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ID
28738
Beschrijving
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
Trefwoorden
Versies (1)
- 30-01-18 30-01-18 -
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psykiatriregister.se (BipoläR)
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30 januari 2018
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Licentie
Creative Commons BY-NC 3.0
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Bipolar Affective Disorder (BipoläR) Swedish National Quality Registry
History of Bipolar Syndrome (Part 8)
- StudyEvent: ODM
Similar models
History of Bipolar Syndrome (Part 8)
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Datatype
Alias
Item Group
Ongoing drug treatment: Mood stabilizing medicine
Item
Refers to ongoing drug treatment and includes Karbamazepine, Clonazepam, Lamotrigine, Lithium, Oxcarbazepine, Quetiapine, Topiramate, Valproate, and any other mood stabilizing drug. A response option can be specified
integer
Code List
Refers to ongoing drug treatment and includes Karbamazepine, Clonazepam, Lamotrigine, Lithium, Oxcarbazepine, Quetiapine, Topiramate, Valproate, and any other mood stabilizing drug. A response option can be specified
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
Mood stabilizing drugs: state which one - Several response options can be specified
Item
Mood stabilizing drugs: state which one - Several response options can be specified: Karbamazepin
boolean
Lamotrigin
Item
Lamotrigin
boolean
Lithium
Item
Lithium
boolean
Valproat
Item
Valproat
boolean
Other
Item
Other
boolean
If the patient is treated with lithium at present: What year was lithium used for the first time?
Item
If the patient is treated with lithium at present: What year was lithium used for the first time?
integer
Enter the last value of S-Lithium, but not older than 12 months
Item
Enter the last value of S-Lithium, but not older than 12 months
float
Item
Have kidney function been investigated with regard to glomerular filtration rate (GFR) in the last 12 months?
integer
Code List
Have kidney function been investigated with regard to glomerular filtration rate (GFR) in the last 12 months?
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
Which kidney function test: Creatinine. Enter the last value of Creatine
Item
Which kidney function test: Creatinine. Enter the last value of Creatine
float
Cystatin C. Enter value
Item
Cystatin C. Enter value
float
Iohexol-clearance. Enter value
Item
Iohexol-clearance. Enter value
float
Other method
Item
Other method
boolean
if other method, please specify
Item
if other method, please specify
text
Item
Refers to ongoing drug treatment including Alimemazine, Aripiprazole, Dixyrazine, Flufenazine, Flupentixol, Haloperidol, Chlorpromazine, Kloprotixen, Klozapine, Levomepromazine, Melperon, Olanzapine, Paliperidone, Perfenazine, Pimozide, Quetiapine, Risperidone, Sertindole, Sulpiride, Tioridazine, Ziprasidone, Zuclopentixol, Ev other antipsychotic drug.
integer
Code List
Refers to ongoing drug treatment including Alimemazine, Aripiprazole, Dixyrazine, Flufenazine, Flupentixol, Haloperidol, Chlorpromazine, Kloprotixen, Klozapine, Levomepromazine, Melperon, Olanzapine, Paliperidone, Perfenazine, Pimozide, Quetiapine, Risperidone, Sertindole, Sulpiride, Tioridazine, Ziprasidone, Zuclopentixol, Ev other antipsychotic drug.
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
Antipsychotics, state which one: Typical antipsychotic drugs
Item
Antipsychotics, state which one: Typical antipsychotic drugs
boolean
Atypical antipsychotic drugs: Aripiprazole
Item
Atypical antipsychotic drugs: Aripiprazole
boolean
Atypical antipsychotic drugs: Klozapine
Item
Atypical antipsychotic drugs: Klozapine
boolean
Atypical antipsychotic drugs: Olanzapine
Item
Atypical antipsychotic drugs: Olanzapine
boolean
Atypical antipsychotic drugs: Quetiapine
Item
Atypical antipsychotic drugs: Quetiapine
boolean
Atypical antipsychotic drugs, other
Item
Atypical antipsychotic drugs, other
boolean
If other, please specify
Item
If other, please specify
text
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
Antidepressants: state which - Dial one or more. : Agomelatin
Item
Antidepressants: state which - Dial one or more. : Agomelatin
boolean
Amitryptiline
Item
Amitryptiline
boolean
Bupropion
Item
Bupropion
boolean
Citalopram
Item
Citalopram
boolean
Duloxetine
Item
Duloxetine
boolean
Escitalopram
Item
Escitalopram
boolean
Fluoxetine
Item
Fluoxetine
boolean
Fluvoxamine
Item
Fluvoxamine
boolean
Imipramine
Item
Imipramine
boolean
Klomipramine
Item
Klomipramine
boolean
Lofepramine
Item
Lofepramine
boolean
Maprotiline
Item
Maprotiline
boolean
Mianserine
Item
Mianserine
boolean
Mirtazapine
Item
Mirtazapine
boolean
Moclobemid
Item
Moclobemid
boolean
Nefazodon
Item
Nefazodon
boolean
Nortryptiline
Item
Nortryptiline
boolean
Paroxetine
Item
Paroxetine
boolean
Phenelzine
Item
Phenelzine
boolean
Reboxetine
Item
Reboxetine
boolean
Sertraline
Item
Sertraline
boolean
Tranylcypromine
Item
Tranylcypromine
boolean
Trimipramine
Item
Trimipramine
boolean
Venlafaxine
Item
Venlafaxine
boolean
Other
Item
Other
boolean
If other, please specify
Item
If other, please specify
text
Item
MEDICINE FOR ADHD: Refers to ongoing drug treatment and includes Atomoxetine, central stimulant, and any other drug against ADHD. By central stimulant medicine is meant e.g. methylphenidate, dexamethetamine, modafinil, but not atomoxetine. A response option can be specified
integer
Code List
MEDICINE FOR ADHD: Refers to ongoing drug treatment and includes Atomoxetine, central stimulant, and any other drug against ADHD. By central stimulant medicine is meant e.g. methylphenidate, dexamethetamine, modafinil, but not atomoxetine. A response option can be specified
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
If yes, specify which / Multiple response options can be specified: Atomoxetin
Item
If yes, specify which / Multiple response options can be specified: Atomoxetin
boolean
Central stimulants
Item
Central stimulants
boolean
Other
Item
Other
boolean
Item
BENSODIAZEPINE OR BENSODIAZEPIN- ALIKE MEDICINAL PRODUCTS: Refers to ongoing drug treatment including Alprazolam, Buspirone, Diazepam, Flunitrazepam, Hydroxizin, Lorazepam, Clomethiazole, Nitrazepam, Oxazepam, Pregabalin, Prometazin, Propiomazine, Propranolol, Triazolam, Valeriana, Zaleplon, Zolpidem, Zopiclone, and any other benzodiazepine-like drug.
integer
Code List
BENSODIAZEPINE OR BENSODIAZEPIN- ALIKE MEDICINAL PRODUCTS: Refers to ongoing drug treatment including Alprazolam, Buspirone, Diazepam, Flunitrazepam, Hydroxizin, Lorazepam, Clomethiazole, Nitrazepam, Oxazepam, Pregabalin, Prometazin, Propiomazine, Propranolol, Triazolam, Valeriana, Zaleplon, Zolpidem, Zopiclone, and any other benzodiazepine-like drug.
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
CL Item
1: The patient received hypothyroidism after a period of lithium treatment (the patient usually knows that she started taking Levaxin ® after a period of lithium treatment) (1)
CL Item
2: The patient has not taken lithium, or had hypothyroidism before starting lithium. (2)
CL Item
3: Patient has or has had hyperthyroidism. Excess thyroid hormone. Can be treated with surgery or with drug treatment to shrink the thyroid gland (3)
CL Item
4: Do not want to answer (4)
Item
Has the patient had any drug addiction during the last 12 months that caused the withdrawal or replacement?
text
Code List
Has the patient had any drug addiction during the last 12 months that caused the withdrawal or replacement?
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
If yes, what preparations were used?
Item
If yes, what preparations were used?
text
Due to which side effects?
Item
Due to which side effects?
text
Item
Does the patient use any hormone substance? Anticonceptive agents
integer
Code List
Does the patient use any hormone substance? Anticonceptive agents
CL Item
Gestagener and Estrogens (Combination Substance) (1)
CL Item
Gestagener (Mini-pill) (2)
CL Item
Means against peri-postmenopausal symptoms, against endometriosis, premenstrual disorders (3)
CL Item
Other hormone substances ............ (4)
If other, please specify
Item
If other, please specify
text
Is the patient continuously on any other drug not documented above? Tex antiinflammatory preparations.
Item
Is the patient continuously on any other drug not documented above? Tex antiinflammatory preparations.
boolean
If yes, which?
Item
If yes, which?
text
Item
Are there any of the following conditions in addition to bipolar disorder? Includes diagnosed states, suspected conditions investigated (even if diagnosis is not yet established) as well as complicating circumstances.
integer
Code List
Are there any of the following conditions in addition to bipolar disorder? Includes diagnosed states, suspected conditions investigated (even if diagnosis is not yet established) as well as complicating circumstances.
CL Item
Yes (1)
CL Item
No (2)
CL Item
No data available (3)
If yes, which? Several response options can be specified.: diabetes Disease
Item
If yes, which? Several response options can be specified.: diabetes Disease
boolean
Cardiovascular disease
Item
Cardiovascular disease
boolean
Hypertension
Item
Hypertension
boolean
Kidney disease
Item
Kidney disease
boolean
Thyroid disease, hypothyroidism
Item
Thyroid disease, hypothyroidism
boolean
Thyroid disease, hyperthyroidism
Item
Thyroid disease, hyperthyroidism
boolean
Psoriasis
Item
Psoriasis
boolean
Allergies / eczema
Item
Allergies / eczema
boolean
Pregnancy
Item
Pregnancy
boolean
Breast-feeding
Item
Breast-feeding
boolean
Rheumatoid arthritis, osteoarthritis
Item
Rheumatoid arthritis, osteoarthritis
boolean
Migraine
Item
Migraine
boolean
Multiple sclerosis
Item
Multiple sclerosis
boolean
Epilepsy
Item
Epilepsy
boolean
Alzheimer's / other dementia disease
Item
Alzheimer's / other dementia disease
boolean
Parkinson's disease
Item
Parkinson's disease
boolean
Gastritis / Ulcus
Item
Gastritis / Ulcus
boolean
IBS irritable bowel syndrom
Item
IBS irritable bowel syndrom
boolean
Crohn's disease
Item
Crohn's disease
boolean
Ulcerative colitis
Item
Ulcerative colitis
boolean
Hepatitis
Item
Hepatitis
boolean
Other disease
Item
Other disease
boolean
if other, please specify
Item
if other, please specify
text
Data not available
Item
Data not available
boolean
Enter the current value of HbA1c.
Item
Enter the current value of HbA1c.
float
Data not available
Item
Data not available
boolean
Enter current systolic blood pressure.
Item
Enter current systolic blood pressure. Systolic blood pressure, upper pressure (mm Hg) registered in sitting after at least two minutes rest (recommendation).
float
Data not available
Item
Data not available
boolean
Enter current diastolic blood pressure.
Item
Enter current diastolic blood pressure. Diastolic blood pressure, lower pressure (mm Hg) recorded in sitting after at least two minutes rest (recommendation).
float
Data not available
Item
Data not available
boolean
Enter the current weight.
Item
Enter the current weight. Weight = kg, without outerwear, jacket and shoes.
float
Data not available
Item
Data not available
boolean
Enter current length
Item
Enter current length. Length = cm, without shoes.
float
Data not available
Item
Data not available
boolean