SCREENING QUESTIONNAIRE FOR PSYCHIATRIC DISORDERS

The following are screening questions for psychiatric disorders. Remember, these are usually states or episodes a person goes through for a specific time and not traits (e.g., personality) a person has had since early adulthood. Also, alcohol, drugs, certain medical conditions and medications can mimic or cause conditions similar to these disorders. In these conditions, symptoms begin after the alcohol, drugs, conditions or medication began.

If you answer YES to ANY questions, please contact a mental health professional in your area OR contact us through the ASK THE DOCTOR-PSYCHIATRIST button at the top of this page. Select YES or NO for each question below and, if needed, print the page for your reference. This is a quick overview and is not meant to be all inclusive. If you experience ANY persistent symptoms that make you uncomfortable, seek the advice of a professional.
      MOOD   DISORDERS:
  Are you currently OR have you ever had a time when you or others thought…
YES   NO

1. Your mood was unusually down, depressed, sad, blue, unhappy, “bored” or empty NEARLY EVERY DAY, FOR MOST OF THE DAY, FOR AT LEAST TWO WEEKS?
YES   NO

2. You lost much, or all, of the interest or pleasure you had for activities you are normally interested in NEARLY EVERY DAY, FOR MOST OF THE DAY, FOR AT LEAST TWO WEEKS?
YES   NO 3. Your mood was UNUSUALLY good, cheerful, high or enthusiastic for about FOUR CONTINUOUS DAYS?
YES   NO 4. Your mood was UNUSUALLY irritable (not during depression) for AT LEAST FOUR CONTINUOUS DAYS?
YES   NO 5. The same as number 3 OR 4, but lasting ONE WEEK or more OR required hospitalization?
YES   NO

6. Your mood was down, depressed, sad, blue, unhappy, “bored” or empty for MORE DAYS THAN NOT FOR AT LEAST TWO YEARS?
      THOUGHT   DISORDERS:
YES   NO

7. You heard a voice or voices, that others did not seem to hear, for a good deal of time in a one-month period?
YES   NO

8. You were certain you were being tormented, tricked, spied on or ridiculed, for a good deal of time in a one-month period?
YES   NO

9. You were certain the television, radio, computer, song lyrics, newspapers, books, gestures, street signs or other things in your environment were directed specifically at you, for a good deal of time in a one-month period?
      ATTENTION   DEFICIT   HYPERACTIVITY   DISORDERS:
YES   NO

10. Since age six, you were too “hyper”, fidgety, loud, talkative, on the go, ran or climbed too much or couldn’t stay in your seat for long?
YES   NO

11. Since age six, you often or very often made careless mistakes, overlooked details, have trouble staying focused, have been accused of not listening, have trouble organizing and finishing things, avoid things that take a lot of mental effort, are easily distracted or forget/lose things too much?
      ANXIETY   DISORDERS:
YES   NO

12. You had unexpected panic attacks and a month (or more) of either worry about having more attacks, about how the attacks might be related to your health, or you changed behavior because of the attacks?
YES   NO

13. You have been extremely bothered, anxious or worried in places or situations where escape might not be possible (or embarrassing) or help might not be available if you developed a panic attack or panic-like symptoms?
YES   NO

14. You have a lot of fear about social or performance situations where there are unfamiliar people and/or you might be scrutinized or noticed by others?
YES   NO

15. You have thoughts, images, urges or impulses that are unwanted and intrusive and are not worries about everyday problems (finances, work, school, etc)? The obsessive thoughts may be about morality, aggression/violence, contamination, health, order/symmetry or sex.
YES   NO

16. You have rituals or repetitive behaviors like checking, cleaning, counting, collecting, hand washing, repeating or praying that you feel driven to do because of an obsession, or because of rules you must follow rigidly?
YES   NO

17. You experienced or witnessed something traumatic that did or could have caused serious harm, injury, or death to you or others and reacted with intense fear, helplessness or horror?
YES   NO

18. You have excessive anxiety and worry, occurring more days than not for at least six months, about a number of events or activities (social, job, finances, health of family members, household chores, car repairs, being late for appointments)?
      DEMENTIA   DISORDERS:
YES   NO

19. You are at least 60 years old and it is much harder to remember, and much easier to forget, new or recent things and not so much memories from years ago?
YES   NO

20. You are at least 60 years old and it is much harder to name or recognize familiar people and things?

YES   NO

21. You are at least 60 years old and it is much harder to carry out a process/action you have known how to do for years?
YES   NO

22. You are at least 60 years old and it is much harder to learn new tasks especially where sequencing, organizing or planning is involved?