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ID
28614
Description
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
Keywords
Versions (2)
- 1/9/18 1/9/18 -
- 1/24/18 1/24/18 -
Copyright Holder
psykiatriregister.se (BipoläR)
Uploaded on
January 24, 2018
DOI
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License
Creative Commons BY-NC 3.0
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Bipolar Affective Disorder (BipoläR) Swedish National Quality Registry
Medical History for Bipolar Syndrome (Part 4)
- StudyEvent: ODM
Similar models
Medical History for Bipolar Syndrome (Part 4)
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Number of siblings:
Item
Number of siblings:
integer
Date of birth male sibling(s)
Item
Date of birth male sibling(s)
integer
Date of birth female sibling(s)
Item
Date of birth female sibling(s)
integer
Number of children
Item
Number of children
integer
Date of birth son(s)
Item
Date of birth son(s)
integer
Date of birth daughter(s)
Item
Date of birth daughter(s)
integer
Patient is adopted and has no knowledge of biological relatives
Item
Patient is adopted and has no knowledge of biological relatives
boolean
Item Group
ASK ACTIVE but not necessary to ignore everything
Type of Disease
Item
Type of Disease
text
Mother
Item
Mother
integer
Father
Item
Father
integer
Sister 1
Item
Sister 1
integer
Sister 2
Item
Sister 2
integer
Sister 3
Item
Sister 3
integer
Brother 1
Item
Brother 1
integer
Brother 2
Item
Brother 2
integer
Brother 3
Item
Brother 3
integer
Daughter 1
Item
Daughter 1
integer
Daughter 2
Item
Daughter 2
integer
Daughter 3
Item
Daughter 3
integer
Son 1
Item
Son 1
integer
Son 2
Item
Son 2
integer
Son 3
Item
Son 3
integer
Item Group
ASK ACTIVE but not necessary to ignore everything
Mother's side: Grandmother
Item
Mother's side: Grandmother
integer
Mother's side: Grandpa
Item
Mother's side: Grandpa
integer
Mother´s side: Aunt 1
Item
Mother´s side: Aunt 1
integer
Mother's side: Uncle 1
Item
Mother's side: Uncle 1
integer
Mother's side: Cousin 1
Item
Mother's side: Cousin 1
integer
Mother's side: Cousin 2
Item
Mother's side: Cousin 2
integer
Father's side: Grandmother
Item
Father's side: Grandmother
integer
Father´s side: Grandfather
Item
Father´s side: Grandfather
integer
Father's Side: Aunt 1
Item
Father's Side: Aunt 1
integer
Father's Side: Uncle 1
Item
Father's Side: Uncle 1
integer
Father's Side: Cousin 1
Item
Father's Side: Cousin 1
integer
Father´s side: Cousin 2
Item
Father´s side: Cousin 2
integer
Item
Has the patient ever previously received patient education for bipolar disorder, systematic psychological treatment and / or neuropsychological investigation? *
integer
Code List
Has the patient ever previously received patient education for bipolar disorder, systematic psychological treatment and / or neuropsychological investigation? *
CL Item
Yes (Specify which / which * Multiple answer options can be specified) (1)
CL Item
No (2)
CL Item
Data not available (3)
Specification of patient education: bipolar syndrome
Item
Specification of patient education: bipolar syndrome (educational initiative that follows a predefined education program comprising a number of training courses where the content aims to provide increased knowledge about disease and treatment, strategies for managing everyday symptoms and opportunity for exchange of experience)
boolean
Specification of patient education psychological treatment
Item
Specification of patient education psychological treatment (eg psychodynamic, dialectic-behavioral, interpersonal, cognitive or cognitive-behavioral therapy)
boolean
Specification of patient education Neuropsychological investigation
Item
Specification of patient education Neuropsychological investigation (investigation with standardized tests that measure cognitive functions as attention, memory function, concentration ability, learning ability)
boolean
Item
If yes, the patient has received patient education for bipolar disorder in the past 12 months, systematically psychologically treatment and / or neuropsychological investigation?
integer
Code List
If yes, the patient has received patient education for bipolar disorder in the past 12 months, systematically psychologically treatment and / or neuropsychological investigation?
CL Item
Yes (Specify which / which * Multiple answer options can be specified) (1)
CL Item
No (2)
CL Item
Data not available (3)
Specification of patient education: bipolar syndrome
Item
Specification of patient education: bipolar syndrome (educational initiative that follows a predefined education program comprising a number of training courses where the content aims to provide increased knowledge about disease and treatment, strategies for managing everyday symptoms and opportunity for exchange of experience)
boolean
Specification of patient education: systematic treatment
Item
Specification of patient education: systematic treatment (eg psychodynamic, dialectic-behavioral, interpersonal, cognitive or cognitive-behavioral therapy)
boolean
Specification of patient education: Neuropsychological investigation
Item
Specification of patient education: Neuropsychological investigation (investigation with standardized tests that measure cognitive functions as attention, memory function, concentration ability, learning ability)
boolean
Item
Has the patient ever been treated with ECT before?
integer
Code List
Has the patient ever been treated with ECT before?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Data not available (3)
If yes, the number of treatment series during life
Item
If yes, the number of treatment series during life
integer
Item
If yes, estimate outcomes for the latest treatment series:
integer
Code List
If yes, estimate outcomes for the latest treatment series:
CL Item
0 (not assessed) (1)
CL Item
1 (Very much improved) (2)
CL Item
2 (much improved) (3)
CL Item
3 (minimally improved) (4)
CL Item
4 (no change) (5)
CL Item
5 (minimally worse) (6)
CL Item
6 (much worse) (7)
CL Item
7 (very much worse) (8)
Item
If yes, has the patient been treated with ECT over the past 12 months?
integer
Code List
If yes, has the patient been treated with ECT over the past 12 months?
CL Item
Yes (1)
CL Item
No (2)
CL Item
Data not available (3)
Item
Estimate the treatment effect according to CGI-I. Compared with the patient's condition before treatment, how much has he / she changed? Dial the appropriate option.
integer
Code List
Estimate the treatment effect according to CGI-I. Compared with the patient's condition before treatment, how much has he / she changed? Dial the appropriate option.
CL Item
0 (not assessed) (1)
CL Item
1 (Very much improved) (2)
CL Item
2 (much improved) (3)
CL Item
3 (minimally improved) (4)
CL Item
4 (no change) (5)
CL Item
5 (minimally worse) (6)
CL Item
6 (much worse) (7)
CL Item
7 (very much worse) (8)
Item
Tax treatment effects according to CGI-I. Compared with the patient's condition before treatment, how much has he / she changed? Dial the appropriate option.
integer
Code List
Tax treatment effects according to CGI-I. Compared with the patient's condition before treatment, how much has he / she changed? Dial the appropriate option.
CL Item
0 (not assessed) (1)
CL Item
1 (Very much improved) (2)
CL Item
2 (much improved) (3)
CL Item
3 (minimally improved) (4)
CL Item
4 (no change) (5)
CL Item
5 (minimally worse) (6)
CL Item
6 (much worse) (7)
CL Item
7 (very much worse) (8)
Treatment with carbamazepine
Item
Treatment with carbamazepine
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
Treatment with clonazepam
Item
Treatment with clonazepam
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
Treatment with Lamotrigin
Item
Treatment with Lamotrigin
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Treatment with Litium
Item
Treatment with Litium
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
Treatment with oxcarbazepine
Item
Treatment with oxcarbazepine
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
Treatment with topiramate
Item
Treatment with topiramate
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
Treatment with valproate
Item
Treatment with valproate
boolean
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
Other
Item
Other
boolean
If other, please specify
Item
If other, please specify
text
How long was the treatment going on, estimate the number of years
Item
How long was the treatment going on, estimate the number of years
float
CL Item
0 (1)
CL Item
1 (2)
CL Item
2 (3)
CL Item
3 (4)
CL Item
4 (5)
CL Item
5 (6)
CL Item
6 (7)
CL Item
7 (8)
Drug side effect that prevented the use of the drug?
Item
Drug side effect that prevented the use of the drug?
boolean
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