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The University of Technology, Jamaica

College of Health Sciences


School of Allied Health & Nursing
BACHE!" !# SC$ENCE $N NU"S$N%
NU" &''() *ENTA HEATH NU"S$N%
The Interview and Assessment Process
PSYCHIATRIC DIAGNOSIS: MAJOR DEPRESSION
Clients Initials: _________ Age:_________ Date:_____________ Marital Status:___________
+"ESENT $NESS
Clients Perception of Problem
Current Symptoms
Precipitating Factors
Current Treatment
Allergies
Substance Use
+AST $NESS
Psychiatric
Meical
Family !istory
Personal " Social !istory
Se#ual !istory
"E,$E- !# S.STE*S
$espiratory
Cario%ascular
&astrointestinal
Urogenital
Se#uality
Sleep " $est
*ENTA STATUS E/A*$NAT$!N
Appearance " 'eha%iour
(e%el of Consciousness
Posture " Motor Mo%ements
Dress " &rooming
Moo
Affect: Flat ___ 'lunte___ Sa___ !appy___ )late___ An#ious___ Incongruent___
Speech
Thought Process
Thought Content
Perceptions
Insight
*ugment
Cogniti%e Functions (memory, attention & concentration, a!tract rea!onin"#
SU$C$0E +!TENT$A
Ieas Current Past
Plans If +es, Specify
Intentions
Access to Means
Attempts $ecent Past
Alcohol-Drugs
Panic Attac.s
Family !istory
!omicial Ieation
Cultural Issues
Spiritual Issues
0S*1$, CASS$#$CAT$!N
A/IS I
A/IS II
A/IS III
A/IS I0
A/IS 0

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