Vortex Psychiatry- Scales

Name:

Date:

Score:

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

Beck's Depression Inventory II

Name

Date

Score

(0) I don't feel sad (1) I feel sad (2) I am sad all the time and I can't snap out of it (3) I am so sad and unhappy that I can't stand it.

(0) I am not particularly discouraged about the future (1) I feel discouraged about the future (2) I feel I have nothing to look forward to (3) I feel the future is hopeless and that thing can't improve

(0) I don't feel like a failure (1) I feel I have failed more than the average person (2) As I look back on my life, all I can see is a a lot of failures (3) I feel I am a complete failure as a person

(0) I get as much satisfaction out of things as I used to (1) I don't enjoy the things as I used to (2) I don't get real satisfaction out of things anymore (3) I am dissatisfied or bored with everything

(0) I don't feel particularly guilty (1) I feel guilty a good part of the time (2) I feel quite guilty most of the time (3) I feel guilty all of the time

(0) I don't feel I am being punished (1) I feel I may be punished (2) I expect to be punished (3) I feel I am being punished

(0) I don't feel disappointed (1) I am disappointed in myself (2) I am disgusted with myself (3) I hate myself

(0) I don't feel I am any worse than anybody else (1) I am critical of myself for my weaknesses or mistakes (2) I blame myself all the time for my faults (3) I blame myself for everything bad that happens

(0) I don't have any thoughts of killings myself (1) I have thoughts of killing myself, but I would not cany them out (2) I would like to kill myself (3) I would kill myself if I had the chance

10.

(0) I would kill myself if I had the chance (1) I cry more now than I used to (2) I cry all the time now (3) I used to be able to cry, but now I can't cry even though I want to

11.

(0) I am no more initiated by things than I ever was (1) I am slightly more initated now than usual (2) I am quite annoyed or initiated a good deal of the time (3) I feel irritated all of the time

11.

(0) I am no more initiated by things than I ever was (1) I am slightly more initated now than usual (2) I am quite annoyed or initiated a good deal of the time (3) I feel irritated all of the time

12.

(0) I have not lost interest in other people (1) I am less interested in other people than I used to be (2) I have lost most of my interest in other people (3) I have lost all of my interest in other people

13.

(0) I make decisions about as well as I ever could (1) I put off making decisions more than I used to (2) I have greater difficulty in making decisions more than I used to (3) I can't make decisions at all anymore

14.

(0) I don't feel that I look any worse than I used to (1) I am won-ied that I am looking old or unattractive (2) I feel there are permanent changes in my appeamnce that make me look unattractive (3) I believe that I look ugly

15.

(0) I can work about as well as before (1) It takes an extra effort to get started at doing something (2) I have to push myself very' hard to do anything (3) I can't do any work at all

16.

(0) I can sleep as well as usual (1) I don't sleep as well as I used to (2) I wake up 1-2 hours earlier than usual and lind it hard to get back to sleep (3) I wake up several hours earlier than I used to and cannot get back to sleep

17.

(0) I don't get more tired than usual (1) I get tired more easily than I used to (2) I get tired from doing almost anything (3) I am too tired to do anything

18.

(0) My appetite is no worse than usual (1) My appetite is not as good as it used to be (2) My appetite is much worse now (3) I have no appetite at all anymore

19.

(0) I have no appetite at all anymore (1) I have lost more than five pounds (2) I have lost more than ten pounds (3) I have lost more than fifteen pounds

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

Not at all Somewhat Moderately A lot

2. Feeling that things around you are strange, unreal or foggy

Not at all Somewhat Moderately A lot

3. Feeling detached from all or part of your body

Not at all Somewhat Moderately A lot

4. Sudden, unexpected panic spells

Not at all Somewhat Moderately A lot

5. Apprehension or a sense of impending doom

Not at all Somewhat Moderately A lot

6. Feeling tense, stressed, "uptight", or an edge

Not at all Somewhat Moderately A lot

Category II: Anxious Thoughts

7. Difficulty Concentrating

Not at all Somewhat Moderately A lot

8. Racing thoughts or having your mind jump from one thing to next

Not at all Somewhat Moderately A lot

9. Frightening fantasies or daydreams

Not at all Somewhat Moderately A lot

10. Feeling that you're on the verge of losing control

Not at all Somewhat Moderately A lot

11. Fears of cracking up or going crazy

Not at all Somewhat Moderately A lot

12. Fears of fainting or passing out

Not at all Somewhat Moderately A lot

13. Fears of physical illness or heart attacks or dying

Not at all Somewhat Moderately A lot

14. Concerns about looking foolish or inadequate in front of others

Not at all Somewhat Moderately A lot

15. Fears of being alone, isolated or abandoned

Not at all Somewhat Moderately A lot

16. Fear of criticism or disapproval

Not at all Somewhat Moderately A lot

17. Fears that something terrible is about to happen

Not at all Somewhat Moderately A lot

Category III: Physical Symptoms

18. Skipping or racing or pounding of the heart

Not at all Somewhat Moderately A lot

19. Pain, pressure or tightness in the chest

Not at all Somewhat Moderately A lot

20. Tingling or numbness in the toes or fingers

Not at all Somewhat Moderately A lot

21. Butterflies or discomfort in the stomach

Not at all Somewhat Moderately A lot

22. Constipation or diarrhea

Not at all Somewhat Moderately A lot

23. Restless or jumpiness

Not at all Somewhat Moderately A lot

24. Tight, tense muscles

Not at all Somewhat Moderately A lot

25. Sweating not brought on by heat

Not at all Somewhat Moderately A lot

26. A lump in the throat

Not at all Somewhat Moderately A lot

27. Trembling or shaking

Not at all Somewhat Moderately A lot

28. Rubbery or "jelly" legs

Not at all Somewhat Moderately A lot

29. Feeling dizzy, light-headed off balance

Not at all Somewhat Moderately A lot

30. Choking or smothering sensations or difficulty breathing

Not at all Somewhat Moderately A lot

31. Headaches or pains in the neck or back

Not at all Somewhat Moderately A lot

32. Hot flashes or cold chills

Not at all Somewhat Moderately A lot

33. Feeling tired, weak or easily exhausted

Not at all Somewhat Moderately A lot

PATIENT HEALTH QUESTIONNAIRE (PHQ-9)

NAME:

DATE:

Over the last 2 weeks, how often have you been bothered by any of the following problems?

Not at all=0

Several days=1

More than half the days=2

Nearly every day=3

1. Little interest or please in doing things.

Not at all Several days More than half days Nearly every day

2. Feeling down, depressed, or hopeless.

Not at all Several days More than half days Nearly every day

3. Trouble falling or staying asleep, or sleeping too much.

Not at all Several days More than half days Nearly every day

4. Feeling tired or having little energy.

Not at all Several days More than half days Nearly every day

5. Poor appetite or overeating.

Not at all Several days More than half days Nearly every day

6. Feeling bad about yourself or that you are a failure or have let yourself or your family down.

Not at all Several days More than half days Nearly every day

7. Trouble concentrating on things, such as reading the newspaper or watching television.

Not at all Several days More than half days Nearly every day

8. Moving or speaking so slowly that other people could have noticed. the opposite being so fidgety or restless that you have been moving around a lot more than usual.

Not at all Several days More than half days Nearly every day

9. Thoughts that you would be better off dead, or of hurting yourself.

Not at all Several days More than half days Nearly every day

Total:

10. If you checked off any problems, how difficult at all have these problems made it for you to do your work, take care of things at home, or get along with other people.

Not difficult at all

Somewhat difficult

Very difficult

Extremely difficult

THE BURNS DEPRESSION INVENTORY

NAME:

DATE:

INSTRUCTIONS: The following is a list of symptoms that people sometimes have. Select an option that best describes how much that symptom or problem has bothered you during this past week.

Not at all =0

Somewhat =1

Moderately =2

A lot =3

SYMPTOM LIST

Sadness: Do you feel sad or down in the dumps?

Not at all Somewhat Moderately A lot

Discouragement: Does your future look hopeless?

Not at all Somewhat Moderately A lot

Low Self-Esteem: Do you feel worthless?

Not at all Somewhat Moderately A lot

Inferiority: Do you feel inadequate or inferior to others?

Not at all Somewhat Moderately A lot

Guilt: Do you get self-critical and blame yourself?

Not at all Somewhat Moderately A lot

Indecisiveness: Is it hard to make decisions?

Not at all Somewhat Moderately A lot

Irritability: Do you frequently feel angry or resentful?

Not at all Somewhat Moderately A lot

Loss of interest in life: Have you lost interest in your career, hobbies, family and friends?

Not at all Somewhat Moderately A lot

Loss of motivation: Do you have to push yourself to do things?

Not at all Somewhat Moderately A lot

Poor Self-Image: Do you feel old and unattractive

Not at all Somewhat Moderately A lot

Appetite Changes: Have you lost your appetite? Do you overeat or binge compulsively?

Not at all Somewhat Moderately A lot

Sleep Changes: Is it hard to get at good night's sleep? Are you excessively tired and sleeping too much?

Not at all Somewhat Moderately A lot

Loss of Libido: Have you lost your interest in sex?

Not at all Somewhat Moderately A lot

Concerns about Health: Do you wo excessively about your health

Not at all Somewhat Moderately A lot

Suicidal Impulses? Do you have thoughts that life is not worth living or think you'd be better off dead?

Not at all Somewhat Moderately A lot

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