M.I.N.I.

KID
MINI INTERNATIONAL NEUROPSYCHIATRIC INTERVIEW
For Children and Adolescents (Parent Version)
English Version 6.0

Patient Name: Date of Birth: Interviewer’s Name: Date of Interview:

Patient Number: Time Interview Began: Time Interview Ended: Total Time:
MEETS CRITERIA

MODULES A MAJOR DEPRESSIVE EPISODE

TIME FRAME

DSM-IV

ICD-10

MAJOR DEPRESSIVE DISORDER

Current (2 weeks) Past Recurrent Current (2 weeks) Past Recurrent Current (Past Month)
Risk: Low Moderate High

296.20-296.26 Single 296.20-296.26 Single 296.30-296.36 Recurrent

F32.x F32.x F33.x

B C D

SUICIDALITY DYSTHYMIA MANIC EPISODE HYPOMANIC EPISODE BIPOLAR I DISORDER BIPOLAR II DISORDER BIPOLAR DISORDER NOS

N/A

N/A

Current (Past 1 year) Current Past Current Past Current Past Current Past Current Past Current (Past Month) Lifetime Current Current (Past Month) Current (Past Month) Generalized Non-Generalized

300.4

F34.1

Not Explored
296.0x-296.6x 296.0x-296.6x 296.89 296.89 296.80 296.80 300.01/300.21 F30.x- F31.9 F30.x -F31.9 F31.8 F31.8 F31.9 F31.9 F40.01-F41.0

E

PANIC DISORDER

USA: D. Sheehan, D. Shytle, K. Milo, J. Janavs University of South Florida - Tampa FRANCE: Y. Lecrubier Hôpital de la Salpétrière - Paris

F G H

AGORAPHOBIA SEPARATION ANXIETY DISORDER SOCIAL PHOBIA (Social Anxiety Disorder)

300.22 309.21

F40.00

F93.0

300.23 300.23
300.29 300.3 309.81 303.9 305.00 304.00-.90/305.20-.90 304.00-.90/305.20-.90 307.23 307.22 307.22

F40.1 F40.1
N/A F42.8 F43.1 F10.2x F10.1 F11.1-F19.1 F11.1-F19.1 F95.2 F95.1 F95.1

© Copyright 1998-2010 Sheehan DV
I SPECIFIC PHOBIA OBSESSIVE COMPULSIVE DISORDER POST TRAUMATIC STRESS DISORDER ALCOHOL DEPENDENCE ALCOHOL ABUSE SUBSTANCE DEPENDENCE (Non-alcohol) SUBSTANCE ABUSE (Non-alcohol) TOURETTE’S DISORDER MOTOR TIC DISORDER VOCAL TIC DISORDER Current (Past Month) Current (Past Month) Current (Past Month) Past 12 Months Past 12 Months Past 12 Months Past 12 Months Current Current Current

All rights reserved. No part of this document may be reproduced or transmitted in any form, or by any means, electronic or mechanical, including photocopying, or by any information storage or retrieval system, without permission in writing from Dr. Sheehan or Dr. Lecrubier. Researchers and clinicians working in nonprofit or publicly owned settings (including universities, nonprofit hospitals, and government institutions) may make paper copies of a M.I.N.I. KID instrument for their own clinical and research use.
DISCLAIMER Our aim is to assist in the assessment and tracking of patients with greater efficiency and accuracy. Before action is taken on any data collected and processed by this program, it should be reviewed and interpreted by a licensed clinician. This program is not designed or intended to be used in the place of a full medical and psychiatric evaluation by a qualified licensed physician – psychiatrist. It is intended only as a tool to facilitate accurate data collection and processing of symptoms elicited by trained personnel.

J K L L M M N

M.I.N.I. Kid Parent 6.0 (January 1, 2010).

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M.I.N.I. Kid Parent 6.0 (January 1, 2010).

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TRANSIENT TIC DISORDER

Current

307.21

F95.0

INTERVIEWER INSTRUCTIONS
INTRODUCING THE INTERVIEW The nature and purpose of the interview should be explained to the child or adolescent prior to the interview. A sample introduction is provided below: "I'm going to ask him/her a lot of questions about his/herself. This is so that I can get to know more about him/her and figure out how to help him/her. Most of the questions can be answered either 'yes' or 'no'. If him/her don't understand a word or a question, ask me, and I'll explain it. If him/her are not sure how to answer a question, don't guess - just tell me him/her are not sure. Some of the questions may seem weird to him/her, but try to answer them anyway. It is important that him/her answer the questions as honestly as him/her can so that I can help him/her. Does (s)he have any questions before we start?" For children under 13, we recommend interviewing the parent and the child together. Questions should be directed to the child, but the parent should be encouraged to interject if s/he feels that the child’s answers are unclear or inaccurate. The interviewer makes the final decision based on his/her best clinical judgment, whether the child’s answers meet the diagnostic criterion in question. With children him/her will need to use more examples than with adolescents and adults. GENERAL FORMAT: The MINI is divided into modules identified by letters, each corresponding to a diagnostic category. •At the beginning of each diagnostic module (except for psychotic disorders module), screening question(s) corresponding to the main criteria of the disorder are presented in a gray box. •At the end of each module, diagnostic box(es) permit the clinician to indicate whether diagnostic criteria are met. CONVENTIONS:

O

ADHD ADHD ADHD

COMBINED INATTENTIVE HYPERACTIVE/IMPULSIVE

Past 6 Months Past 6 Months Past 6 Months Past 12 Months

314.01 314.00 314.01 312.8

F90.0

F98.8
F90.0 F91.x

P

CONDUCT DISORDER

Q R

OPPOSITIONAL DEFIANT DISORDER PSYCHOTIC DISORDERS

Past 6 Months Lifetime Current Lifetime Current Current (Past 3 Months) Current (Past 3 Months) Current Current (Past 6 Months) Current

313.81 295.10-295.90/297.1/ 297.3/293.81/293.82/ 293.89/298.8/298.9 296.24/296.34/296.44 296.24/296.34/296.44 307.1 307.51 307.1

F91.3 F20.xx-F29

MOOD DISORDER WITH PSYCHOTIC FEATURES

S T

ANOREXIA NERVOSA BULIMIA NERVOSA
ANOREXIA NERVOSA, BINGE EATING/PURGING TYPE

F32.3/F33.3/ F30.2/F31.2/F31.5/ F31.8/F31.9/F39 F50.0 F50.2 F50.0

U V

GENERALIZED ANXIETY DISORDER ADJUSTMENT DISORDERS

300.02 309.24/309.28 309.3/309.4

F41.1 F43.xx

W MEDICAL, ORGANIC, DRUG CAUSE RULED OUT
X

No
Current PRIMARY DISORDER

Yes

Uncertain
F84.0/.2/.3/.5/.9

PERVASIVE DEVELOPMENTAL DISORDER

299.00/299.10/299.80

Sentences written in «normal font» should be read exactly as written to the patient in order to standardize the assessment of diagnostic criteria. Sentences written in «CAPITALS» should not be read to the patient. They are instructions for the interviewer to assist in the scoring of the diagnostic algorithms. Sentences written in «bold» indicate the time frame being investigated. The interviewer should read them as often as necessary. Only symptoms occurring during the time frame indicated should be considered in scoring the responses. Answers with an arrow above them () indicate that one of the criteria necessary for the diagnosis(es) is not met. In this case, the interviewer should go to the end of the module and circle «NO» in all the diagnostic boxes and move to the next module. When terms are separated by a slash (/) the interviewer should read only those symptoms known to be present in the patient. Phrases in (parentheses) are clinical examples of the symptom. These may be read to the patient to clarify the question. FORMAT OF THE INTERVIEW The interview questions are designed to elicit specific diagnostic criteria. The questions should be read verbatim. If the child or adolescent does not understand a particular word or concept, him/her may explain what it means or give examples that capture its essence. If a child or adolescent is unsure if s/he has a particular symptom, him/her may ask him/her provide an explanation or example to determine if it matches the criterion being investigated. If an interview item has more than 1 question, the interviewer should pause between questions to allow the child or adolescent time to respond.

IDENTIFY THE PRIMARY DIAGNOSIS BY CHECKING THE APPROPRIATE CHECK BOX.

Which problem troubles him/her the most or dominates the others or came first in the natural history? .
DISCLAIMER Our aim is to assist in the assessment and tracking of patients with greater efficiency and accuracy. Before action is taken on any data collected and processed by this program, it should be reviewed and interpreted by a licensed clinician. This program is not designed or intended to be used in the place of a full medical and psychiatric evaluation by a qualified licensed physician – psychiatrist. It is intended only as a tool to facilitate accurate data collection and processing of symptoms elicited by trained personnel.

M.I.N.I. Kid Parent 6.0 (January 1, 2010).

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M.I.N.I. Kid Parent 6.0 (January 1, 2010).

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nearly every day? At any time in his/her life: A2 a Was (s)he bored a lot or much less interested in things (Like playing his/her favorite games)? Did (s)he feel that (s)he couldn't enjoy things? IF YES TO ANY.usf.edu or dshytle@hsc. to ensure accurate coding.I. Because children may have difficulty estimating time. The rating is done at the right of each question by circling either Yes or No. Depression and Anxiety Disorders Research Institute University of South Florida College of Medicine 3515 East Fletcher Avenue Tampa.D. him/her may assist them by helping them connect times to significant events in their lives. CIRCLE NO IN ALL DIAGNOSTIC BOXES. did (s)he feel this way. University of South Florida College of Medicine 3515 East Fletcher Avenue Tampa.B. the end or beginning of a school year.I. Ph.usf.N. and/or alternatives).e.I. CODE YES NO NO YES YES NO NO YES YES IF YES. CODE NO TO A2a AND A2b. FL USA 33613-4706 tel :+1 (813) 974 – 2848 / (813) 974 . -6- . suggestions. NO NO YES YES Did (s)he feel this way most of the time. The rater should ask for examples when necessary. M. ASK FOR EXAMPLES. CODE YES NO YES NO YES NO YES NO YES d Did (s)he feel tired most of the time? e Did (s)he feel bad about him/herself most of the time? Did (s)he feel guilty most of the time? IF YES TO EITHER.4575 e-mail: dsheehan@health. for at least 2 weeks? b For the past 2 weeks.4575 e-mail : jjanavs@health. Kid Parent 6. Symptoms better accounted for by an organic cause or by the use of alcohol or drugs should not be coded positive in the MINI KID. most of the day.edu A3 A1 a Did (s)he feel sad or depressed? Felt down or empty? Felt grouchy or annoyed? IF YES TO ANY.D.0 (January 1. time frame.. CODE YES Past 2 Weeks NO YES Past Episode NO YES b Did (s)he have trouble sleeping almost every night (“trouble sleeping” means trouble falling asleep. KID.A. CONTINUE. most of the day.0 (January 1. when (s)he felt depressed / grouchy / uninterested: a Was (s)he less hungry or more hungry most days? Did (s)he lose or gain weight without trying? [i. CODE YES NO YES NO YES M.edu Juris Janavs. For example. waking up too early or sleeping too much)? c Did (s)he talk or move slower than usual? Was (s)he fidgety. for at least 2 weeks? b For the past 2 weeks. MAJOR DEPRESSIVE EPISODE ( MEANS : GO TO THE DIAGNOSTIC BOXES. restless or couldn’t sit still almost every day? IF YES TO EITHER.4544 fax : +1 (813) 974 . or Doug Shytle. For any questions. The clinician should take each dimension of the question into account (for example.Questions about the duration of symptoms are included for diagnoses when the time frame of symptoms is a critical element. IF NO TO ALL. AND MOVE TO THE NEXT MODULE) At any time in his/her life: All questions must be rated. THE EXAMPLES ARE CONSISTENT WITH A DELUSIONAL IDEA.usf. nearly every day? NO NO  NO YES YES IS A1 OR A2 CODED YES? YES IF A1b OR A2b = YES: EXPLORE THE CURRENT AND THE MOST SYMPTOMATIC PAST EPISODE.I. CODE NO TO A1a AND A1b . 2010). 2010).D. OTHERWISE IF A1b AND A2b = NO: EXPLORE ONLY THE MOST SYMPTOMATIC PAST EPISODE In the past two weeks. Did (s)he feel this way most of the time.N.I.I. please contact: David V Sheehan. frequency. IF NO TO ALL. -5- M. the starting point for "past year" might relate to a birthday. M. Clinical judgment by the rater should be used in coding the responses. severity. CONTINUE. a particular holiday or another annual event.N. RATING INSTRUCTIONS: A.. Current Episode 7 No 7 Yes Past Episode 7 No 7 Yes f Did (s)he have trouble concentrating or did (s)he have trouble making up his/her mind? IF YES TO EITHER. The child or adolescent should be encouraged to ask for clarification on any question that is not absolutely clear. Kid Parent 6. by ± 5% of body weight in the past month]? IF YES TO EITHER. did (s)he feel this way. waking up in the middle of the night. or information about updates of the M.4544 fax:+1 (813) 974 . need for a training session. M. FL USA 33613-4706 tel : +1 (813) 974 .

g. IF A5 IS CODED YES. 2010). Kid Parent 6. how.B.N.0 (January 1. SKIP TO B13: How many times? _____ Hope to be rescued / survive Expected / intended to die NO NO YES YES 4 9 7 7 -8- M. was (s)he free of depression for of at least 2 months? NO YES NO YES B1a NO YES 0 A5 NO YES B1b B2 NO NO NO NO YES YES YES YES 0 1 1 4 ARE 5 OR MORE ANSWERS (A1-A3) CODED YES AND IS A4 CODED YES FOR THAT TIME FRAME? NO YES B3 B4 SPECIFY IF THE EPISODE IS CURRENT AND / OR PAST. SUICIDALITY g Did (s)he feel so bad that (s)he wished that (s)he was dead? NO Did (s)he think about hurting him/herself? Did (s)he have thoughts of death? Did (s)he think about killing him/herself? IF YES TO ANY.I.I. with at least a slight intent to die. Kid Parent 6. IF YES.I.N. ASK B1b: Intend to die as a result of any accident? Feel hopeless? Think that (s)he would be better off dead or wish (s)he were dead? Think about hurting or injuring him/herself or have mental images of harming him/herself. SKIP TO B2: IF YES. Intend to follow through on a plan to kill him/herself? Intend to die as a result of trying to kill him/herself? Take any active steps to prepare to injure him/herself or to prepare for a suicide attempt in which (s)he expected or intended to die? How many times? _____ NO NO YES YES 8 8 B8 B9 B10 NO NO YES YES 8 8 NO YES 9 B11 B12 Injure him/herself on purpose without intending to kill him/herself? Attempt suicide (to kill him/herself)? A suicide attempt means (s)he did something where (s)he could possibly be injured. -7- M. MAJOR DEPRESSIVE EPISODE CURRENT PAST RECURRENT 7 7 7 B5 NO YES 6 A6 a How many episodes of depression did (s)he have in his/her lifetime? _____ Between each episode there must be at least 2 months without any significant depression. by not avoiding a risk)? IF NO TO B1a. CODE YES FOR RECURRENT. SKIP TO B2. Occasionally Often Very often 7 7 7 Mild 7 Moderate Severe 7 7 B6 B7 Feel unable to control these impulses? Have a method or plan to kill him/herself in his/her mind (e. SKIP TO B9. CODE YES YES NO YES B1 Points In the past month did (s)he: Suffer any accident? This includes taking too much of your medication accidentally.0 (January 1.g. IF NO TO B1. 2010). IF NO. . SKIP TO B7. ASK B1a: Plan or intend to hurt him/herself in any accident either actively or passively (e.I. when or where)? IF NO TO B7. depressed feelings cause a lot of problems at home? At school? With friends? With other people? Or in some other important way? In between the times of depression. OTHERWISE ASK: Frequency Intensity NO YES 0 A4 Did these sad. with at least some intent or awareness that (s)he might die as a result? How many times? _____ Think about killing him/herself? How many times? _____ IF NO TO B5.

I. C2 IS AT LEAST 1 OF THE ABOVE (EXCEPT B1) CODED YES? YES In the past year. Kid Parent 6. DO NOT EXPLORE THIS MODULE. Kid Parent 6.g. with at least some intent (> 0) to die as a result or if intent can be inferred.I.” (C-CASA definition). Am J Psychiatry 164:7. Posner K et al.N. July 2007. most of the time: a Was (s)he less hungry than (s)he used to be? Was (s)he more hungry than (s)he used to be? IF YES TO EITHER. e. waking up in the middle of the night. AND MOVE TO THE NEXT MODULE) 4 IF PATIENT'S SYMPTOMS MEET CRITERIA FOR MAJOR DEPRESSIVE EPISODE IN THE PAST YEAR. CODE YES NO YES f Did (s)he feel that things would never get better? ARE 2 OR MORE C3 ITEMS CODED YES? NO  NO YES YES C4 Did these feelings of being depressed / grouchy / uninterested upset him/her a lot? Did they cause him/her problems at home? At school? With friends? IF YES TO ANY.N. 2010). CODE YES NO YES DYSTHYMIA CURRENT M.I.0 (January 1.0 (January 1. ADD THE TOTAL POINTS FOR THE ANSWERS (B1-B13) CHECKED ‘YES’ AND SPECIFY THE SUICIDALITY SCORE AS INDICATED IN THE BOX: NO YES MAKE ADDITIONAL COMMENTS ABOUT YOUR ASSESSMENT OF THIS PATIENT’S CURRENT AND NEAR FUTURE SUICIDALITY IN THE SPACE BELOW: 1-8 points Low 9-16 points Moderate > 17 points High 7 7 7 b Did (s)he have trouble sleeping (“trouble sleeping” means trouble falling asleep. even though denying intent. or felt down or empty. -10- . DYSTHYMIA GO TO THE DIAGNOSTIC BOX. 2010). or felt grouchy or annoyed.In his/her lifetime: B13 a) Did (s)he ever feel so bad that (s)he wished (s)he were dead or felt like killing him/herself? b) Did (s)he ever take any active steps to prepare to kill him/herself? How many times? _____ c) Did (s)he ever try to kill him/herself? How many times? _____ NO NO YES YES 4 ( MEANS : C.I. CODE YES NO YES NO NO YES YES e Did (s)he have trouble paying attention? Did (s)he have trouble making up his/her mind? IF YES TO EITHER. Has (s)he felt OK for two months or more in a row? OK MEANS NOT ALWAYS BEING GROUCHY OR FREE OF DEPRESSION. -9- M. for the past year?  NO “A suicide attempt is any self injurious behavior. NO YES 4 C1 Has (s)he felt sad or depressed. CODE YES IF YES. waking up too early or sleeping too much)? c Did (s)he feel more tired than (s)he used to? d Did (s)he feel less confident of him/herself? Did (s)he feel bad about him/herself? IF YES TO EITHER. NO  YES NO YES SUICIDALITY CURRENT C3 During the past year. CIRCLE NO. if it is clearly not an accident or the individual thinks the act could be lethal. most of the time.

D4 b Is (s)he currently feeling grouchy or annoyed? NO  NO YES D5 YES What is the longest time these symptoms lasted? a) 3 days or less b) 4 to 6 days c) 7 days or more Was (s)he put in the hospital for these problems? IF YES. having rapid thoughts. OTHERWISE IF D1b AND D2b = NO: EXPLORE ONLY THE MOST SYMPTOMATIC PAST EPISODE D6 Did these symptoms cause a lot of problems at home? At school? With friends? With other people? Or in some other important way? IF YES TO ANY. ARE 3 OR MORE D3 ANSWERS CODED YES? CODE YES ONLY IF THE ABOVE 3 OR 4 SYMPTOMS OCCURRED DURING THE SAME TIME PERIOD.0 (January 1. WHILE IRRITABLE MOOD ALONE REQUIRES 4 OF THE D3 SYMPTOMS. being full of ideas. 2010). needing less sleep. needing less sleep. ETC. that (s)he yelled or started fights with people outside his/her family? Has (s)he or others noticed that (s)he have been more grouchy than other kids. THE EXAMPLES ARE CONSISTENT WITH A DELUSIONAL IDEA Current Episode Past Episode No No Yes Yes Past Episode NO YES NO YES M.0 (January 1.N. -12- . skipping school. BIRTHDAYS. Kid Parent 6.I. sodium valproate (Depakote or Valproate). driving dangerously or spending too much money)? IF YES TO ANY. IF YES. b Need less sleep (Did (s)he feel rested after only a few hours of sleep)? NO YES NO YES c Talk too much without stopping? Talk so fast that people couldn’t understand or follow what (s)he was saying? d Have racing thoughts or too many thoughts switching quickly? e Get distracted very easily by little things? NO YES NO YES IF YES. (HYPO) MANIC EPISODE ( MEANS : Current Episode GO TO THE DIAGNOSTIC BOXES. full of energy. NO 7 7 7 YES NO 7 7 7 YES IS D1a or D2a CODED YES? D3 IF D1b OR D2b = YES: EXPLORE THE CURRENT AND THE MOST SYMPTOMATIC PAST EPISODE. creativity or impulsive behavior. lamotrigine (Lamictal)? THIS QUESTION IS NOT A CRITERION FOR BIPOLAR DISORDER BUT IS ASKED TO INCREASE THE CLINICIAN’S VIGILANCE ABOUT RISK FOR BIPOLAR DISORDER. STOP HERE AND CIRCLE YES IN MANIC EPISODE FOR THAT TIME FRAME. CODE YES. full of energy. CODE NO TO D2b: IF YES TO ANY. even when (s)he thought (s)he was right to act this way? DO NOT CONSIDER TIMES WHEN THE PATIENT WAS INTOXICATED ON DRUGS OR ALCOHOL.I. PLEASE SPECIFY WHO:____________________________________ NO NO NO YES YES YES NO NO NO YES YES YES D1 a Has there ever been a time when (s)he was so happy that (s)he felt 'up' or 'high' or ‘hyper’? By 'up' or 'high' or ‘hyper’ I mean feeling really good. IF NO TO ALL. motivation. 2010). having an increase in productivity. CODE NO TO D1b: IF YES TO ANY. CIRCLE NO TO THE RELEVANT TIME FRAME IN THE DIAGNOSTIC BOXES AND THEN MOVE TO THE NEXT MODULE) Past Episode NO YES Does (s)he have anyone in his/her family who had manic depressive illness or bipolar disorder or a family member who had mood swings treated with a medication like lithium. ASK: NO NO YES YES WHEN RATING PAST EPISODE: IF D1a IS NO. ARE 4 OR MORE D3 ANSWERS CODED YES? IF D1a IS YES. having racing thoughts or being full of ideas. Kid Parent 6.I. or irritable did him/her: Current Episode a Feel that (s)he could do things others couldn't do? Feel that (s)he is a very important person? IF YES TO EITHER. CODE YES NO YES NO YES During the times when him/her felt high.D. IF NO TO ALL. CODE YES NO YES NO YES energy. phoning or working or working excessively or spending more money. DO NOT CONSIDER TIMES WHEN THE PATIENT WAS INTOXICATED ON DRUGS OR ALCOHOL OR DURING SITUATIONS THAT NORMALLY OVER STIMULATE AND MAKE CHILDREN VERY EXCITED LIKE CHRISTMAS. RULE: ELATION/EXPANSIVENESS REQUIRES ONLY THREE D3 SYMPTOMS. IF PATIENT IS PUZZLED OR UNCLEAR ABOUT WHAT HIM/HER MEAN BY ‘UP’ OR ‘HIGH’ OR ‘HYPER’ CLARIFY AS FOLLOWS: By ‘up’ or ‘high’ or ‘hyper’ I mean: having elated mood. ASK: D3 SUMMARY: WHEN RATING CURRENT EPISODE: IF D1b IS NO.N. ARE 3 OR MORE D3 ANSWERS CODED YES? NO YES NO YES b Is (s)he currently feeling ‘up’ or ‘high’ or ‘hyper’ or full of energy? D2 a Has there ever been a time when (s)he was so grouchy or annoyed.I. increased NO YES f Get much more involved in things than others or much more fidgety or restless? g Want to do fun things even if (s)he could get hurt doing them? Want to do things even though it could get him/her into trouble? (Like staying out late. ASK FOR EXAMPLES. -11- M. ARE 4 OR MORE D3 ANSWERS CODED YES? IF D 1b IS YES.

g. . 7 7 NO YES E4 Think about the time (s)he was most frightened or nervous for no good reason: a Did his/her heart beat fast or loud? Did (s)he sweat? Did his/her hands sweat a lot? IF YES TO EITHER. was (s)he afraid it would happen again or that something bad would happen as a result of these attacks? Did (s)he change what (s)he did because of these attacks? (e.0 (January 1. CODE YES  NO YES EXPLORED ARE D3 SUMMARY AND D4a CODED YES AND IS D5 CODED NO? HYPOMANIC SYMPTOMS NO NO NO YES YES YES SPECIFY IF THE EPISODE IS CURRENT AND / OR PAST. CODE YES NO NO YES YES NO YES h Did (s)he feel dizzy or faint? -14- NO YES M.I. THEN CODE CURRENT HYPOMANIC EPISODE AS NO. 2010).N. CODE YES NOT d e EXPLORED D7 a) IF MANIC EPISODE IS POSITIVE FOR EITHER CURRENT OR PAST ASK: Did (s)he have 2 or more of these (manic) episodes lasting 7 days or more (D4c) in his/her lifetime (including the current episode if present)? b) IF MANIC OR HYPOMANIC EPISODE IS POSITIVE FOR EITHER CURRENT OR PAST ASK: Did (s)he have 2 or more of these (hypomanic) episodes lasting just 4 to 6 days (D4b) in his/her lifetime (including the current episode)? f NO YES g Did (s)he have pain or pressure in his/her chest? Did (s)he feel like throwing up? Did (s)he have an upset stomach? Did (s)he have diarrhea? IF YES TO ANY. IF YES TO PAST MANIC EPISODE. CODE YES.  NO  NO  NO YES CURRENT 7 7 NO YES b Did this happen more than one time? YES c Did this nervous feeling increase quickly over the first few minutes? PAST YES 7 7 7 NO YES NOT E2 E3 Has this ever happened when (s)he didn’t expect it? a After this happened. not wanting to leave his/her house.0 (January 1. (including the current episode if present)? NO YES 7 7 E.ARE D3 SUMMARY AND D5 AND D6 CODED YES? OR ARE D3 SUMMARY AND D4c AND D6 CODED YES AND IS D5 CODED NO? NO YES MANIC EPISODE CURRENT PAST c) IF THE PAST “HYPOMANIC SYMPTOMS” CATEGORY IS CODED POSITIVE ASK: Did (s)he have (hypomanic) symptoms like these lasting only 1 to 3 days (D4a). 2010). Kid Parent 6.I. THEN CODE PAST HYPOMANIC EPISODE AS NOT EXPLORED . or has (s)he ever been really frightened or nervous in a situation where most kids would not feel that way? IF YES TO EITHER. going out only with someone. THEN CODE CURRENT HYPOMANIC SYMPTOMS AS NO. Kid Parent 6. going to the doctor more frequently)? b Did (s)he have these worries for a month or more? E3 SUMMARY: IF YES TO BOTH E3a AND E3b QUESTIONS.I. IF YES TO PAST MANIC EPISODE OR YES TO PAST HYPOMANIC EPISODE. THEN CODE PAST HYPOMANIC SYMPTOMS AS NOT EXPLORED. IS D3 SUMMARY CODED YES AND ARE D5 AND D6 CODED NO AND IS EITHER D4b OR D4C CODED YES? OR ARE D3 SUMMARY AND D4b AND D6 CODED YES AND IS D5 CODED NO? SPECIFY IF THE EPISODE IS CURRENT AND / OR PAST. PANIC DISORDER ( MEANS : CIRCLE NO IN E5. IF NO TO ALL CODE NO.. IF YES TO CURRENT MANIC EPISODE. -13- M. CODE YES NO NO NO NO NO YES YES YES YES YES PAST 7 7 7 NO YES b c Did his/her hands or body shake? Did (s)he have trouble breathing? Did (s)he feel like (s)he was choking? Did (s)he feel (s)he couldn't swallow? IF YES TO EITHER. HYPOMANIC EPISODE E1 a Has (s)he ever been really frightened or nervous for no reason.I.N. CURRENT IF YES TO CURRENT MANIC EPISODE OR HYPOMANIC EPISODE. E6 AND E7 SUMMARY AND SKIP TO F1) SPECIFY IF THE EPISODE IS CURRENT AND / OR PAST. 2 or more times in his/her lifetime.

going out only with someone..0 (January 1. 2010). Did anything change for him/her because of the attack? (e. CODE YES AGORAPHOBIA CURRENT NO YES LIMITED SYMPTOM ATTACKS LIFETIME NO YES IS F2 (CURRENT AGORAPHOBIA) CODED NO AND IS E7 (CURRENT PANIC DISORDER) CODED YES? NO YES PANIC DISORDER without Agoraphobia CURRENT NO NO NO YES YES YES IS F2 (CURRENT AGORAPHOBIA) CODED YES AND NO YES NO YES IS E7 (CURRENT PANIC DISORDER) CODED YES? PANIC DISORDER CURRENT PANIC DISORDER with Agoraphobia CURRENT IS F2 (CURRENT AGORAPHOBIA) CODED YES AND IS E5 (PANIC DISORDER LIFETIME) CODED NO? NO YES AGORAPHOBIA. scared. CODE YES NO PANIC DISORDER LIFETIME YES Is (s)he so afraid of these things that (s)he tries to stay away from them? Or (s)he can only do them if someone is with him/her? Or (s)he does them. CODED YES? IF YES TO E5. Did (s)he worry that it would happen again? c.N. 2010). In the past month. CODE YES NO YES F. or traveling in a bus. not wanting to leave his/her house. Kid Parent 6.i Did things around him/her feel strange or like they weren't real? Did (s)he feel or see things as if they were far away? Did (s)he feel outside of or cut off from his/her body? IF YES TO ANY. -15- M. Did (s)he worry that something bad would happen because of the attack? d.0 (January 1. or when crossing a bridge. when (s)he is all alone. AND 4 OR MORE E4 ANSWERS. CIRCLE NO IN F2. going to the doctor more frequently)? E7 SUMMARY: IF YES TO E7b or E7c or E7d.I.N. train or car? IF YES TO ANY. or uneasy in places or situations where (s)he might become really frightened. CODE YES NO YES k l Was (s)he afraid that (s)he was dying? Did parts of his/her body tingle or go numb? NO NO NO NO YES YES YES YES F2 IF F1 = NO. did (s)he have these problems more than one time? IF NO. ARE ANY E4 QUESTIONS CODED YES? THEN SKIP TO F1.g. CODE YES NO YES Does (s)he feel anxious. E7 a. standing in a line (queue). but it's really hard for him/her? IF YES TO ANY. -16- . m Did (s)he feel hot or cold? E5 ARE BOTH E3 SUMMARY. SKIP TO E7 E6 IF E5=NO.I. CURRENT without history of Panic Disorder M. Kid Parent 6. like being in a crowd.I. AGORAPHOBIA F1 j Was (s)he afraid that (s)he was losing control? Were (s)he afraid that (s)he were going crazy? IF YES TO EITHER. For the past month: b.I. CIRCLE NO TO E7 SUMMARY AND MOVE TO F1.

N. “MOST” SOCIAL SITUATIONS IS USUALLY OPERATIONALIZED TO MEAN 4 OR MORE SOCIAL G2 SUMMARY: ARE AT LEAST 3 OF G2a-h CODED YES? G3 G4 Did this last for at least 4 weeks? Did his/her fears of being away from ______ really bother him/her a lot? Cause him/her a lot of problems at home? At school? With friends? In any other way? IF YES TO EITHER. heart beating fast or feeling dizzy) when (s)he was away from ______ ? Did (s)he feel sick a lot when (s)he thought (s)he was going to be away from ______ ? IF YES TO EITHER.N.I. CODE NO NO YES NO YES H5 Did this social fear / social anxiety last at least 6 months? SUBTYPES Does (s)he fear and avoid 4 or more social situations? If YES If NO Generalized social phobia (social anxiety disorder) Non-generalized social phobia (social anxiety disorder) NO YES NO NO NO YES YES YES SOCIAL PHOBIA (Social Anxiety Disorder) CURRENT GENERALIZED NON-GENERALIZED 7 7 h Did (s)he feel sick a lot (like headaches. CIRCLE NO AND MOVE TO THE NEXT MODULE) H.0 (January 1. URINATING IN A PUBLIC WASHROOM.I. CIRCLE NO AND MOVE TO THE NEXT MODULE) G1 a In the past month. SOCIAL PHOBIA (Social Anxiety Disorder) ( MEANS : GO TO THE DIAGNOSTIC BOX. G3 AND G4 CODED YES? NO YES SEPARATION ANXIETY DISORDER M. CODE YES Is (s)he more afraid of these things than other kids his/her age?  NO  NO YES NO YES H3 Is (s)he so afraid of these things that (s)he tries to stay away from them? Or (s)he can only do them if someone is with him/her? Or (s)he does them but it's really hard for him/her? Do these social fears have a big effect on his/her life? Do they cause problems when (s)he interacts with others or cause problems in his/her relationships? Do they cause a lot of problems at school or at work? Do they cause him/her to feel upset and want to be alone? IF YES TO ANY. nausea or vomiting. ALTHOUGH THE DSM. 2010). -17- M. ATTENDING PARTIES. CODE YES NO YES b Who is (s)he afraid of losing or being away from _________________ ? H2 G2 a Does (s)he get upset a lot when (s)he was away from ______ ? Does (s)he get upset a lot when (s)he thought (s)he would be away from ______ ? IF YES TO EITHER. was (s)he afraid or embarrassed when others his/her age were watching him/her? Was (s)he afraid of being teased? Like talking in front of the class? Or eating or writing in front of others? IF YES TO ANY. CODE YES YES b Did (s)he get really worried that (s)he would lose ______ ? Did (s)he get really worried that something bad would happen to ______ ? (like having a car accident or dying).G. SPEAKING TO AUTHORITY FIGURES. IF YES TO EITHER.0 (January 1. CODE YES NO YES H4  NO YES c Did (s)he get really worried that (s)he would be separated from ______ ? (Like getting lost or being kidnapped?) d Did (s)he refuse to go to school or other places because (s)he was afraid to be away from ______ ? e Did (s)he get really afraid being at home if ______ wasn't there? f Did (s)he not want to go to sleep unless ______ was there? g Did (s)he have nightmares about being away from ______ ? Did this happen more than once? IF NO TO EITHER.I. PUBLIC SPEAKING.IV DOES NOT EXPLICITLY STATE THIS. CODE YES  NO  NO  NO SITUATIONS. YES ARE G1. YES YES EXAMPLES OF SUCH SOCIAL SITUATIONS TYPICALLY INCLUDE INITIATING OR MAINTAINING A CONVERSATION. has (s)he been really afraid about being away from someone close to him/her.I. Kid Parent 6. -18- . EATING IN FRONT OF OTHERS. stomach aches. or has (s)he been really afraid that (s)he would lose somebody (s)he is close to ? (Like getting lost from his/her parents or having something bad happen to them) IF YES TO EITHER. 2010). PARTICIPATING IN SMALL GROUPS. ETC. CODE YES NO YES NOTE TO INTERVIEWER: PLEASE ASSESS WHETHER THE SUBJECT’S FEARS ARE RESTRICTED TO NONGENERALIZED (“ONLY 1 OR SEVERAL”) SOCIAL SITUATIONS OR EXTEND TO GENERALIZED (“MOST”) SOCIAL SITUATIONS. SEPARATION ANXIETY DISORDER ( MEANS : GO TO THE DIAGNOSTIC BOX. DATING. CODE YES  NO YES H1  In the past month. Kid Parent 6. G2 SUMMARY.

2010). SEXUAL BEHAVIOR. -19- M. like washing over and over? Straightening things up over and over? Counting something or checking on something over and over? Saying or doing something over and over? compulsions YES IF YES TO ANY. has (s)he been really afraid of something like: snakes or bugs? Dogs or other animals? High places? Storms? The dark? Or seeing blood or needles? List any specific phobia(s): _______________________  NO J1 YES I2 In the past month. did (s)he do something over and over without being able to stop NO doing it. CODE YES DO NOT INCLUDE SIMPLY EXCESSIVE WORRIES ABOUT REAL LIFE PROBLEMS. CURRENT M.N. CIRCLE NO AND MOVE TO THE NEXT MODULE) J. CODE YES NO YES O.I. Kid Parent 6. OR ALCOHOL OR DRUG ABUSE BECAUSE THE PATIENT MAY DERIVE PLEASURE FROM THE ACTIVITY AND MAY WANT TO RESIST IT ONLY BECAUSE OF ITS NEGATIVE CONSEQUENCES NO  SKIP TO J4 YES I3 Is (s)he more afraid of __________ than other kids his/her age are?  NO  NO YES I4 Is (s)he so afraid of ___________ that (s)he tries to stay away from it / them? Or (s)he can only be around it / them if someone is with him/her? Or can (s)he be around it / them but it's really hard for him/her? IF YES TO ANY. CODE YES YES I5 Does this fear really bother him/her a lot? Does it cause him/her problems at home or at school? Does it keep him/her from doing things (s)he wants to do? IF YES TO ANY. has (s)he been bothered by bad things that come into his/her mind that (s)he couldn't get rid of? Like bad thoughts or urges? Or nasty pictures? For example. DO NOT INCLUDE OBSESSIONS DIRECTLY RELATED TO EATING DISORDERS.0 (January 1.I. CODE YES IS J3 OR J4 CODED YES?  NO  YES J5 Did (s)he have these thoughts or rituals we just spoke about. CODE YES NO YES J2 Did they keep coming back into his/her mind even when (s)he tried to ignore or get rid of them? NO  SKIP TO J4 YES J3 IS I5 CODED YES? NO YES Does (s)he think that these things come from his/her own mind and that they are not from outside of his/her head? NO YES obsessions SPECIFIC PHOBIA CURRENT J4 In the past month.I.I. -20- .C. 2010).N.I.0 (January 1.D. OBSESSIVE COMPULSIVE DISORDER ( MEANS : GO TO THE DIAGNOSTIC BOX. more than other kids his/her age? NO YES J6 Did these thoughts or actions cause him/her to miss out on things at home? At school? With friends? Did they cause a lot of problems with other people? Did these things take more than one hour a day? IF YES TO ANY. Kid Parent 6. SPECIFIC PHOBIA ( MEANS : GO TO THE DIAGNOSTIC BOX. did (s)he think about hurting somebody even though it disturbs or distresses him/her? Was (s)he afraid (s)he or someone would get hurt because of some little thing (s)he did or didn't do? Did (s)he worry a lot about having dirt or germs on him/her? Did (s)he worry a lot that (s)he would give someone else germs or make them sick somehow? Or was (s)he afraid that (s)he would do something really shocking? IF YES TO ANY. CIRCLE NO AND MOVE TO THE NEXT MODULE) I1 In the past month.

Kid Parent 6.N. tornado or earthquake? Like being in a fire or a really bad accident? Like seeing someone being killed or badly hurt.K.I. CODE YES NO PTSD CURRENT YES K1 Has anything really awful ever happened to him/her? Like being in a flood. Kid Parent 6. CODE YES YES NO NO NO NO NO  NO YES YES YES YES YES SUMMARY OF K5: ARE 2 OR MORE K5 ANSWERS CODED YES? YES M. POSTTRAUMATIC STRESS DISORDER ( MEANS : GO TO THE DIAGNOSTIC BOXES. 2010). 2010).I.0 (January 1. or feel helpless or upset?  NO YES K2  NO  NO YES K3 In the past month.N. have these problems upset him/her a lot? Have they caused him/her to have problems at school? At home? With his/her friends? IF YES TO ANY. has this awful thing come back to him/her in some way? Like dreaming about it or having a strong memory of it or feeling it in his/her body? YES K4 In the past month: a Has (s)he tried not to think about or talk about this awful thing? b Has (s)he tried to stay away from things that might remind him/her of it? c Has (s)he had trouble remembering some important part of what happened? d Has (s)he been much less interested in his/her hobbies or his/her friends? e Has (s)he felt cut off from other people? f Has (s)he noticed that his/her feelings are less than before? NO NO NO NO NO NO YES YES YES YES YES YES YES g Has (s)he felt that his/her life will be shortened or that (s)he will die sooner than other people? NO  NO SUMMARY OF K4: ARE 3 OR MORE K4 ANSWERS CODED YES? K5 In the past month: a Has (s)he had trouble sleeping? b Has (s)he been moody or angry for no reason? c Has (s)he had trouble paying attention? d Was (s)he nervous or watching out in case something bad might happen? e Would (s)he jump when (s)he heard noises? Or when (s)he saw something out of the corner of his/her eye? IF YES TO EITHER. AND MOVE TO THE NEXT MODULE) K6 In the past month. CIRCLE NO IN ALL DIAGNOSTIC BOXES.I.I.0 (January 1. Has (s)he ever been attacked by someone? Did (s)he respond with intense fear. -21- M. -22- .

and get over it. CODE NO NO N/A YES  NO YES ALCOHOL ABUSE CURRENT L2 In the past year: a Did (s)he need to drink a lot more alcohol to get the same feeling (s)he got when (s)he first started drinking? b Whenever (s)he cut down on drinking or stopped drinking. f Did (s)he spend less time on other things because of his/her drinking (Like school.I.N. -23- M. did (s)he end up drinking more than (s)he had planned to? d Has (s)he tried to cut down or stop drinking alcohol but was not able to? e On days when (s)he drank. DEPENDENCE PREEMPTS ABUSE. Kid Parent 6.I. CODE YES NO YES ARE 1 OR MORE OF L3 ANSWERS CODED YES? L1 In the past year. did his/her hands shake? Did (s)he sweat? Did (s)he feel nervous or like (s)he couldn't sit still? Did (s)he ever drink to keep from getting those problems? Did (s)he drink again to keep from getting a hangover? IF YES TO ANY.L.0 (January 1.I.0 (January 1. CIRCLE NO IN ALL DIAGNOSTIC BOXES. has (s)he had 3 or more drinks of alcohol in a day? At those times.I. or using machines)? c Did (s)he have legal problems more than once because of his/her drinking (Like getting arrested or stopped by the police)? NO YES NO YES M.N. like schoolwork or responsibilities at home? Did this cause any problems? CODE YES ONLY IF THIS CAUSED PROBLEMS ALCOHOL DEPENDENCE CURRENT NO YES b Was (s)he drunk more than once while doing something risky (Like riding a bike. drink it. AND MOVE TO THE NEXT MODULE) d Did (s)he keep drinking even if his/her drinking caused problems with his/her family or with other people? IF YES TO EITHER. hobbies. did (s)he spend more than three hours doing it? Count the time it took him/her to get the alcohol. CIRCLE N/A IN THE ABUSE BOX AND MOVE TO THE NEXT DISORDER. -24- . ALCOHOL ABUSE AND DEPENDENCE ( MEANS : GO TO THE DIAGNOSTIC BOXES. 2010). driving a car or boat. In the past year: L3 a Was (s)he drunk or hung-over more than once when (s)he had something important to do. did (s)he have 3 or more drinks in 3 hours? Did (s)he do this 3 or more times in the past year? IF NO TO ANY. Kid Parent 6. SKIP L3 QUESTIONS. CODE YES NO YES NO YES c When (s)he drank alcohol. 2010). or being with friends)? g Did his/her drinking cause problems with his/her health or his/her mind? Did (s)he keep on drinking even though (s)he knew that it caused these problems? NO NO NO YES YES YES NO YES NO YES ARE 3 OR MORE L2 ANSWERS CODED YES? NO YES* * IF YES.

feeling nervous. SPECIFY DRUG(S): __________________________________ NO YES* SUBSTANCE DEPENDENCE * IF YES.N. moody or like (s)he can't sit still. in the past year. -26- . Vicodin. morphine. Cocaine: snorting. did his/her body feel bad or did (s)he go into withdrawal? ("Withdrawal" might mean feeling sick. “rush”.N. achy. Miltown. Marijuana: hashish ("hash"). (“Special K”). ethyl chloride. "crank". barbiturates. -25- M. Stop me if. Halcion. GHB. Demerol. “ecstasy”.I. Narcotics: heroin. Miscellaneous: Steroids.I. Dalmane. "grass". CIRCLE NO IN ALL DIAGNOSTIC BOXES. when (s)he had something important to do? Like schoolwork or responsibilities at home? Did this happen more than one time? Did this cause any problems? CODE YES ONLY IF THIS CAUSED PROBLEMS NO YES b Was (s)he high from the drug(s) more than once while doing something risky (Like riding a bike. IV. methadone. NON-ALCOHOL PSYCHOACTIVE SUBSTANCE USE DISORDERS ( MEANS : GO TO THE DIAGNOSTIC BOXES. use it and get over it. Kid Parent 6.M. mescaline. Dilaudid. 2010). Dexadrine.) Did (s)he use the drug(s) again to keep from getting sick or to feel better? IF YES TO EITHER. CIRCLE N/A IN ABUSE BOX MOVE TO THE NEXT DISORDER. "speedball". Valium. Ritalin. AND MOVE TO THE NEXT MODULE) e On days when (s)he took (NAME THE DRUG/DRUG CLASS SELECTED).0 (January 1. "speed". did (s)he end up taking more than (s)he had planned to? d Has (s)he tried to cut down or stop taking (NAME THE DRUG/DRUG CLASS SELECTED)? Did (s)he find out that (s)he couldn't do it? IF NO TO EITHER. "Peace Pill"). psilocybin. PCP ("angel dust". feeling his/her heart pounding. Kid Parent 6.I. Xanax. THC. codeine. “rush”. nitrous oxide ("laughing gas"). crystal meth. Inhalants: "glue". “Roofies”. did (s)he spend more than three hours doing it? Count the time it took him/her to get (NAME THE DRUG/DRUG CLASS SELECTED). Ativan. running a temperature. 2010). Librium. crack. CODE YES NO YES NO YES NO YES M2 Think about his/her use of (NAME THE DRUG/DRUG CLASS SELECTED) over the past year: a Did (s)he need to take a lot more of the drug to get the same feeling (s)he got when (s)he first started taking it? b Whenever (s)he cut down or stopped using the drug(s). AND CURRENT Think about his/her use of (NAME THE DRUG/DRUG CLASS SELECTED) over the past year: In the past year: M3 a Was (s)he high or hung-over from the drug(s) more than once. IF NOT. Tranquilizers: Quaalude. opium. SKIP M3 QUESTIONS. driving a car or boat. freebase.I. trouble sleeping. STP. Darvon. SKIP TO NEXT MODULE. or using machines)? c Did (s)he have legal problems because of his/her use of the (NAME THE DRUG/DRUG CLASS SELECTED) more than once? (Like getting arrested or stopped by the police)? d Did (s)he keep using the (NAME THE DRUG/DRUG CLASS SELECTED) even though it caused problems with his/her family or with other people? IF YES TO EITHER. MDMA or ketamine. "mushrooms". MDA. DEPENDENCE PREEMPTS ABUSE. Percodan. diet pills. EXPLORE THE NEXT MOST PROBLEMATIC DRUG. feeling weak. "pot". peyote. OxyContin. amyl or butyl nitrate ("poppers"). Seconal ("reds"). non prescription sleep or diet pills. CODE NO NO YES NO YES M. having an upset stomach or diarrhea. "reefer". f Did (s)he spend less time on other things because of his/her use of (NAME THE DRUG/DRUG CLASS SELECTED)? Like school. Roofinol. hobbies or being with friends? YES g Did his/her use of (NAME THE DRUG/DRUG CLASS SELECTED) cause problems with his/her health or his/her mind? Did (s)he keep on using (NAME THE DRUG) even though (s)he knew it caused problems? ARE 3 OR MORE M2 ANSWERS CODED YES? NO YES M1 a Now I am going to read a list of street drugs or medicines. Hallucinogens: LSD ("acid"). sweating. Cough medicine? Any others? Specify MOST USED Drug(s): WHICH DRUG(S) CAUSE THE BIGGEST PROBLEMS?: FIRST EXPLORE THE DRUG CAUSING THE BIGGEST PROBLEMS AND THE ONE MOST LIKELY TO MEET DEPENDENCE / ABUSE CRITERIA.0 (January 1. CODE YES NO YES ARE 1 OR MORE M3 ANSWERS CODED YES? NO YES SPECIFY DRUG(S): __________________________________ NO N/A YES SUBSTANCE ABUSE CURRENT c When (s)he used (NAME THE DRUG/DRUG CLASS SELECTED). (s)he has taken any of them more than one time to get high? To feel better or to change his/her mood?  NO NO YES NO YES CIRCLE EACH DRUG TAKEN: Stimulants: amphetamines. shaking. IF PATIENT’S SYMPTOMS MEET CRITERIA FOR ABUSE /DEPENDENCE. "weed".

CURRENT N3 Did these "tics" upset him/her a lot? Did they get in the way of school? Did they cause him/her problems at home? Did they cause him/her problems with friends? Did other kids pick on him/her because of his/her tics? IF YES TO ANY. CURRENT N5 d b Has (s)he ever had a tic that made him/her say something or make a sound over and over and was hard to stop? Like coughing or sniffling or clearing his/her throat over and over when (s)he did not have a cold. 2010).I. or shrugging his/her shoulders over and over. A tic might be blinking his/her eyes over and over. -28- . Adderal. -27- M.N. or grunting or snorting or barking. Kid Parent 6. CODE YES  NO YES N4 Did the tics only occur when (s)he is taking Ritalin.? NO YES TRANSIENT TIC DISORDER. or squatting.I. having to say bad words. AND N2c CODED NO. NO YES VOCAL TIC DISORDER. AND MOVE TO THE NEXT MODULE) ARE N1b + N2a + N2c + N3 CODED YES AND IS N1a CODED NO? NO YES N1 a In the past month did (s)he have movements of his/her body called "Tics"? "Tics" are quick movements of some part of his/her body that are hard to control.I. CIRCLE NO IN ALL DIAGNOSTIC BOXES. CURRENT N5 b ARE N1a + N2a + N2c + N3 CODED YES AND IS N1b CODED NO? NO YES MOTOR TIC DISORDER. Dexedrine.N. Kid Parent 6. Concerta or other medications for ADHD ? NO  YES N5 a ARE N1a+ N1b + N2a + N2c AND N3 CODED YES? NO YES TOURETTE’S DISORDER. 2010).0 (January 1. TIC DISORDERS N5 c ( MEANS : GO TO THE DIAGNOSTIC BOXES. twitches of his/her face. Provigil. making a movement with his/her hand over and over. or having to repeat sounds (s)he hears or words that other people say? IF BOTH N1A AND N1B ARE CODED NO.I.0 (January 1.N. CURRENT M. having to say certain words over and over. Cylert. CIRCLE NO IN ALL DIAGNOSTIC BOXES AND SKIP TO O1 N2 a Did these "tics" happen many times a day? b Did they happen nearly every day for at least 4 weeks? c Did they happen for a year or more? d Did they ever go away completely for 3 months in a row during this time? NO NO NO NO YES YES YES  YES NO YES ARE N1 (a or b) AND N2a AND N2b AND N3 CODED YES. jerking his/her head.

ODD) d Has (s)he often had a hard time playing quietly? O1 Has anyone (teacher. being hyper. ALSO CODE NO TO CONDUCT DISORDER AND OPPOSITIONAL DEFIANT DISORDER NO NO NO NO YES YES YES YES  NO YES e Was (s)he always "on the go"? f Has (s)he often talked too much? g Has (s)he often blurted out answers before the person or teacher has finished the question? In the past six months: O2 a Has (s)he often not paid enough attention to details? Made careless mistakes in school? b Has (s)he often had trouble keeping his/her attention focused when playing or doing schoolwork? c Has (s)he often been told that (s)he does not listen when others talk directly to him/her? d Has (s)he often had trouble following through with what (s)he was told to do (Like not following through on schoolwork or chores)? Did this happen even though (s)he understood what (s)he was supposed to do? Did this happen even though (s)he wasn't trying to be difficult? IF NO TO ANY. -30- b Did (s)he often get out of his/her seat in class when (s)he was M. -29- . 2010). YES NO YES IS O2 SUMMARY & O3 SUMMARY CODED YES? e Has (s)he often had a hard time getting organized? f Has (s)he often tried to avoid things that make him/her concentrate or think hard (like schoolwork)? Does (s)he hate or dislike things that make him/her concentrate or think hard? IF YES TO EITHER. or toys? h Does (s)he often get distracted easily by little things (Like sounds or things outside the room)? i Does (s)he often forget to do things (s)he needs to do every day (Like forget to comb his/her hair or brush his/her teeth)? O2 SUMMARY: ARE 6 OR MORE O2 ANSWERS CODED YES? In the past six months: O3 a Did (s)he often fidget with his/her hands or feet? Or did (s)he squirm in his/her seat? IF YES TO EITHER. friend or parent) ever complained about his/her behavior or performance in school? IF NO TO THIS QUESTION.I. ATTENTION DEFICIT/HYPERACTIVITY DISORDER ( MEANS : GO TO THE DIAGNOSTIC BOXES. AND MOVE TO THE NEXT MODULE) not supposed to? c Has (s)he often run around or climbed on things when (s)he wasn't supposed to? Did (s)he want to run around or climb on things even though (s)he didn't? IF YES TO EITHER. CODE YES NO YES SCREENING QUESTION FOR 3 DISORDERS (ADHD.N. Kid Parent 6.I. CODE YES NO YES IS O2 SUMMARY CODED YES AND O3 SUMMARY CODED NO? NO YES NO YES Attention Deficit/ Hyperactivity Disorder INATTENTIVE NO YES IS O2 SUMMARY CODED NO AND O3 SUMMARY CODED YES? NO YES NO YES Attention Deficit/ Hyperactivity Disorder HYPERACTIVE /IMPULSIVE NO NO YES YES M.I. CIRCLE NO IN ALL DIAGNOSTIC BOXES. baby sitter.I.0 (January 1. or impulsive before (s)he was 7 years old? Did these things cause problems at school? At home? With his/her family? With his/her friends? CODE YES IF TWO OR MORE ARE ENDORSED YES.O. 2010). CODE YES NO NO YES YES NO YES Attention Deficit/ Hyperactivity Disorder COMBINED g Has (s)he often lost or forgotten things (s)he needed? Like homework assignments. pencils. CODE NO h Has (s)he often had trouble waiting his/her turn? NO YES i Has (s)he often interrupted other people? Like butting in when other people are talking or busy or when they are on the phone? O3 SUMMARY: ARE 6 OR MORE O3 ANSWERS CODED YES? NO NO YES YES NO YES O4 NO  NO YES NO NO YES YES O5 Did (s)he have problems paying attention. CD.0 (January 1.N. Kid Parent 6.

CONDUCT DISORDER ( MEANS : GO TO THE DIAGNOSTIC BOXES.N. gun. -32- . CIRCLE NO IN ALL DIAGNOSTIC BOXES.P. 2010).0 (January 1. AND MOVE TO THE NEXT MODULE) P3 Did these behaviors cause big problems at school? At home? With his/her family? Or with his/her friends? IF YES TO ANY. -31- M. baby sitter. CODE YES l Has (s)he stolen things that were worth money (Like shoplifting or forging a check)? NO YES m Has (s)he often stayed out a lot later than his/her parents let him/her? Did this start before (s)he was 13 years old? IF NO TO EITHER. or other object? d Has (s)he hurt someone (physically) on purpose (excluding siblings)? e Has (s)he hurt animals on purpose? f Has (s)he stolen things using force? Like robbing someone using a weapon or grabbing something from someone like purse snatching? g Has (s)he forced anyone to have sex with him/her? h Has (s)he started fires on purpose in order to cause damage? i j Has (s)he destroyed things that belonged to other people on purpose? Has (s)he broken into someone's house or car? NO NO NO NO NO NO NO NO NO NO NO YES YES YES YES YES YES YES YES YES YES YES k Has (s)he lied many times in order to get things from people or to get out of things? Tricked other people into doing what (s)he wanted? IF YES TO EITHER. parent) ever complained about his/her behavior or performance in school?)  NO YES P2 In the past year: a Has (s)he bullied or threatened other people (excluding siblings)? b Has (s)he started fights with others (excluding siblings)? c Has (s)he used a weapon to hurt someone? Like a knife. CODE YES NO YES SCREENING QUESTION P1 IF QUESTION O1 IN ADHD IS ANSWERED NO.I. CODE NO TO CONDUCT DISORDER IF O1 WAS NOT ASKED ALREADY.I. CODE NO NO NO  NO YES YES P2 SUMMARY: ARE 3 OR MORE P2 ANSWERS CODED YES WITH AT LEAST ONE PRESENT IN THE PAST 6 MONTHS? YES M. CODE NO NO YES n Has (s)he run away from home two times or more? o Has (s)he skipped school often? Did this start before (s)he was 13 years old? IF NO TO EITHER. bat.0 (January 1. Kid Parent 6.I. Kid Parent 6. friend. 2010).I.N. ASK THE QUESTION BELOW CONDUCT DISORDER CURRENT (Has anyone (teacher.

INVESTIGATE WHETHER DELUSIONS QUALIFY AS "BIZARRE". RUIN OR DESTITIUTION. OR WHEN TWO OR MORE VOICES ARE CONVERSING WITH EACH OTHER. AND MOVE TO THE NEXT MODULE) ATTENTION: IF CODED POSITIVE FOR CONDUCT DISORDER. books. PSYCHOTIC DISORDERS AND MOOD DISORDERS WITH PSYCHOTIC FEATURES Q. CODE YES YES b IF YES OR YES BIZARRE: Does (s)he believe this now? NO YES YES R6 YES R5 ARE Q2 SUMMARY & Q3 CODED YES? NO YES a Have his/her family or friends ever thought that any of his/her beliefs were strange or weird? Please give me an example.N. ASK THE QUESTION BELOW HALLUCINATIONS ARE SCORED "BIZARRE" IF: A VOICE COMMENTS ON THE PERSON'S THOUGHTS OR BEHAVIOR. R1  NO YES b a Has (s)he ever believed that people were secretly watching him/her? Has (s)he believed that someone was trying to get him/her. DELUSIONS ARE "BIZARRE" IF: CLEARLY IMPLAUSIBLE. 2010).I. SCREENING QUESTION Q1 IF QUESTION O1 IN ADHD IS ANSWERED NO.I. CODE YES YES YES YES R6 YES R2 NO NO NO YES YES YES R3 NO NO NO NO NO YES YES YES YES YES R4 a Has (s)he ever believed that someone was reading his/her mind or that someone could hear his/her thoughts? Or that (s)he could actually read someone else's mind or hear what they were thinking? IF YES TO ANY. or to hurt him/her? IF YES TO ANY. BEFORE CODING. friend. OPPOSITIONAL DEFIANT DISORDER ( MEANS : GO TO THE DIAGNOSTIC BOXES.0 (January 1. ASK FOR AN EXAMPLE OF EACH QUESTION ANSWERED POSITIVELY. AND MOVE TO THE NEXT MODULE) ( MEANS : GO TO THE DIAGNOSTIC BOXES. CIRCLE NO IN ALL DIAGNOSTIC BOXES. magazines or through his/her games or toys? Has (s)he ever believed that a person (s)he did not personally know was especially interested in him/her? IF YES TO ANY. b IF YES OR YES BIZARRE: Do they think that his/her beliefs are still strange? NO YES YES M. CODE YES NOTE: ASK FOR EXAMPLES TO RULE OUT ACTUAL STALKING IF YES OR YES BIZARRE: Does (s)he believe this now? BIZARRE NO YES YES (Has anyone (teacher.0 (January 1. Now I am going to ask you about unusual experiences that some people have. CODE YES NOTE: ASK FOR EXAMPLES AND DISCOUNT ANY THAT ARE NOT PSYCHOTIC IF YES OR YES BIZARRE: Does (s)he believe this now? NO NO YES YES YES R6 YES d Has (s)he often annoyed people on purpose? e Has (s)he often blamed other people for his/her mistakes or for his/her bad behavior? f Has (s)he often been "touchy" or easily annoyed by other people? g Has (s)he often been angry and resentful toward others? h Has (s)he often been "spiteful" or quick to "pay back" somebody who treats him/her wrong? b NO YES YES R6 YES Q2 SUMMARY: ARE 4 OR MORE OF Q2 ANSWERS CODED YES?  NO  NO YES a Has (s)he ever believed that (s)he was being sent special messages through the TV. JEALOUSY GUILT. SOMATIC OR RELIGIOUS DELUSIONS NO YES OPPOSITIONAL DEFIANT DISORDER CURRENT OR DELUSIONS OF GRANDIOSITY. FOR EXAMPLE.I. newspapers. NOT UNDERSTANDABLE. radio. -33- M. AND CANNOT DERIVE FROM ORDINARY LIFE EXPERIENCE. Kid Parent 6. ABSURD. CIRCLE NO IN ALL DIAGNOSTIC BOXES.I. parent) ever complained about his/her behavior or performance in school?) NO Q2 In the past six months: a Has (s)he often lost his/her temper? b Has (s)he often argued with adults? c Has (s)he often refused to do what adults tell him/her to do? Refused to follow rules? IF YES TO EITHER. ONLY CODE YES IF THE EXAMPLES ARE CLEARLY DELUSIONAL AND ARE NOT EXPLORED IN QUESTIONS R1 TO R4. -34- . CODE YES NO YES Q3 Did these behaviors cause problems at school? At home? With his/her family? Or with his/her friends? IF YES TO ANY. internet.N. baby sitter.R. INTERVIEWER:. CODE YES ONLY IF THE EXAMPLES CLEARLY SHOW A DISTORTION OF THOUGHT OR OF PERCEPTION OR IF THEY ARE NOT CULTURALLY APPROPRIATE. ETC. CIRCLE NO IN THE DIAGNOSTIC BOX AND MOVE TO THE NEXT MODULE. Kid Parent 6. CODE NO TO OPPOSITIONAL DEFIANT DISORDER IF O1 WAS NOT ASKED ALREADY. CODE YES NO b IF YES OR YES BIZARRE: Does (s)he believe this now? a Has (s)he ever believed that someone or something put thoughts in his/her mind that were not his/her own? Has (s)he believed that someone or something made him/her act in a way that was not his/her usual self? Has (s)he ever felt that (s)he was possessed? IF YES TO ANY. 2010).

YES R8b MANIC OR HYPOMANIC EPISODE. CODE NO TO THIS DISORDER.N. PROMINENT DURING THE INTERVIEW? R11 a ARE 1 OR MORE « a » QUESTIONS FROM R1a TO R7a CODED YES OR YES BIZARRE AND IS EITHER: MAJOR DEPRESSIVE EPISODE. Did (s)he have the beliefs and experiences (s)he just described [GIVE EXAMPLES PATIENT FROM SYMPTOMS CODED YES FROM R1a TO R7a] only when (s)he was feeling depressed? high? very moody? very irritable? TO NO YES MOOD DISORDER WITH PSYCHOTIC FEATURES LIFETIME IF THE PATIENT EVER HAD A PERIOD OF AT LEAST 2 WEEKS OF HAVING THESE BELIEFS OR EXPERIENCES (PSYCHOTIC SYMPTOMS) WHEN THEY WERE NOT DEPRESSED/HIGH/IRRITABLE. (CURRENT) OR IF YES: Did (s)he hear a voice talking about him/her? Did (s)he hear more than one voice talking back and forth? b IF YES OR YES BIZARRE TO R6: Has (s)he heard these things in the past month? HALLUCINATIONS ARE SCORED "BIZARRE" ONLY IF PATIENT ANSWERS YES TO THE FOLLOWING: NO YES NO YES NO YES Did (s)he hear a voice talking about him/her? Did (s)he hear more than one voice talking? back and forth? R7 a Has (s)he ever had visions or has (s)he ever seen things other people couldn't see? NOTE: CHECK TO SEE IF THESE ARE CULTURALLY INAPPROPRIATE.I.0 (January 1. CODED YES BIZARRE? PSYCHOTIC DISORDER OR MANIC OR HYPOMANIC EPISODE. such as voices? [HALLUCINATIONS ARE SCORED "BIZARRE" ONLY IF PATIENT ANSWERS YES TO THE FOLLOWING]: NO YES R12a ARE 1 OR MORE « b » QUESTIONS FROM R1b TO R7b CODED YES OR YES BIZARRE AND IS EITHER: MAJOR DEPRESSIVE EPISODE. Kid Parent 6.I. ALSO CIRCLE NO TO R12 AND MOVE TO R13 M. NO R13 YES ARE 2 OR MORE « a » QUESTIONS FROM R1a TO R7a. OR MARKED LOOSENING OF ASSOCIATIONS? b IS THE PATIENT CURRENTLY EXHIBITING DISORGANIZED OR CATATONIC BEHAVIOR? NO YES R13 ARE 1 OR MORE « b » QUESTIONS FROM R1b TO R6b.I. IF THE ANSWER IS NO TO THIS DISORDER . (CURRENT OR RECURRENT) OR NO YES R14 IS R13 CODED YES OR NO YES ARE 1 OR MORE « a » QUESTIONS FROM R1a TO R6a. CIRCLE NO TO R13 AND R14 AND MOVE TO THE NEXT MODULE. CIRCLE NO IN BOTH ‘MOOD DISORDER WITH PSYCHOTIC FEATURES’ DIAGNOSTIC BOXES AND MOVE TO R13.N.0 (January 1. Kid Parent 6. CODED YES (RATHER THAN YES BIZARRE)? AND DID AT LEAST TWO OF THE PSYCHOTIC SYMPTOMS OCCUR DURING THE SAME 1 MONTH PERIOD? LIFETIME b You told me earlier that (s)he had period(s) when (s)he felt (depressed/high/persistently irritable). CODED YES (RATHER THAN YES BIZARRE)? CURRENT R9 NO YES AND DID AT LEAST TWO OF THE PSYCHOTIC SYMPTOMS OCCUR DURING THE SAME 1 MONTH PERIOD? R10 b ARE NEGATIVE SYMPTOMS OF SCHIZOPHRENIA.I. (CURRENT OR PAST) CODED YES? IF NO TO R11 a. E. 2010). POVERTY OF SPEECH (ALOGIA) OR AN INABILITY TO INITIATE OR PERSIST IN GOAL DIRECTED ACTIVITIES (AVOLITION).G. M. -35- -36- . NO YES b IF YES: Has (s)he seen these things in the past month? CLINICIAN'S JUDGMENT R8 b IS THE PATIENT CURRENTLY EXHIBITING INCOHERENCE. DISORGANIZED SPEECH. CODED YES BIZARRE? OR NO YES NO YES PSYCHOTIC DISORDER ARE 2 OR MORE « b » QUESTIONS FROM R1b TO R10b. SIGNIFICANT AFFECTIVE FLATTENING.R6 a Has (s)he ever heard things other people couldn't hear. 2010). (CURRENT) CODED YES? MOOD DISORDER WITH PSYCHOTIC FEATURES CURRENT IF THE ANSWER IS YES TO THIS DISORDER (LIFETIME OR CURRENT).

CODE YES.S. Kid Parent 6. CODE YES NO NO  NO  NO YES YES c Did (s)he think that his/her low weight was normal or overweight ? S5 ARE 1 OR MORE S4 ANSWERS CODED YES? YES S6 FOR POST PUBERTAL FEMALES ONLY: During the last 3 months. AND MOVE TO THE NEXT MODULE) FOR GIRLS : ARE S5 AND S6 CODED YES? FOR BOYS : IS S5 CODED YES? NO YES S1 a How tall is (s)he? b. 2010). did she miss all her menstrual periods when they were expected to occur (when she was not pregnant)? YES M.3 kg or more) in the last 3 months? e If (s)he is less than age 14.I. CODE YES YES ft/in lb cm kg 5'4 102 163 46 5'5 105 165 48 5'6 108 168 49 5'7 112 170 51 5'8 115 173 52 5'9 118 175 54 5'10 122 178 55 5'11 125 180 57 6'0 129 183 59 6'1 132 185 60 6'2 136 188 62 6'3 140 191 64 NO YES The weight thresholds above are calculated using a body mass index (BMI) equal to or below 17. S4 a Has (s)he seen him/herself as being too big / fat or that part of his/her body was too big / fat? IF YES TO EITHER. 2010). -37- M.5 KG/M YES ) NO NO YES YES d Has (s)he lost 5 lb or more (2. This is the threshold guideline below which a person is deemed underweight by the DSM-IV and the ICD-10 Diagnostic Criteria for Research for Anorexia Nervosa.I. Kid Parent 6. CIRCLE NO IN ALL DIAGNOSTIC BOXES. CODE NO.I.5 KG/M Height/Weight ft/in lb cm kg 3'0 32 91 15 3'1 34 94 15 3'2 36 97 16 3'3 38 99 17 3'4 40 102 18 3'5 42 104 19 3'6 44 107 20 3'7 46 109 21 2 c IS PATIENT’S WEIGHT EQUAL TO OR BELOW THE THRESHOLD CORRESPONDING TO HIS / HER HEIGHT? (SEE TABLE BELOW) (THIS IS = A BMI OF < 17.5 kg/m2 for the patient's height. -38- .N. 6 6 6cm 6 6 6lb 6 6 6kg NO 2 ANOREXIA NERVOSA CURRENT HEIGHT / WEIGHT TABLE CORRESPONDING TO A BMI THRESHOLD OF 17.I. OTHERWISE CODE NO. f Has anyone thought that (s)he lost too much weight in the last 3 months? 3'8 48 112 22 3'9 50 114 23 3'10 53 117 24 3'11 55 119 25 4'0 57 122 26 4'1 60 125 27 NO  NO YES IF YES TO S1c OR d OR e OR f. YES ft/in lb cm kg 4'2 62 127 28 4'3 65 130 29 4'4 67 132 31 4'5 70 135 32 4'6 72 137 33 4'7 75 140 34 4'8 78 142 35 4'9 81 145 37 4'10 84 147 38 4'11 87 150 39 5'0 89 152 41 5'1 92 155 42 5'2 96 158 43 5'3 99 160 45 In the past 3 months: S2 Has (s)he been trying to keep him/herself from gaining any weight?  NO  S3 Has (s)he been very afraid of gaining weight? Has (s)he been very afraid of getting too fat / big? IF YES TO EITHER. CODE YES NO YES b Has his/her weight strongly affected how (s)he feels about him/herself? Has his/her body shape strongly affected how (s)he feels about him/herself? IF YES TO EITHER. ANOREXIA NERVOSA ( MEANS : GO TO THE DIAGNOSTIC BOXES.0 (January 1. What was his/her lowest weight in the past 3 months? 6ft 66in.0 (January 1. Has (s)he failed to gain any weight in the last 3 months? IF PATIENT IS 14 OR OLDER.N.

Kid Parent 6. wakening up too early or sleeping too much)? ARE 1 OR MORE U3 ANSWERS CODED YES?  NO YES T9 IS T7 CODED YES? NO YES U4 ANOREXIA NERVOSA Binge Eating Type CURRENT Do these worries or anxieties cause a lot of problems at school or with his/her friends or at home or at work or with other people? NO YES GENERALIZED ANXIETY DISORDER CURRENT M.N. Kid Parent 6. most of the time: T6 DO THE PATIENT'S SYMPTOMS MEET CRITERIA FOR ANOREXIA NERVOSA? NO YES  SKIP to T8 a Feel like (s)he can't sit still? b Feel tense in his/her muscles? c Feel tired. CODE YES  NO YES T2 YES T3 During an eating binge. CIRCLE NO IN ALL DIAGNOSTIC BOXES. CODE NO IF THE SYMPTOMS ARE CONFINED TO FEATURES OF ANY DISORDER EXPLORED PRIOR TO THIS POINT.T.I.I. When (s)he is worried. Did (s)he have eating binges two times a week or more?  NO  NO U1 YES a For the past six months. CIRCLE NO AND MOVE TO NEXT DISORDER) In the past 3 months: T1 Did (s)he have eating binges? An "eating binge" is when (s)he eats a very large amount of food within two hours. did (s)he feel that (s)he couldn't control him/herself?  NO YES b Does (s)he worry most days? IS THE PATIENT’S ANXIETY RESTRICTED EXCLUSIVELY TO. (like school. Has (s)he worried a lot or been nervous? Has (s)he been worried or nervous about several things. weak or exhausted easily? d Have a hard time paying attention to what (s)he is doing? Does his/her mind go blank? NO NO NO YES YES YES T7 Do these binges occur only when (s)he is under ( lb/kg)? NO YES INTERVIEWER: WRITE IN THE ABOVE ( ). OR BETTER EXPLAINED BY. CODE YES  NO YES U2 Does (s)he find it hard to stop worrying? Do the worries make it hard for him/her to pay attention to what (s)he is doing? IF YES TO EITHER.I. or something bad happening)? Has (s)he been more worried than other kids his/her age? IF YES TO ANY. GENERALIZED ANXIETY DISORDER ( MEANS : GO TO END OF DISORDER.0 (January 1. CODE YES  NO YES T5 Does his/her weight strongly affect how (s)he feels about him/herself? Does his/her body shape strongly affect how (s)he feel about him/herself? IF YES TO EITHER. THE THRESHOLD WEIGHT FOR THIS PATIENT'S HEIGHT FROM THE HEIGHT/WEIGHT TABLE IN THE ANOREXIA NERVOSA MODULE NO e Feel grouchy or annoyed? NO NO YES YES YES T8 IS T5 CODED YES AND IS EITHER T6 OR T7 CODED NO? NO YES BULIMIA NERVOSA CURRENT f Have trouble sleeping ("trouble sleeping" means trouble falling asleep. -40- . 2010).N. waking up in the middle of the night. CODE YES  NO U3 YES FOR THE FOLLOWING.0 (January 1. BULIMIA NERVOSA ( MEANS : GO TO THE DIAGNOSTIC BOXES. AND MOVE TO THE NEXT MODULE) U. his/her health. -39- M.I. Does (s)he . 2010). ANY DISORDER PRIOR TO THIS POINT?  NO NO YES  YES T4 Did (s)he do anything to keep from gaining weight? Like making him/herself throw up or exercising very hard? Trying not to eat for the next day or more? Taking pills to make him/her have to go to the bathroom more? Or taking any other kinds of pills to try to keep from gaining weight? IF YES TO ANY.

then code as Adjustment disorder with mixed anxiety and depressed mood.0 / 309.0 (January 1. then code as Adjustment disorder with depressed mood. 2010). misbehavior such as fighting. B and C. 309. 309. CODE NO TO ADJUSTMENT DISORDER. and of conduct. worry. vandalism. jitteriness. then code as Adjustment disorder with depressed mood. physical complaints or social withdrawal. D School problems. IDENTIFIED STRESSOR: ______________________________________________ DATE OF ONSET OF STRESSOR: _________________________________________ V2 Did his/her symptoms/behavior problems start soon after the stress began? [Within 3 months of the onset of the stressor]  NO  NO  NO YES IF V1 AND V2 AND (V3a or V3b) ARE CODED YES. CIRCLE NO IN ALL DIAGNOSTIC BOXES. V1 Is (s)he stressed out about something? Is this making him/her upset or making his/her behavior worse? IF NO TO EITHER. THEN CODE THE DISORDER YES WITH SUBTYPES. ORGANIC OR DRUG CAUSES FOR ALL DISORDERS IF THE PATIENT CODES POSITIVE FOR ANY CURRENT DISORDER ASK: b Do these stresses or upsets cause him/her problems in school? Problems at home? Problems with his/her family or with his/her friends? IF YES TO ANY. CODE NO  NO YES [Examples include anxiety/depression/physical complaints. 309. then code as Adjustment disorder with depressed mood and of conduct.28 C and (A or B). RULE OUT MEDICAL.28 A.3 A. C Misbehavior (Like fighting.3 A. then code as Adjustment disorder with mixed anxiety and depressed mood. 309. CODE YES YES Just before these symptoms began: W1a Was (s)he taking any drugs or medicines? W1b Did (s)he have any medical illness? 7 Uncertain IN THE CLINICIAN’S JUDGMENT: ARE EITHER OF THESE LIKELY TO BE DIRECT CAUSES OF THE PATIENT'S DISORDER? IF NECESSARY ASK ADDITIONAL OPEN-ENDED QUESTIONS. 309. 309.I. skipping school. then code as Adjustment disorder of conduct. and of conduct. 309. tearfulness or hopelessness. 7 7 No No 7 Yes 7 7 Yes Uncertain V4 BEREAVEMENT IS PRESENT IF THESE EMOTIONAL/BEHAVIORAL SYMPTOMS ARE DUE ENTIRELY TO THE LOSS OF A LOVED ONE AND ARE SIMILAR IN SEVERITY. Kid Parent 6. C and D. driving recklessly. ADJUSTMENT DISORDERS ( MEANS : GO TO THE DIAGNOSTIC BOXES.28 / 309. or illegal activity].I.24 C only.N.24 / 309. Kid Parent 6.V. 309. IF NO. vandalism. then code as Adjustment disorder of conduct.0 (January 1. 309. B. then code as Adjustment disorder with anxious mood. NO N/A YES Adjustment Disorder with____________________ (see above for subtypes) V3 a Is (s)he more upset by this stress than other kids his/her age would be? YES W. then code as Adjustment Disorder unspecified.3 A and B only.3 ONLY ASK THESE QUESTIONS IF THE PATIENT CODES NO TO ALL OTHER DISORDERS. AND MOVE TO THE NEXT MODULE) IF MARKED: • • • • • • • • • • • • • • A only. AND V5 IS CODED NO.0 A. 2010).24 B. then code as Adjustment disorder with mixed anxiety and depressed mood.I. then code as Adjustment disorder with anxious mood and of conduct. C and D. 309. then code as Adjustment disorder with mixed anxiety and depressed mood.N. 309. DO NOT USE AN ADJUSTMENT DISORDER DIAGNOSIS IF ANY OTHER PSYCHIATRIC DISORDER IS PRESENT. skipping school. B Anxiety.28 / 309. violating the rights of others.9 C and D.0 B only. then code as Adjustment disorder of emotions and of conduct. CIRCLE N/A IN DIAGNOSTIC BOX AND SKIP THE ADJUSTMENT DISORDER MODULE IF THE PATIENT'S SYMPTOMS MEET CRITERIA FOR ANOTHER SPECIFIC AXIS I DISORDER OR ARE MERELY AN EXACERBATION OF A PREEXISTING AXIS I OR II DISORDER. -41- M. doing illegal things). LEVEL OF IMPAIRMENT AND DURATION TO WHAT OTHERS WOULD SUFFER UNDER SIMILAR CIRCUMSTANCES HAS BEREAVEMENT BEEN RULED OUT?  NO YES  YES MOST W2 SUMMARY: HAS AN ORGANIC (MEDICAL/DRUG) CAUSE BEEN RULED OUT? 7 No 7 Yes 7 Uncertain V5 Have these problems gone on for 6 months or more after the stress stopped? WHICH OF THESE EMOTIONAL / BEHAVIORAL SUBTYPES ARE PRESENT? A Depression. 309.I. violating other's rights. then code as Adjustment disorder with anxious mood. 309.3 B and D. driving recklessly. NO Mark all that apply M. C and D. B and D.4 D only. nervousness. -42- . EVEN IF A LIFE STRESS IS PRESENT OR A STRESS PRECIPITATED THE PATIENT'S DISORDER.3 A and D. 309.

Sheehan D. Lecrubier Y. Hergueta T. The above screening is to rule out the diagnosis.N. 2010). Wilkinson B. M. European Psychiatry. 1998. Sheehan D: DSM-III-R Psychotic Disorders: procedural validity of the Mini International Neuropsychiatric Interview (M. T.I. IF ANY X ANSWERS ARE CODED UNSURE.REFERENCES X. X1 Since the age of 4. C Santana Y. J.I. -43- M.I. M. the diagnosis of PDD cannot be ruled out. Weiller E.N. Based on the above responses. Knapp E. Janavs J. 1998. -44- .Milo. 13:26-34. Sheehan DV.N.I.71(3):313-326. THIS CONCLUDES THE INTERVIEW Acknowledgments: We would like to thank Mary Newman. Reliability and Validity of the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI–KID). European Psychiatry. CODE UNSURE. rather than with other children? NO YES UNSURE Sheehan DV.N. Hergueta T. but needs to be more thoroughly investigated by a board certified child psychiatrist.I. 12:232-241. Balazs A. Berney Wilkinson. Engeler B. Shytle. The MINI International Neuropsychiatric Interview (M.I. Baker R. Sheehan KH.N.) A Short Diagnostic Structured Interview: Reliability and Validity According to the CIDI.I. Bonara I. J Janavs. We are grateful to Michael Van Ameringen MD for his valuable assistance in improving the ADHD module. Harnett-Sheehan K.I.0 (January 1. K. Bannon Y. Janavs J. Janavs J. Milo KM. Weiller E. Lecrubier Y.). Amorim P. Bonora I.I. Kid Parent 6. Keskiner A. CODE YES.I. Dunbar G: The Mini International Neuropsychiatric Interview (M.I. PERVASIVE DEVELOPMENT DISORDER Sheehan DV.I. European Psychiatry. 12: 224-231. Stock SL. Amorim P. D. Concordance and causes for discordance with the CIDI. Rogers JE. A. Sheehan. Soto. 2010). OTHERWISE CODE NO. Clin Psychiatry. 1997. Amorim P. Lecrubier. Gothelf. Weiller E.): According to the SCID-P.59(suppl 20):22-33. J Clin Psychiatry. Sheehan MF. NO UNSURE YES * PERVASIVE DEVELOPMENT DISORDER CURRENT Translations English Spanish French Hungarian Turkish German Hebrew M.I. Hergueta J. Has (s)he had difficulty making friends? Does (s)he have problems because (s)he keeps to him/herself? Is it because (s)he is shy or because (s)he doesn’t fit in? IF YES TO ANY. Weiller E.N. X3 X4 NO NO YES UNSURE YES UNSURE International Advisory Committee for MINI Kid version 2. Janavs J. KID D. Harnett-Sheehan K. and Marie Salmon for their help and suggestions. Kid Parent 6. Dunbar G. Plattner D. Schinka J.N.0 Manuel Bouvard Lars von Knorring Naomi Breslau Martine Flament Donald Klein Rachel Gittelman Klein Phillipe Mazet Marie Christine Mouren-Simeoni Stephan Renou Frank Verhulst Lars von Knorring Anne-Liis von Knorring X5 ARE ALL X ANSWERS CODED YES? IF SO. rather than to rule it in.I.): The Development and Validation of a Structured Diagnostic Psychiatric Interview. 2010. Lecrubier Y.0 (January 1. Pardo * Pervasive Developmental Disorder is possible. Shytle RD. Dunbar GC. Reliability and Validity of the MINI International Neuropsychiatric Interview (M. CODE YES NO YES UNSURE X2 Is (s)he fixated on routines and rituals or does (s)he have interests that are special and interfere with other activities? Do other kids think (s)he is weird or strange or awkward? Does (s)he play mostly alone. Lecrubier Y. We are grateful to Pauline Powers MD and Yvonne Bannon RN for their valuable assistance in improving the Anorexia Nervosa module. Sheehan K. 1997.

MOOD DISORDERS: DIAGNOSTIC ALGORITHM e Consult Modules: A D R Major Depressive Episode (Hypo)manic Episode Psychotic Disorders Is Major Depressive Episode coded YES (current or past) and Is Hypomanic Episode coded YES (current or past) and Is Manic Episode coded NO (current and past)? Specify: MODULE R: 1a 1b IS R11b CODED YES? IS R12a CODED YES? NO NO YES YES Most Recent Episode • If the Bipolar Disorder is current or past or both • If the most recent mood episode is hypomanic or depressed (mutually exclusive) Hypomanic Depressed 6 6 BIPOLAR II DISORDER current past Bipolar II Disorder 6 6 MODULES A and D: 2 a CIRCLE YES IF A DELUSIONAL IDEA IS IDENTIFIED IN A3e b CIRCLE YES IF A DELUSIONAL IDEA IS IDENTIFIED IN D3a Current YES YES Past YES YES f c Is a Major Depressive Episode coded YES (current or past)? and is Manic Episode coded NO (current and past)? and is Hypomanic Episode coded NO (current and past)? and is “Hypomanic Symptoms” coded NO (current and past)? Specify: • If the depressive episode is current or past or both • With Psychotic Features Current: If 1b or 2a (current) = YES With Psychotic Features Past: If 1a or 2a (past) = YES MAJOR DEPRESSIVE DISORDER current past MDD 6 6 Is MDE coded NO (current and past) and Is Manic Episode coded NO (current and past) and Is D4b coded YES for the appropriate time frame and Is D7b coded YES? ___________________________________________________ or ___________________________________________________ Is Manic Episode coded NO (current and past) and Is Hypomanic Episode coded NO (current and past) and Is D4a coded YES for the appropriate time frame and Is D7c coded YES? Specify if the Bipolar Disorder NOS is current or past or both.I.0 (January 1. Kid Parent 6. Kid Parent 6. 2010). depressed. mixed or hypomanic or unspecified (all mutually exclusive) • Unspecified if the Past Manic Episode is coded YES AND Current (D3 Summary AND D4a AND D6 AND W2) are coded YES M.I.I. -45- BIPOLAR I DISORDER current past Bipolar I Disorder 6 6 Single Manic Episode 6 6 With Psychotic Features Current 6 Past 6 Most Recent Episode Manic 6 Depressed 6 Mixed 6 Hypomanic 6 M. 2010). BIPOLAR DISORDER NOS current past Bipolar Disorder NOS 6 6 With Psychotic Features Current 6 Past 6 d Is a Manic Episode coded YES (current or past)? Specify: • If the Bipolar I Disorder is current or past or both • With Single Manic Episode: If Manic episode (current or past) = YES and MDE (current and past) = NO • With Psychotic Features Current: If 1b or 2a (current) or 2b (current)= YES With Psychotic Features Past: If 1a or 2a (past) or 2b (past) = YES • If the most recent mood episode is manic.0 (January 1.N. -46- .I.N.

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