Informações:
Falhas:
ID
28611
Descrição
Bipolar Affective Disorder (BipoläR) Swedish National Quality Registry Head of Registry: Mikael Landén Professor at the Sahlgrenska Academy, consultant at Sahlgrenska University Hospital, 411 18 Gothenburg Source: http://www.psykiatriregister.se/dokumentarkiv/bipolar S:t Göranprojekts (Making Projects) Anamnesis protocol for bipolar syndrom
Link
http://www.psykiatriregister.se/dokumentarkiv/bipolar
Palavras-chave
Versões (2)
- 03/01/2018 03/01/2018 -
- 24/01/2018 24/01/2018 -
Titular dos direitos
psykiatriregister.se (BipoläR)
Transferido a
24 de janeiro de 2018
DOI
Para um pedido faça login.
Licença
Creative Commons BY-NC 3.0
Comentários do modelo :
Aqui pode comentar o modelo. Pode comentá-lo especificamente através dos balões de texto nos grupos de itens e itens.
Comentários do grupo de itens para :
Comentários do item para :
Para descarregar formulários, precisa de ter uma sessão iniciada. Por favor faça login ou registe-se gratuitamente.
Bipolar Affective Disorder (BipoläR) Swedish National Quality Registry
Medical History for Bipolar Syndrome (Part 1)
- StudyEvent: ODM
Similar models
Medical History for Bipolar Syndrome (Part 1)
- StudyEvent: ODM
Name
Tipo
Description | Question | Decode (Coded Value)
Tipo de dados
Alias
Name
Item
Name
text
Patient No.
Item
Patient No.
integer
Code - Number
Item
Code - Number
integer
Date of Medical history online
Item
Date of Medical history online
date
Comments on recent transfer
Item
Comments on recent transfer
text
CL Item
Swedish (1)
CL Item
Other (specify) (2)
CL Item
Sweden (1)
CL Item
Other country, which (2)
Age immigrated to Sweden
Item
Age immigrated to Sweden
integer
CL Item
Ordinary household (1)
CL Item
Ordinary household with support granted (2)
CL Item
supported housing (3)
CL Item
No housing/looking for housing (4)
CL Item
Living alone (1)
CL Item
Sharing households with spouse / partner / cohabitant (2)
CL Item
Sharing households with parent / parents (3)
CL Item
Sharing households with other adults (including own children 18 years of age or older) (4)
CL Item
Shared households with children under 18 years of age (5)
CL Item
Data not available (6)
Item
Does the patient have children under 18 years of age regardless of custody?
integer
Code List
Does the patient have children under 18 years of age regardless of custody?
CL Item
Yes, numer (1)
CL Item
No (2)
CL Item
Data not available (3)
Item
Does the patient have custody of children under the age of 18?
integer
Code List
Does the patient have custody of children under the age of 18?
CL Item
Yes, how many: (1)
CL Item
No (2)
CL Item
Data not available (3)
Item
Indicate the patient's main supply during the last six months?
integer
Code List
Indicate the patient's main supply during the last six months?
CL Item
Self-sufficiency (payroll, study funding, parental benefit retirement pension, guarantee pension) (1)
CL Item
private insurance (2)
CL Item
Sick / sickness (3)
CL Item
Financial assistance (Social contributions) (4)
CL Item
Provided by relatives (5)
CL Item
Equity (6)
CL Item
Other (7)
CL Item
Data not available (8)
Item
What is the patient's highest level of education?
integer
Code List
What is the patient's highest level of education?
CL Item
Unfinished secondary education (1)
CL Item
Completed upper secondary education (2)
CL Item
Completed secondary education (3)
CL Item
Completed secondary education (at least 2 years) (4)
CL Item
Completed secondary education (at least 3 years) (5)
CL Item
4 years of university studies or more (6)
CL Item
Data not available (7)
Profession
Item
Profession
text
Item Group
2. DETERMINATE INCORPORATED INCREASING MODE (EVERYTHING LIFE)
Item
Has anyone in your family had or has manodepressive disease or bipolar disorder? Or has someone in your family had fluctuations in the mood treated with lithium (Lithionit), valproate (Ergenyl, Absenor, Orfiril) or lamotrigine (Lamictal)?
integer
Code List
Has anyone in your family had or has manodepressive disease or bipolar disorder? Or has someone in your family had fluctuations in the mood treated with lithium (Lithionit), valproate (Ergenyl, Absenor, Orfiril) or lamotrigine (Lamictal)?
CL Item
No (1)
CL Item
Yes (2)
Comment
Item
Comment
text
Item Group
The general criteria for mania / hypomania: Persistent abnormally elevated, expansive or irritable mood
Item
Has it ever happened that you felt so good or been so upset that others thought you were not yourself?
integer
Code List
Has it ever happened that you felt so good or been so upset that others thought you were not yourself?
CL Item
loud (1)
CL Item
filled with energy (2)
CL Item
excited (3)
CL Item
filled with ideas (4)
CL Item
increased performance (5)
CL Item
extra creative (6)
CL Item
quick thought business (7)
CL Item
No (8)
Has it ever happened that you have been so screwed up that you have been in trouble in any way?
Item
Has it ever happened that you have been so screwed up that you have been in trouble in any way?
boolean
Persistent abnormally elevated, expansive mood
Item
Persistent abnormally elevated, expansive mood
boolean
Item
Has it ever happened that you were so annoying that you bumped people out of trouble or bothered? Have you been in horror with strangers?
integer
Code List
Has it ever happened that you were so annoying that you bumped people out of trouble or bothered? Have you been in horror with strangers?
CL Item
edgy (1)
CL Item
overreacted even if there were reasons for the reaction (2)
Persistent abnormal irritable mood
Item
Persistent abnormal irritable mood
boolean
Please exemplify (if multiple episodes, identify the worst) each of the items above
Item
Please exemplify (if multiple episodes, identify the worst) each of the items above
text
Item Group
For the most serious identified case above ...
CL Item
hospitalized (1)
CL Item
never treated for mania in hospitals (2)
CL Item
been hospitalized according to LPT (1)
CL Item
been hospitalized according to LRV (2)
CL Item
No, no involuntary treatment for mania (3)
CL Item
hours (1)
CL Item
days (2)
CL Item
weeks (3)
CL Item
month (4)
Item Group
Associated symptoms under the most severe forest above (Code from -3 (much less), over 0 (no symptoms), to +3 (much more / increased) See also APPENDIX 1)
During the times when you felt "high", "full of energy" or straightforward, "how was your self-esteem? (did you feel more confident than usual or that you were special, more talented, attractive or more intelligent than usual?)
Item
During the times when you felt "high", "full of energy" or straightforward, "how was your self-esteem? (did you feel more confident than usual or that you were special, more talented, attractive or more intelligent than usual?) (Self-esteem)
float
During the times when you felt "high", "full of energy" or easy-going "did you sleep less but still feel rested? (-3 = <2h or 5h less than usual; - 2 = sleep 1.5h less than normal without functioning worse; -1 = sleep less than normal; - 0.5 = discernible) (sleep need)
Item
During the times when you felt "high", "full of energy" or easy-going "did you sleep less but still feel rested? (-3 = <2h or 5h less than usual; - 2 = sleep 1.5h less than normal without functioning worse; -1 = sleep less than normal; - 0.5 = discernible) (sleep need)
float
During those times when you felt "high", "full of energy" or straightforward "were you more talkative than usual? (difficult to interrupt, or difficult to understand what you meant, difficult to keep up with) (Numeracy)
Item
During those times when you felt "high", "full of energy" or straightforward "were you more talkative than usual? (difficult to interrupt, or difficult to understand what you meant, difficult to keep up with) (Numeracy)
float
During those times when you felt "high", "full of energy" or easy-going "did you have more ideas usually? Was it like the thoughts rushed in the head? Hard to shave your mind? (Idea racing)
Item
During those times when you felt "high", "full of energy" or easy-going "did you have more ideas usually? Was it like the thoughts rushed in the head? Hard to shave your mind? (Idea racing)
float
During the times when you felt "high", "full of energy" or straightforward "did you have trouble concentrating because the smallest event distracted you? Difficult to focus on a task? (Distractibility)
Item
During the times when you felt "high", "full of energy" or straightforward "did you have trouble concentrating because the smallest event distracted you? Difficult to focus on a task? (Distractibility) (Lättdistraherad)
float
During the times when you felt "high", "full of energy" or easy-going "what did you do on the days (work, friends, leisure time)? Were you active or made many things at the same time? Were you so active that people were worried about you? Were you restless and had trouble sitting still? (Targeted Activity / Psychomotor Agitation)
Item
During the times when you felt "high", "full of energy" or easy-going "what did you do on the days (work, friends, leisure time)? Were you active or made many things at the same time? Were you so active that people were worried about you? Were you restless and had trouble sitting still? (Targeted Activity / Psychomotor Agitation)
float
During the times when you felt "high", "full of energy" or easy-to-do "did you do anything that could have worried you or your family (Bought things you did not need?) (Sexual contacts out of the ordinary for you? ) (Careless car driving?) Did you do anything that could have caused problems if you got caught? (Lust / risk behavior)
Item
During the times when you felt "high", "full of energy" or easy-to-do "did you do anything that could have worried you or your family (Bought things you did not need?) (Sexual contacts out of the ordinary for you? ) (Careless car driving?) Did you do anything that could have caused problems if you got caught? (Lust / risk behavior)
float
Item
What consequences have the worst-case episodes / episodes received in terms of relationship problems, work, study problems, economic problems, violence, clammy with justice
integer
Code List
What consequences have the worst-case episodes / episodes received in terms of relationship problems, work, study problems, economic problems, violence, clammy with justice
CL Item
no (1)
CL Item
mild (2)
CL Item
moderate (3)
CL Item
severe (4)
CL Item
very difficult (5)
Example for consequences
Item
Example for consequences
text
FIRST EPISODE: How old were you the first time you had a hypomania?
Item
FIRST EPISODE: How old were you the first time you had a hypomania?
float
FIRST EPISODE: How old were you the first time you had a mania?
Item
FIRST EPISODE: How old were you the first time you had a mania?
integer
Item Group
Determine psychotic symptoms during an attack of elevated mood
Persecutory performances
Item
Persecutory performances
boolean
Delusions
Item
Delusions
boolean
Hallucinations
Item
Hallucinations
boolean
Mood-Congruent Psychotic Symptoms
Item
Mood-Congruent Psychotic Symptoms
boolean
Mood-related psychotic symptoms
Item
Mood-related psychotic symptoms
boolean
Has any typical triggering stress factor for mania been identified
Item
Has any typical triggering stress factor for mania been identified
boolean
Has any typical early sign been identified? (in form of some behavior that can be measured / counted)
Item
Has any typical early sign been identified? (in form of some behavior that can be measured / counted)
boolean
Mania
Item
Mania
boolean
Hypomania
Item
Hypomania
boolean
Enhanced mood mode UNS
Item
Enhanced mood mode UNS
boolean
No sign of mania
Item
No sign of mania
boolean
Euphoric type (Everything is interesting, amazing, expansive)
Item
Euphoric type (Everything is interesting, amazing, expansive)
boolean
Dysphoric or mixed mania (mania with at least 2 depressive symptoms, and dysphoria, filled with negative energy, agitated, guilt and SU thoughts)
Item
Dysphoric or mixed mania (mania with at least 2 depressive symptoms, and dysphoria, filled with negative energy, agitated, guilt and SU thoughts)
boolean
Can not determine / Not applicable
Item
Can not determine / Not applicable
boolean
Have you experienced any period when you felt depressed or depressed most throughout the day, almost every day for two weeks?
Item
1. Have you experienced any period when you felt depressed or depressed most throughout the day, almost every day for two weeks?
boolean
Have you experienced a period when you felt much less interested than usual most of your life or felt it difficult to enjoy what you usually like? (almost every day for two weeks?)
Item
2. Have you experienced a period when you felt much less interested than usual most of your life or felt it difficult to enjoy what you usually like? (almost every day for two weeks?)
boolean
Item Group
If one of the general criteria is yes: Significant symptoms during the most severe episode
....how was your night's sleep?
Item
3)...how was your night's sleep?
float
....did you feel guilty of what you did or failed to do?
Item
4a) ....did you feel guilty of what you did or failed to do?
float
... how was your self-esteem (worthlessness)?
Item
4b)... how was your self-esteem (worthlessness)?
float
...how was your energy? Were there things you would have done but did not do due to bad energy and fatigue?
Item
5) ...how was your energy? Were there things you would have done but did not do due to bad energy and fatigue?
float
... did you have trouble thinking or concentrating? Could you read the magazine or watch TV? Was it difficult to make decisions in everyday matters (ambivalence)?
Item
6) ... did you have trouble thinking or concentrating? Could you read the magazine or watch TV? Was it difficult to make decisions in everyday matters (ambivalence)?
float
... did you decrease or increase weight? How was your appetite?
Item
7) ... ... did you decrease or increase weight? How was your appetite?
float
... were you so worried or restless that you could not sit still? Or, conversely, you talked or moved more slowly than usual? If I was there, would I´ve noticed something was wrong?
Item
8a) ... were you so worried or restless that you could not sit still? Or, conversely, you talked or moved more slowly than usual? If I was there, would I´ve noticed something was wrong?
float
... or on the contrary so you spoke or moved more slowly than usual? If I were there, would I´ve noticed something was wrong?
Item
8b)... or on the contrary so you spoke or moved more slowly than usual? If I were there, would I´ve noticed something was wrong?
float
... was it so hard you came to think of death or that it was better if you were dead?
Item
9a) ... was it so hard you came to think of death or that it was better if you were dead?
boolean
... did you think about taking your life or hurting yourself?
Item
9b)... did you think about taking your life or hurting yourself?
boolean
...did you make any attempt to commit suicide?
Item
9c) ...did you make any attempt to commit suicide?
boolean
Item Group
For the most serious identified case above ...
CL Item
hospitalized (1)
CL Item
never been treated for depression in hospital (2)
CL Item
been treated for depression according to LPT (1)
CL Item
been treated for depression according to LRV (2)
CL Item
never forcibly been treated for depression (3)
CL Item
hours (1)
CL Item
days (2)
CL Item
weeks (3)
CL Item
month (4)
Item Group
The patient has at some time met the criteria for:
Depression
Item
Depression
boolean
Dysthymia
Item
Dysthymia (Clear depressive symptoms but do not meet depression criteria, such as clear mood for a week or 4 symptoms).
boolean
No signs of depression
Item
No signs of depression
boolean
When was your first episode for a week or longer?
Item
When was your first episode for a week or longer?
text
Age of first episode
Item
Age of first episode
integer
Anhedonia
Item
Anhedonia (The ability to feel joy has completely disappeared)
boolean
Indelible
Item
Indelible (Does not react to positive stimuli)
boolean
Distinct quality of sadness
Item
Distinct quality (Completely different from sadness and worries)
boolean
Worst in the morning
Item
Worst in the morning
boolean
Early morning awakening (At least 2 hours before normal time)
Item
Early morning awakening (At least 2 hours before normal time)
boolean
Strong psychomotor inhibition or agitation
Item
Strong psychomotor inhibition or agitation
boolean
Significant weight loss
Item
Significant weight loss
boolean
Exaggerated, unjustified guilty feelings
Item
Exaggerated, unjustified guilty feelings
boolean
CL Item
No (1)
CL Item
Yes, if the patient ever had melancholic depression (2)
Item Group
Specification of psychosis symptoms for depression relapse
Persecutory performances
Item
Persecutory performances
boolean
If yes, please specify
Item
If yes, please specify
text
Delusions
Item
Delusions
boolean
If yes, please specify
Item
If yes, please specify
text
Hallucinations
Item
Hallucinations
boolean
If yes, please specify
Item
If yes, please specify
text
If yes, at any psychosis symptoms: Mood-Congruent Psychotic Symptoms (includes depression, debt, illness, death, punishment)
Item
If yes, at any psychosis symptoms: Mood-Congruent Psychotic Symptoms (includes depression, debt, illness, death, punishment)
boolean
If yes, at any psychosis symptoms: Mood-Incongruent Psychotic Symptoms
Item
If yes, at any psychosis symptoms: Mood-Incongruent Psychotic Symptoms (which does not include the depression theme, such as thought imprisonment, persecution ideas, thought-out, influence and governance experiences)
boolean
Has any depression typical triggering stress factor been identified?
Item
Has any depression typical triggering stress factor been identified?
boolean
If yes, please specify depression typical triggering stress factor
Item
If yes, please specify depression typical triggering stress factor
text
Item Group
Determine the presence of MIXED EPISODES. Has the patient also had depressive symptoms during manic episodes, or hypomanic symptoms in depression?
YES Mixed episodes (During the same week, the criteria [in addition to duration] met on depression and mania)
Item
YES Mixed episodes (During the same week, the criteria [in addition to duration] met on depression and mania)
boolean
YES Dysphonic mania (mania with at least 2 depressive symptoms, such as guilt and SU thoughts)
Item
YES Dysphonic mania (mania with at least 2 depressive symptoms, such as guilt and SU thoughts)
boolean
YES Agitated depression (Depression with at least 2 hypomanal symptoms, such as severe restlessness, idea-reflection)
Item
YES Agitated depression (Depression with at least 2 hypomanal symptoms, such as severe restlessness, idea-reflection)
boolean
NO
Item
NO
boolean
Item Group
Psychotic syndrom: These are questions in support of the differential diagnosis of schizophrenia or psychosis secondary to somatic disease or abuse. Non mandatory questions.
Current or past delusions
Item
Current or past delusions
boolean
Current or past hallucinations
Item
Current or past hallucinations
boolean
Current or past formal mental disorders (incoherent numbers, escaped associations)
Item
Current or past formal mental disorders (incoherent numbers, escaped associations)
boolean
Current or past negative symptoms (excluded effects, initiativeless) in addition to depression episodes
Item
Current or past negative symptoms (excluded effects, initiativeless) in addition to depression episodes
boolean
Current or past bizarre behavior, catatony, or disorganized behavior
Item
Current or past bizarre behavior, catatony, or disorganized behavior
boolean
A markedly low level of functioning even before symptoms of affective disease began
Item
A markedly low level of functioning even before symptoms of affective disease began
boolean
Has any of the psychotic symptoms occurred without serious mood?
Item
Has any of the psychotic symptoms occurred without serious mood?
boolean
Have any of the above symptoms occurred without intoxication, medication (eg steroids) or neurological or metabolic disease?
Item
Have any of the above symptoms occurred without intoxication, medication (eg steroids) or neurological or metabolic disease?
boolean
If misconduct has occurred, has this lasted briefly compared with the positive or negative symptoms?
Item
If misconduct has occurred, has this lasted briefly compared with the positive or negative symptoms?
boolean
Have any of the above-mentioned positive symptoms lasted for a longer period (a month's time, or less if the patient has become successfully treated)?
Item
Have any of the above-mentioned positive symptoms lasted for a longer period (a month's time, or less if the patient has become successfully treated)?
boolean
Has disorganization been conducted for at least 6 months (shorter time if successfully treated)?
Item
Has disorganization been conducted for at least 6 months (shorter time if successfully treated)?
boolean
CL Item
No (1)
CL Item
Yes, age at first psychosis (2)
If yes, please specify age of first psychosis
Item
If yes, please specify age of first psychosis
integer
Fill in an appropriate psychosis diagnosis below: affective psychosis, depression - psychosis associated with depressive episodes
Item
Fill in an appropriate psychosis diagnosis below: affective psychosis, depression - psychosis associated with depressive episodes
boolean
Affective psychosis, mania - Psychosis associated with manic episodes
Item
Affective psychosis, mania - Psychosis associated with manic episodes
boolean
Cycloid Psychosis - Significant confusion, acute debut, such as insomnia, dramatic mood swings, such as postpartum dysfunction
Item
Cycloid Psychosis - Significant confusion, acute debut, such as insomnia, dramatic mood swings, such as postpartum dysfunction
boolean
Schizoaffective disease - Psychosis Symptoms That Persist > 2 weeks after the end of the affective episode
Item
Schizoaffective disease - Psychosis Symptoms That Persist > 2 weeks after the end of the affective episode
boolean
Schizophrenia - The affective disease symptoms duration is significantly shorter than the psychosis
Item
Schizofreni Schizophrenia - The affective disease symptoms duration is significantly shorter than the psychosis
boolean
Psychosis secondary to psychiatric drugs - All psychotic symptoms can be attributed to prescribed treatment with antidepressant or central stimulants
Item
Psychosis secondary to psychiatric drugs - All psychotic symptoms can be attributed to prescribed treatment with antidepressant or central stimulants
boolean
Psychosis secondary to addiction - All psychotic symptoms can be attributed to substance abuse. Either during use or during withdrawal phase.
Item
Psychosis secondary to addiction - All psychotic symptoms can be attributed to substance abuse. Either during use or during withdrawal phase.
boolean
Psychosis secondary to somatic disease - All psychotic symptoms can be attributed to somatic disease
Item
Psychosis secondary to somatic disease - All psychotic symptoms can be attributed to somatic disease
boolean
Other type of psychosis
Item
Other type of psychosis
boolean
If other type of psychosis please specify
Item
If other type of psychosis please specify
text