Self Screening
Copyright 2009 NYCGS: Individual Psychotherapy. All Rights Reserved.
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News Letter
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1.
In the last month has there been a period of time when you were feeling depressed or down most of the day nearly every day? If yes, did it last as long as 2 weeks?
In the last month has there been a period of time when you were feeling depressed or down most of the day nearly every day? If yes, did it last as long as 2 weeks?2.What about being a lot less interested in most things or unable to enjoy the things you used to enjoy?
What about being a lot less interested in most things or unable to enjoy the things you used to enjoy? 3.Have you ever had a period when you were feeling depressed or down most of the day nearly every day?
Have you ever had a period when you were feeling depressed or down most of the day nearly every day? 4.In the last month, has there been a period of time when you were feeling so good or hyper that other people thought you were not your normal self or you were so hyper that you got into trouble? Did anyone say you were manic? Was that more than just feeling good?
In the last month, has there been a period of time when you were feeling so good or hyper that other people thought you were not your normal self or you were so hyper that you got into trouble? Did anyone say you were manic? Was that more than just feeling good?5.What about a time when you were so irritable that you would shout at people or start fights or arguments?
What about a time when you were so irritable that you would shout at people or start fights or arguments?6.Have you ever had a time when you were feeling so good or hyper that other people thought that you were not your normal self or you were so hyper that you got into trouble? Did anyone say that you were manic? Was that more than just feeling good?
Have you ever had a time when you were feeling so good or hyper that other people thought that you were not your normal self or you were so hyper that you got into trouble? Did anyone say that you were manic? Was that more than just feeling good?7.For the past couple of years, have you been bothered by a depressed mood most of the day, more days than not?
For the past couple of years, have you been bothered by a depressed mood most of the day, more days than not? 8.Have you had any unusual experiences, for example did it ever seem like people were talking about you or taking a special notice of you?
Have you had any unusual experiences, for example did it ever seem like people were talking about you or taking a special notice of you?9.What about receiving special messages from people or from the way things were arranged around you, or from the newspaper, radio, or TV?
What about receiving special messages from people or from the way things were arranged around you, or from the newspaper, radio, or TV?10.Other than when you were depressed or feeling high, has there been a time when you heard voices, had visions, or saw or smelled things that others couldn’t see or smell? Or did you do something to call attention to yourself like dressing in some odd way or doing something strange?
Other than when you were depressed or feeling high, has there been a time when you heard voices, had visions, or saw or smelled things that others couldn’t see or smell? Or did you do something to call attention to yourself like dressing in some odd way or doing something strange?11.Was there ever a period of time when you drank too much? Has alcohol ever been a problem for you?
Was there ever a period of time when you drank too much? Has alcohol ever been a problem for you?12.Has any one objected to your drinking?
Has any one objected to your drinking?13.Have you used any street drugs or have you used prescription drugs in an amount or way that wasn’t prescribed?
Have you used any street drugs or have you used prescription drugs in an amount or way that wasn’t prescribed?14.Have you ever had a panic attack, when you suddenly felt frightened, anxious or extremely uncomfortable?
Have you ever had a panic attack, when you suddenly felt frightened, anxious or extremely uncomfortable?15.Were you afraid of going out of the house alone, being in crowds, standing in line or traveling on buses or trains?
Were you afraid of going out of the house alone, being in crowds, standing in line or traveling on buses or trains?16.Is there anything that you were afraid to do or uncomfortable doing in front of other people like speaking, eating or writing?
Is there anything that you were afraid to do or uncomfortable doing in front of other people like speaking, eating or writing?17.Are there any other things that you have been especially afraid of, like flying, heights, seeing blood, closed places, or certain kinds of animals or insects?
Are there any other things that you have been especially afraid of, like flying, heights, seeing blood, closed places, or certain kinds of animals or insects?18.Have you ever been bothered by thoughts that didn’t make any sense and kept coming back to you even when you tried not to have them.
Have you ever been bothered by thoughts that didn’t make any sense and kept coming back to you even when you tried not to have them.19.was there ever anything that you had to do over and over again and couldn’t resist doing, like washing your hands again and again or checking something several times to make sure you’d done it right?
was there ever anything that you had to do over and over again and couldn’t resist doing, like washing your hands again and again or checking something several times to make sure you’d done it right?20.In the last six months, have you been particularly nervous or anxious?
In the last six months, have you been particularly nervous or anxious?21.Do you worry a lot about terrible things that might happen?
Do you worry a lot about terrible things that might happen?22.Do you worry a lot about your physical health? Does your doctor think that you worry too much?
Do you worry a lot about your physical health? Does your doctor think that you worry too much?23.Have you ever had a time when you weighed much less than people thought you ought to weigh? At
Have you ever had a time when you weighed much less than people thought you ought to weigh? At that time were you very afraid that you could become fat?
24.Have you ever had eating binges when you ate a lot in a short period of time? During these binges, did you feel your eating was out of control?
Have you ever had eating binges when you ate a lot in a short period of time? During these binges, did you feel your eating was out of control?