected given the type,duration or amount of thesubstance used

    IF UNKNOWN: Have you had any otherepisodes of (DELUSIONS /HALLUCINATIONS)?

    IF YES: How many? Were youusing (SUBSTANCES) at thosetimes?

    4) there is evidence suggestingthe existence of an independentnon-substance-induced PsychoticDisorder (e.g. , a history of

    recurrent non-substance-relatedpsychotic episodes).

    IF UNKNOWN: How much did(DELUSIONS / HALLUCINATIONS)interfere with your life?

    E. The symptoms cause clinicallysignificant distress or impairment insocial, occupational, or other importantareas of functioning.

    1 2 3 _ 8 9 C044

    D. The disturbance does not occur

    exclusively during the course of Delirium.

    1 3 _ 9 C045

    SUBSTANCE

    INDUCED

    DELERIUM

    SUBSTANCE

    INDUCED

    PSYCHOTIC

    DISORDER

    RETURN TO

    EPISODE

    BEING

    EVALUATE

    RETURN TO EPISODE BEING EVALUATED.

    1=absent or false 2=subthreshold 3=threshold or true _ 8=clearly due to medical condition 9=inadequate

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    WMHSCID2000 3/5/03 Notes 1

    G.A.F. SCORE: _______ (SEE NEXT PAGE.)

    60

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    WMHSCID2000 3/5/03 Notes 2

    DSM-IV Axis V: Global Assessment of Functioning (G.A.F.) Scale

    Consider psychological, social, and occupational functioning on a hypothetical continuum of mentalhealth-illness. Do not include impairment in functioning due to physical (or environmental) limitations.

    Indicate appropriate code for the LOWEST level of functioning during the week of POORESTfunctioning in the past 12 months. (Use intermediate level when appropriate, e.g., 45, 68, 72.) Note:

    Make a rating of 0 if inadequate information.

    100 Superior functioning in a wide range of activities, lifes problemsI never seem to get out of hand, is sought out by others because of91 his or her many positive qualities. No symptoms.

    90 Absent or minimal symptoms (e.g., mild anxiety before an exam), good func-I tioning in all areas, interested and involved in a wide range of activities,I socially effective, generally satisfied with life, no more than everyday81 problems or concerns (e.g., an occasional argument with family members).

    80 If symptoms are present, they are transient and expectable reactions to

    I psychosocial stressors (e.g., difficulty concentrating after familyI argument), no more than slight impairment in social, occupational, or71 school functioning (e.g., temporarily falling behind in school work).

    70 Some mild symptoms (e.g., depressed mood and mild insomnia) OR someI difficulty in social, occupational, or school functioning (e.g., occa-I sional truancy, or absences from work), but generally functioning61 pretty well, has some meaningful interpersonal relationships.

    60 Moderate symptoms (e.g., flat affect and circumstantial speech, occasionalI panic attacks) OR moderate difficulty in social, occupational, or school51 functioning (e.g., new friends, conflicts with workers).

    50 Serious symptoms (e.g., suicidal ideation, several obsessional rituals,I frequent shoplifting) OR any serious impairment in social, occupational,41 or school functioning (e.g., no friends, unable to keep a job).

    40 Some impairment in reality testing or communication (e.g., speech is at timesI illogical, obscure, or irrelevant) OR major impairment in several areas. SuchI as work or school, family relations, judgment, thinking, or mood (e.g., depressedI man avoids friends, neglects family, and is unable to work; child frequently31 beats up younger children, is defiant at home, and is failing in school).

    30 Behavior is considerably influenced by delusions or hallucinations ORI serious impairment in communication or judgement (e.g., sometimes incoherent,I acts grossly inappropriately, suicidal occupation) OR inability to function21 in almost all areas (e.g., stay in bed all day; no job, home, or friends).

    20 Some danger of hurting self or others (e.g., suicide attempts without clearI expectation of death, frequently violent, manic excitement) OR occasionallyI fails to maintain minimal personal hygiene (e.g., smears feces) OR gross11 impairment in communication (e.g., largely incoherent or mute).

    10 Persistent danger of severely hurting self or others (e.g., recurrentI violence) OR persistent inability to maintain minimal personal hygiene OR serious suicide act

    with clear expectation of death

    61

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    WMHSCID2000 3/5/03 Notes 3

    NOTES ON THIS INTERVIEW

    1. Was this interview completed? YES NO

    If not, why was it interrupted?

    Was it rescheduled? YES NODay Month Year

    2. Were there any unusual circumstances or aspects of the interview situation that affected Rsanswers?Please describe:

    3. Are you satisfied that this was a valid interview? YES NO

    If not, why not?

    4. Please list any other factors that you think affected Rs responses or your coding.

    5. What is the principal AXIS-I diagnosis? (This is not a formal diagnosis or based on countingSCID criteria. It is your impression at this point.)

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    WMHSCID2000 3/5/03 Notes 4

    PLEASE DESCRIBE THE COURSE OF ILLNESS:

    I.E. OUTLINE THE TEMPORAL RELATIONSHIPS BETWEEN PERIODS OF MOOD EPISODESAND PSYCHOTIC EPISODES.


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