Vortex Psychiatry- Scales

HAM-D SCALE

Patient Name:

Patient Date of Birth:

Date of Scales Completed

1. DEPRESSION MOOD (Gloomy attitude, permission about future, feeling of sadness, tendency of weep)

Absent Sadness etc Occasional weeping Frequent weeping Extreme symptoms

2. FEELINGS OF GUILT

Absent Self approach, feels he/she has let people down. Ideas of guilt Present illness is a punishment; delusions of guilt Hallucinations of guilt

3. SUICIDE

Absent Feels life is not worth living Wishes he/she were dead Suicidal ideas or gestures Attempts at suicide

4. INSOMNIA - Initial (Difficulty in falling asleep)

Absent Occasional Frequent

5. INSOMNIA - Middle (Complains of being restless, disturbed and waking up during night))

Absent Occasional Frequent

6. INSOMNIA - Delayed (Walking in early hours of the morning and unable to fall asleep again)

Absent Occasional Frequent

7. WORK AND INTERESTS

No difficulty Feelings of incapacity, listlessness, indecision, and vacillation Loss of interest in hobbies, decreased social activites Productivity decreased Unable to work

8. AGITATION (Restlessness associated with anxiety)

Absent Occasional Frequent

9. ANXIETY - PSYCHIC

No difficulty Tension and irritability Worrying about minor matters Apprehensive attitude Fears

10. ANXIETY - SOMANTIC

Absent Mild Moderate Severe Incapacitating

11. SOMANTIC SYMPTOMS - GASTROINTESTINAL (Loss of appetite, heavy feeling in abdomen; constipation)

Absent Mild Severe

12. SOMANTIC SYMPTOMS - GENERAL (Heaviness in limbs, back or head; diffuse backache; loss of energy and fatigability)

Absent Mild Severe

13. GENERAL SYMPTOMS (Loss of libido, menstrual disturbance)

Absent Mild Severe

14. HYPOCHONDRIASIS

No Present Self-absorption (bodily) Preoccupation with health Querulous attitude Hypochondriacal delusions

15. WEIGHT LOSS

No weight loss Slight Obvious or severe

16. INSIGHT (Insight must be interpreted in terms of patient's understanding and background)

No loss Partial or double loss Loss of insight

17. DIURNAL VARIATION (Symptoms worse in morning or evening . Note which it is)

No variation Mild variation Severe variation

18. DEPERSONALIZATION AND DEREALIZATION

Absent Mild Moderate Severe Incapacitating

19. PARANOID SYMPTOMS (Not with a depressive quality)

None Suspicious Ideas of reference Delusions of reference and persecution Hallucinations, persecutory

20. OBSESSIONAL SYMPTOMS (Obsessive thoughts and compulsions against which the patient struggles)

Absent Mild Severe

20.

(0) I am no more worried about my health than usual (1) I am worried about physical problems like aches, pains, upset stomach, or constipation (2) I am very worried about physical problems and it's hard to think of much else (3) I am so worried about my physical problems that I cannot think of anything else

21.

(0) I have not noticed any recent change in my interest in sex (1) I am less interested in sex than I used to be (2) I have almost no interest in sex (3) I have lost interest in sex completely

BURN'S ANXIETY INVENTORY

Name Patient

Patient Date of Birth

Total

Instructions: Select the answer that best describes how much that symptom or problem has bothered you during the past seven(7) days.

Not at all= 0

Somewhat= 1

Moderately=2

A lot= 3

Category I: Anxious Feeling

1. Anxiety, nervousness, worry or fear