Professional Documents
Culture Documents
CAMP
SELECTED SECTIONS* OF THE
STRUCTURED CLINICAL INTERVIEW
FOR DSM-IV AXIS I DISORDERS
CLINICIAN VERSION
SCID-I
Michael B. First, M.D.
Robert L. Spitzer, M.D.
Miriam Gibbon, M.S.W.
Janet B. W. Williams, D.S.W.
*Modified and used with the permission of the authors. Selected modules were modified to examine disorders that
have occurred during the past 5 years, and to give instructions specific to the CAMP project. The modules used
include: Module A (Mood Episodes, modified to include the sections that cover Major Depressive, Manic, and
Hypomanic Episodes, and Mood Disorder Due to a General Medical Condition or Substance Use), and Module B-
E,. The E module was modified to have Substance Dependence Disorders screened first, followed by Substance
Abuse Disorders. The B module was modified by the addition of 3 optional questions to item B5 to inquire for other
delusions common in schizophrenia.
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OVERVIEW
OCCUPATIONAL HISTORY
1 What kind of work do you do? Are you
working now?
IF YES: How long have you worked there?
(IF LESS THAN 6 MONTHS: Why did you
leave your last job?) Have you always
done that kind of work?
IF NO: Why is that? What kind of work
have you done before?
How are you supporting yourself now?
2 IF UNKNOWN: Has there ever been a
period of time when you were unable to
work or go to school?
IF YES: When? Why was that?
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OTHER CURRENT PROBLEMS
9 Have you had any other problems in the
past month?
OVERVIEW DIAGNOSES
P25 MOST LIKELY CURRENT DIAGNOSES:
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A. MOOD EPISODES
MAJOR DEPRESSIVE EPISODE
CRITERIA FOR MAJOR DEPRESSIVE EPISODE: A. Five (or
more) of the following symptoms have been present during the same
2-week period and represent a change from previous functioning; at
PAST PAST 5
least one of the symptoms is either (1) depressed mood or (2) loss
MONTH YEARS
of interest or pleasure.
A1 In the past month (1) depressed mood most of ? No* Yes ? No** Yes
has there been a period of time the day, nearly every day, as
when you were feeling depressed indicated by either subjective
or down most of the day, nearly report (e.g. feels sad or empty)
every day? (What was that like?) or observation made by others
(e.g. appears tearful).
IF YES: How long did it last? (As
long as 2 weeks?)
A2 what about losing interest or (2) markedly diminished ? No* Yes ? No** Yes
pleasure in things you usually interest or pleasure in all, or
enjoyed? almost all, activities most of
IF YES: Was it nearly every day? the day, nearly every day (as
How long did it last? (As long as 2 indicated by either subjective
weeks?) account or observation made
by others).
*If neither A1 nor A2 is Yes during the current month, check for Major Depressive Episode in the past 5
years by asking questions A1 and A2 again, beginning with In the past 5 years has there been
IF AT LEAST ONE PAST DEPRESSED PERIOD: In the past 5 years have you had more than one time
like that? Which one was the worst?
**If neither A1 nor A2 has been Yes in the past 5 years go to A16 (Manic Episode).
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A5 were you so fidgety or restless that you (5) psychomotor agitation or ? No Yes
were unable to sit still? (Was it so bad retardation nearly every day
that other people noticed it? What did (observable by others, not merely
they notice? Was that nearly every day?) subjective feelings of restlessness or
being slowed down)
IF NO: What about the opposite- talking
or moving more slowly than is normal for
you? (Was it so bad that other people
noticed it? What did they notice? Was that
nearly every day?)
A6 what was your energy like? (Tired all (6) fatigue or loss of energy nearly ? No Yes
the time? Nearly every day?) every day
A7 how did you feel about yourself? (7) feelings of worthlessness or ? No Yes
(Worthless? Nearly every day?) excessive or inappropriate guilt
(which may be delusional) nearly
every day (not merely self-reproach or
IF NO: What about feeling guilty about
guilt about being sick)
things you had done or not done? (Nearly
every day?) NOTE: CODE NO IF ONLY LOW
SELF- ESTEEM
A8 did you have trouble thinking or (8) diminished ability to think or ? No Yes
concentrating? (What kinds of things did it concentrate, or indecisiveness, nearly
interfere with? Nearly every day?) every day (either by objective account
or as observed by others)
IF NO: Was it hard to make decisions
about everyday things?
A9 were things so bad that you were (9) recurrent thoughts of death (not ? No Yes
thinking a lot about death or that you just fear of dying), recurrent suicidal
would be better off dead? What about ideation without specific plan, or a
thinking of hurting yourself? suicide attempt or a specific plan for
committing suicide.
IF YES: Did you do anything to hurt
yourself?
A10 A. AT LEAST FIVE OF ITEMS A1-A9 ? No Yes
ARE Yes AND AT LEAST ONE OF
THESE ITEMS IS A1 OR A2.
If A10 above is No (i.e., fewer than five are Yes), ask the following if unknown:
In the past 5 years have there been any other times when youve been depressed and had even more of
the symptoms that weve just talked about?
A11 IF UNCLEAR: Has [the depression/OWN C. The symptoms cause clinically ? No Yes
WORDS] made it hard for you to do your significant distress or impairment in
work, take care of things at home, or get social, occupational, or other A16
along with other people? important areas of functioning.
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A12 Just before this began, were you D. The symptoms are not due to the ? No Yes
physically ill? Just before this began, direct physiological effects of a
were you taking any medications? substance (e.g., a drug of abuse, *A16
IF YES: Any change in the amount that medication) or a general medical
you were taking? condition.
Just before this began, were you drinking
or using any street drugs?
Etiological general medical conditions include degenerative neurological illnesses (e.g. Parkinsons
disease, cerebrovascular disease (e.g. stroke), metabolic conditions (e.g. vitamin B12 deficiency),
endocrine conditions (e.g. hyper- and hypothyroidism), viral or other infections (e.g. hepatitis), and certain
cancers (e.g. carcinoma of the pancreas). Etiological substances include alcohol, amphetamines,
cocaine, hallucinogens, inhalants, opioids, phencyclidine, sedatives, hypnotics, anxiolytics. Medications
include antihypertensives, oral contraceptives, corticosteroids, anabolic steroids, anticancer agents,
analgesics, anticholinergics, cardiac medications.
*If A12 above is No (i.e., mood is due to substance or general medical condition), ask the following:
Have there been any other times when youve been depressed and it was not because of [GENERAL
MEDICAL CONDITION/SUBSTANCE USE]?
If yes go back to A1 and ask about that episode.
If no go to A16.
A13 IF UNKNOWN: Did this begin soon after E. The symptoms are not better ? No Yes
someone close to you died? accounted for by Bereavement, i.e.,
after the loss [death] of a loved one, *A16
the symptoms persist for longer
than 2 months or are characterized
by marked functional impairment,
morbid preoccupation with
worthlessness, suicidal ideation,
psychotic symptoms, or
psychomotor retardation.
*If A13 above is No (i.e., the depressed mood is better accounted for by Bereavement), ask the
following: Have there been any other times when youve been depressed and it was not because of a
loss of a loved one?
If yes go back to A1 and ask about that episode.
If no go to A16 (Manic Episode).
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MANIC EPISODE (Note: In order to rule out schizoaffective and bipolar disorder,
inquire for lifetime experience of manic symptoms. )
A16 Have you ever had a period of time when A. A distinct period of abnormally ? No Yes
you were feeling so good, high, excited, or and persistently elevated,
hyper that other people thought you were expansive, or irritable mood B1
not your normal self or you got into trouble?
(Did anyone say you were manic? Was that
more than just feeling good?)
What was that like?
IF NO: What about a period of time when
you were so irritable that you found yourself
shouting at people or starting fights or
arguments? (Did you find yourself yelling at
people you didnt really know?)
A17 How long did that last? (As long as 1 lasting at least 1 week (or any ? No Yes
week? Did you have to go into the duration if hospitalization is
hospital?) necessary) A30
B. During the period of mood
disturbance, three (or more) of the
following symptoms have persisted
(four if the mood is only irritable)
During [PERIOD OF WORST MANIC and have been present to a
SYMPTOMS] significant degree:
A18 how did you feel about yourself? (1) inflated self-esteem or ? No Yes
(More self-confident than usual? Any grandiosity
special powers or abilities?)
A19 did you need less sleep than usual? (2) decreased need for sleep (e.g. ? No Yes
IF YES: Did you still feel rested? feels rested after only 3 hours of
sleep)
A20 were you more talkative than usual? (Did (3) more talkative than usual or ? No Yes
people have trouble stopping you or pressure to keep talking
understanding you? Did people have
trouble getting a word in edgewise?)
A21 were your thoughts racing through your (4) flight of ideas or subjective ? No Yes
head? experience that thoughts are racing
A22 were you so easily distracted by things (5) distractibility (i.e., attention too ? No Yes
around you that you had trouble easily drawn to unimportant or
concentrating or staying on one track? irrelevant external stimuli)
A23 how did you spend your time? (Work, (6) increase in goal-directed activity ? No Yes
friends, hobbies? Were you so active that (socially, at work or school, or
your friends or family were concerned about sexually) or psychomotor agitation
you?)
IF NO INCREASED ACTIVITY: Were you
physically restless? (How bad was it?)
A24 did you do anything that could have (7) excessive involvement in ? No Yes
caused trouble for you or your family? pleasurable activities that have a
(Buying things you didnt need? Anything high potential for painful
sexual that was unusual for you? Reckless consequences (e.g., engaging in
driving?) unrestrained buying sprees, sexual
indiscretions, or foolish business
investments)
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A25 B. AT LEAST THREE OF ITEMS ? No Yes
A18-A24 ARE Yes (OR FOUR IF
MOOD IS IRRITABLE AND NOT *B1
ELEVATED)
*If A25 above is No (i.e., fewer than three are Yes) ask the following:
Have there been any other times when you were [high/irritable/OWN WORDS] and had even more of the
symptoms that weve just talked about?
If yes, go back to A16 and ask about that episode.
If no go to B1 (Psychotic and Associated Symptoms).
A26 IF NOT KNOWN; At that time, did you have C. The mood disturbance is ? No* Yes
serious problems at home or at work sufficiently severe to cause marked
(school) because you were [SYMPTOMS] impairment in occupational
or did you have to go into a hospital? functioning or in usual social
activities or relationships with others,
or to necessitate hospitalization to
prevent harm to self or others, or
there are psychotic features.
*If A26 above is No (i.e., not sufficiently severe) ask the following:
Have there been any other times when you were [high/irritable/OWN WORDS] and you got into trouble
with people or were hospitalized?
If yes, go back to A16 and ask about that episode.
If no go to A39 (Criterion C for Hypomanic Episode).
A27 Just before this began, were you physically D. The symptoms are not due to the ? No* Yes
ill? Just before this began, were you taking direct physiological effects of a
any medications? IF YES: Any change in substance (e.g., a drug of abuse,
the amount that you were taking? medication) or a general medical
Just before this began, were you drinking or condition*.
using any street drugs?
*If A27 above is No (i.e., the mania is due to a substance or general medical condition) ask the
following:
Have there been any other times when you were [high/irritable/OWN WORDS] and you were not
[physically ill/taking medication/using SUBSTANCE]?
If yes, go back to A16 and ask about that episode.
If no go to A39 (Criterion C for Hypomanic Episode).
*Note: Manic-like episodes that are clearly caused by somatic antidepressant treatment (e.g. medication,
electroconvulsive therapy, light therapy) should not count toward a diagnosis of Bipolar I Disorder but are
considered Substance-Induced Mood Disorders. Etiological general medical conditions include
degenerative neurological illnesses (e.g. Huntingtons Disease, Multiple Sclerosis), cerebrovascular
disease (e.g. stroke), metabolic conditions (e.g. vitamin B12 deficiency, Wilsons disease), endocrine
conditions (e.g., hyperthyroidism), viral or other infections, and certain cancers (e.g., cerebral neoplasms).
Etiological substances include alcohol, amphetamines, cocaine, hallucinogens, inhalants, opioids,
phencyclidine, sedatives, hypnotics, and anxiolytics. Medications include psychotropic medications (e.g.
antidepressants), antihypertensives, oral contraceptives, corticosteroids, anabolic steroids, isoniazid,
antiparkinson medication (e.g. levodopa), and sympathomimetics/decongestants.
Page 8 of 29
A28 CRITERIA A, B, C, AND D ARE Yes No Yes
(MAKE A DIAGNOSIS OF MANIC EPISODE)
A29 How many separate times were you Total number of Manic Episodes, ___ ___
[HIGH/OWN WORDS] and had including current (CODE 99 if too GO TO B1
[ACKNOWLEDGED MANIC SYPTOMS] for indistinct or numerous to count)
at least a week (or were hospitalized)?
A36 how did you spend your time? (Work, (6) increase in goal-directed activity ? No Yes
friends, hobbies? Were you so active that (either socially, at work or school, or
your friends or family were concerned about sexually) or psychomotor agitation
you?)
IF NO INCREASED ACTIVITY: Were you
physically restless? (How bad was it)
A37 did you do anything that could have (7) excessive involvement in ? No Yes
caused trouble for you or your family? pleasurable activities that have a
(Buying things you didnt need? Anything high potential for painful
sexual that was unusual for you? Reckless consequences (e.g., engaging in
driving?) unrestrained buying sprees, sexual
indiscretions, or foolish business
investments)
Page 9 of 29
A38 B. AT LEAST THREE OF A(31)- ? No Yes
A(37) ARE Yes (OR FOUR IF
MOOD IS IRRITABLE AND NOT B1
ELEVATED)
If A38 is No (i.e., fewer than three are Yes), ask the following:
Have there been any other times when you were [high/irritable/OWN WORDS] and had even more of the
symptoms that weve just talked about?
A39 IF UNKNOWN; Is this very different from the C. The episode is associated with an ? No Yes
way you usually are? (How were you unequivocal change in functioning
different? At work? With friends? that is uncharacteristic of the person B1
when not symptomatic.
A40 IF UNKNOWN: Did other people notice the D. The disturbance in mood and the ? No Yes
change in you? (What did they say?) change in functioning are observable
by others. B1
If A40 No (i.e., not observable by others). Have there been any other times when you were
[high/irritable/OWN WORDS] and other people did notice the change in the way you were acting?
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A41 IF UNKNOWN: At the time, did you have E. The episode is not severe enough ? No Yes
serious problems at home or at work to cause marked impairment in
(school) because you were [SYMPTOMS] social or occupational functioning, or A26
or did you have to go into a hospital to necessitate hospitalization, and
there are no psychotic features.
If A41 is No (i.e., severe enough to cause marked impairment), go back to A26, code Yes for that item,
and continue with A27.
A42 Just before this began, were you physically F. The symptoms are not due to the ? No Yes
ill? direct physiological effects of a
Just before this began, were you taking any substance (i.e., a drug of abuse, a
medication) or a general medical A45
medications?
condition.
IF YES: Any change in the amount you
were taking?
Page 11 of 29
A46 B. Either: ? No Yes
There is evidence from the history, physical examination, or laboratory findings that
the disturbance is the direct physiological consequence of a general medical
condition,
Or
There is evidence from the history, physical examination, or laboratory findings of
either (1) or (2):
(1) the symptoms in criterion A developed during, or within a month of, substance
intoxication or withdrawal
(2) medication use is etiologically related to the disturbance.
A47 D. The disturbance is not better accounted for by another mental disorder. ? No Yes
A48 E. The symptoms cause clinically significant distress or impairment in social, ? No Yes
occupational, or other important areas of functioning.
A49 CRITERIA A, B, C, AND E ARE YES (MAKE A DIAGNOSIS OF MOOD No Yes
DISORDER DUE TO A GENERAL MEDICAL CONDITION OR SUBSTANCE USE)
(This diagnosis is not scored on SCID/Psychiatric History source document.)
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B. PSYCHOTIC AND ASSOCIATED SYMPTOMS
DELUSIONS: False personal beliefs based on incorrect inference about external reality and firmly
sustained in spite of what almost everyone else believes and in spite of what constitutes incontrovertible
and obvious proof or evidence to the contrary. The belief is not one ordinarily accepted by other
members of the persons culture or subculture. Do not consider as delusions unreasonable and
sustained beliefs that are maintained with less than delusional intensity (overvalued ideas).
B1 Now I am going to ask you about unusual Delusion of reference; i.e., events, ? No Yes
experiences that people sometimes have. objects, or other people in the
Has it ever seemed like people were talking individuals environment have a
about you or taking special notice of you? particular or unusual significance
(Has it ever seemed as if someone on the that is clearly unwarranted.
radio, TV, or newspaper is sending you a
special message?)
B2 What about anyone going out of his or her Persecutory delusion; i.e., the ? No Yes
way to give you a hard time, or trying to hurt individual (or his or her group) is
you? being attacked, cheated, persecuted,
or conspired against.
B3 Did you ever feel that you were especially Grandiose delusion; i.e., content ? No Yes
important in some way, or that you had involves exaggerated power,
special powers to do things that other knowledge, or importance, or a
people couldnt do? special relationship to a deity or
(Do you have a special relationship with famous person.
someone who is famous? Do you have a
special relationship with God?)
B4 Did you ever feel that something was very Somatic delusion; i.e., content ? No Yes
wrong with you physically even though your involves change or disturbance in
doctor said nothing was wronglike you body appearance of functioning.
had cancer or some terrible disease?
Have you ever been convinced that
something was very wrong with the way a
part or parts of you body looked?
(Did you ever feel that something strange
was happening to parts of your body?)
B5 (Did you ever have any unusual religious Other delusions; i.e., religious, ? No Yes
experiences?) jealous, erotomanic, delusions of
Did you ever feel that guilt, delusions of being controlled,
thought broadcasting, thought
(you had committed a crime or done
insertion, thought withdrawal.
something terrible for which you should be
punished?) (Check here if delusions are bizarre,
i.e. that involve a phenomenon that
(someone or something outside yourself
the persons culture would regard as
was controlling your thoughts or actions
totally implausible.:___)
against your will?)
(someone could read your mind? you
could read someone elses mind?)
(certain thoughts that were not your own
were put into your head? What about taken
out of your head? How about that your
thoughts were broadcast out loud so that
other people could hear them?)
(Do you have any other beliefs that most
people would consider unusual?)
Page 13 of 29
HALLUCINATIONS: A sensory perception that has the compelling sense of reality of a true perception
but occurs without external stimulation or the relevant sensory organ.
B6 Did you hear things that other people Auditory hallucinations when fully ? No Yes
couldnt hear, such as noises, or the voices awake, heard either inside or outside
of people whispering or talking.. the head.
IF YES: What did you hear? How often did (Check if voices give a running
you hear it? commentary on patients thoughts
and behavior ___)
B7 Did you ever have visions or see things that Visual hallucinations. ? No Yes
other people couldnt see? (Were you
awake at the time?)
B8 What about strange sensations in your body Tactile hallucinations, e.g., ? No Yes
or on your skin? electricity.
B9 What about smelling or tasting things that Other hallucinations, e.g., gustatory, ? No Yes
other people couldnt smell or taste? olfactory.
Page 14 of 29
C. DIFFERENTIAL DIAGNOSIS OF PSYCHOTIC DISORDERS
C1 Psychotic symptoms occur at times other than during Major Depressive, No Yes
Manic, and Mixed Episodes.
The following question may be asked for clarification: IF MAJOR DEPRESSIVE, D1 C2
MANIC, OR MIXED EPISODE HAS EVER BEEN PRESENT; Has there ever been a
time when you had [PSYCHOTIC SYMPTOMS] and you were not
[DEPRESSED/MANIC]?
SCHIZOPHRENIA CRITERIA
C2 A. Two (or more) of the following, (only one symptom required if delusions are No Yes
bizarre* or hallucinations consist of a voice keeping up a running commentary on
the persons behavior or thoughts, or two or more voices conversing with each
other), each present for a significant portion of time during a 1-month period (or C15
less if successfully treated).
(1) delusions
(2) hallucinations
(3) disorganized speech (e.g., frequent derailment or incoherence)
(4) grossly disorganized or catatonic behavior
(5) negative symptoms i.e., affective flattening, alogia, or avolition
*Bizarre delusions involve a phenomenon that the persons culture would regard as
totally implausible. For example, a bizarre delusion would be that the patients
mother has been replaced by an exact double, or that the patients internal organs
are all removed. A non-bizarre delusion would be that the patient is under
surveillance, or that someone is poisoning him/her.
C3 D. Schizoaffective Disorder and Mood Disorder with Psychotic Features have been No Yes
ruled out because either:
(1) no Major Depressive, Manic, or Mixed Episodes have occurred concurrently with C8
the active-phase symptoms (i.e., the A symptoms listed in C2).
The following question may be asked for clarification: Has there ever been a time
when you had [PSYCHOTIC SYMPTOMS] at the same time that you were
depressed/high/irritable/OWN WORDS]?
(2) If mood episodes have occurred concurrently during active-phase symptoms,
their total duration has been brief relative to the duration of the active and
residual periods.
Question for clarification: How much of the time that you have had [SYMPTOMS
FROM ACTIVE AND RESIDUAL PHASES] would you say you have also been
depressed/high/irritable/OWN WORDS?
NOTE: Answer yes if :
1. there have never been any Major Depressive, Manic, or Mixed Episodes,
2. if all such episodes occurred during the prodromal or residual phase,
3. or if episodes overlap with psychotic symptoms AND the mood symptoms are
NOT a significant part of the total disturbance.
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C4 C. Continuous signs of the disturbance persist for at least 6 MONTHS. This 6-month No Yes
period must include at least one month of symptoms (or less if successfully treated
that meet criterion A (i.e., active-phase symptoms) and may include periods of
prodromal or residual symptoms. During these prodromal or residual periods, the C13
signs of the disturbance may be manifested by only negative symptoms (i.e.,
affective flattening, alogia, avolition) or two or more symptoms listed in criterion A
present in an attenuated form (e.g., odd beliefs, unusual perceptual experiences).
Question for clarification: Between [MULTIPLE EPISODES], were you back to
your normal self? How long did each episode last?
C5 B. For a significant portion of the time since the onset of the disturbance, one or No Yes
more major areas of functioning such as work, interpersonal relations, or self-care
are markedly below the level achieved prior to the onset (or when the onset is in
childhood, or adolescence, failure to achieve expected level of interpersonal, C15
academic, or occupational achievement).
C6 E. The disturbance is not due to the direct physiological effects of a substance* No Yes
(e.g., a drug abuse, a medication) or general medical condition*.
Questions for clarification: Were you taking any drugs or medicines during this C26
time? Were you physically ill at this time?
?
If C6 No (i.e., psychotic symptoms likely due to the direct effects of a substance or medical condition),
go back to C2 and determine whether there are psychotic symptoms that are not due to a substance or
general medical condition. Otherwise, go to C32.
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C11 D. The disturbance is not due to the direct physiological effects of a substance No Yes
(e.g., a drug of abuse, a medication) or a general medial condition. NOTE: Refer
to list of general medical questions and substances in items C6. C26
Questions for clarification: Were you taking any drugs or medicines during this
time? Were you physically ill at this time?
C12 CRITERIA A, B, C, AND D ARE MET Yes
PATIENT MEETS DIAGNOSTIC CRITERIA FOR SCHIZOAFFECTIVE
DISORDER, AND THUS MEETS DIAGNOSTIC CRITERIA FOR THE CAMP D13
TRIAL.
(Score on SCID/Psychiatric History source document.)
EXCLUSIONARY DIAGNOSES
DELUSIONAL DISORDER
C15 A. Nonbizzare delusions (i.e., involving situations that occur in real life, such as No Yes
being followed, poisoned, infected, loved at a distance, or deceived by a spouse
or lover, or having a disease) of at least 1 months duration. C21
C16 B. Criterion A for Schizophrenia has never been met. NOTE: Tactile and No Yes
olfactory hallucinations may be present in Delusional Disorder if they are
related to the delusional theme. C31
C17 C. Apart from the impact of the delusion(s) or its ramifications, functioning is not No Yes
markedly impaired and behavior is not obviously odd or bizarre.
C31
C18 D. If mood episodes have occurred concurrently with delusions, their total duration No Yes
has been brief relative to the duration of the delusional periods.
Questions for clarification: Has there ever been a time when you have believed C8
[DELUSIONS] at the same time you were [depressed/high/irritable/OWN
WORDS]? How much of the time that you have believed [DELUSIONS]. Would
you say you have also been [depressed/high/irritable/OWN WORDS]?
NOTE: Answer yes if 1) there have never been any mood episodes at all, 2)
mood episodes occurred at times other than during delusional periods, or 3) mood
episodes were brief relative to total duration of the delusional periods. Answer no
if symptoms meeting criteria for mood episodes have been present for a
substantial portion of the total duration of the disturbance.
Page 17 of 29
C19 E. The disturbance is not due to the direct physiological effects of a substance No Yes
(e.g., a drug of abuse, a medication) or a general medical condition. NOTE:
Refer to list of general medical conditions and substances in item C6, page 31. C26
Questions for clarification: Were you taking any drugs or medicines during this
time? Were you physically ill at the time?
Page 18 of 29
C28 B (2). There is evidence from the history, physical examination, or laboratory No Yes
findings of either:
1. the symptoms in criterion A developed during, or within a month of, C31
Substance Intoxication or Withdrawal, or
2. medication use is etiologically related to the disturbance.
C29 C. The disturbance is not better accounted for by a Psychotic Disorder that is not No Yes
substance induced or due to a general medical conditon. If the disturbance is
better accounted for by a non-substance-induced psychotic disorder, return to
the disorder being evaluated. Evidence that the symptoms are better accounted
for by a Psychotic Disorder that is not substance induced include:
(1) the psychotic symptoms precede the onset of the substance or medication
use or the general medical condition
(2) the psychotic symptoms persist for a substantial period of time (e.g., about a
month) after the cessation of acute withdrawal or severe intoxication.
(3) the psychotic symptoms are substantially in excess of what would be
expected given the type or amount of the substance used or the duration of
use.
(4)there is other evidence that suggests the existence of an independent non-
substance-induced Psychotic Disorder (e.g., a history of recurrent non-
substance related psychotic episodes).
C30 CRITERIA A, B, AND C ARE MET Yes
(MAKE A DIAGNOSIS OF SUBSTANCE INDUCED PSYCHOTIC DISORDER OR
DUE TO A GENERAL MEDICAL CONDITION.) Excluded
END SCID
Page 19 of 29
D. MOOD DISORDERS
BIPOLAR I DISORDER CRITERIA (BPAD)
Page 20 of 29
D9 Not due to the direct physiological effects of a general medical condition or No Yes
substance (including somatic antidepressant treatment) use.
D11
D10 If UNKNOWN: Have you had [MANIC OR DEPRESSIVE SYMPTOMS] in the past No Yes
month?
D11
Cyclothymic Disorder (must meet all three of the following criteria): Excluded
END SCID
A. For at least 2 years, the presence of numerous periods with hypomanic
symptoms and numerous periods with depressive symptoms that do not meet
criteria for a Major Depressive Episode.
B. During the above 2-year period, the person has not been without the
symptoms in criterion A for more than 2 months at a time.
C. No Major Depressive Episode, Manic Episode, or Mixed Episode has been
present during the first 2 years of the disturbance.
Bipolar Disorder Not Otherwise Specified (for disorders with bipolar features
that do not meet criteria for any specific Bipolar Disorder)
Page 21 of 29
E. ALCOHOL AND OTHER SUBSTANCE USE DISORDERS
E1 What are your drinking habits like? (How In the past five years, has had a period ? No Yes
much do you drink?) (How often?) (What do of excessive drinking OR had evidence
you drink?) IF NOT CURRENTLY of alcohol-related problems. E15
DRINKING HEAVILY: In the past 5 years
has there been a time when you were
drinking a lot more? (How often were you
drinking) (What were you drinking? How
much? How long did that period last?)
Page 22 of 29
E6 IF NOT ALREADY KNOWN: Has your (7) alcohol use is continued despite ? No Yes
drinking ever caused any psychological knowledge of having a persistent or
problems such as making you depressed or recurrent physical or psychological
anxious, making it hard to sleep, or causing problem that is likely to have been
blackouts caused or exacerbated by alcohol
IF NOT ALREADY KNOWN: Has your (e.g., continued drinking despite
drinking ever caused significant physical recognition that an ulcer was made
problems or made a physical problem worse by alcohol consumption)
worse?
IF YES TO EITHER OF ABOVE: Did you
keep on drinking anyway?
E7 Have you found that you needed to drink a (1) tolerance, as defined by either of ? No Yes
lot more in order to get the feeling you the following:
wanted than you did when you first started (a) a need for markedly increased
drinking? amounts of alcohol to achieve
IF YES: How much more? intoxication or desired effect
IF NO: What about finding that when you (b) markedly diminished effect with the
drank the same amount, it had much less continued use of the same amount
effect than before? of alcohol
E8 Have you had any withdrawal symptoms (2) withdrawal, as manifested by either ? No Yes
when you cut down or stopped drinking (a) or (b):
such as. (a) at least two of the following
sweating or racing heart? developing within several hours to
hand shakes? a few days after cessation of (or
reduction in) heavy and prolonged
trouble sleeping?
alcohol use:
feeling nauseated or vomiting?
-automatic hyperactivity (e.g., sweating
feeling agitated? or pulse rate greater than 100)
or feeling anxious? -increased hand tremor
(How about having a seizure or seeing, -insomnia
feeling, or hearing things that werent really
-nausea or vomiting
there?)
-psychomotor agitation
IF NO: have you ever started the day with a
drink, or did you often drink or take some -anxiety
other drug or medication to keep yourself -grand mal seizures
from getting the shakes or becoming sick? -transient visual, tactile, or auditory
hallucinations or illusions
(b) alcohol (or a substance from the
sedative/hypnotic/anxiolytic class)
taken to relieve or avoid withdrawal
symptoms
Page 23 of 29
E9 IF UNKNOWN: When did [SYMPTOMS IN THE PAST 5 YEARS, AT LEAST No Yes
RATED Yes ABOVE] occur? (Did they all THREE DEPENDENCE ITEMS (E2-
happen around the same time?) E9) ARE Yes AND OCCURRED E10
WITHIN THE SAME 12-MONTH
PERIOD
Patient has met diagnostic criteria for
Alcohol Dependence in past 5 years.
(Score on SCID/Psychiatric History
source document.)
ACTIVE IN PAST MONTH No Yes
E15 E15
Page 24 of 29
NONALCOHOLIC SUBSTANCE USE DISORDERS
E15 In the past five years have you taken any of B. In the past 5 years a maladaptive ? No Yes
these to get high, to sleep better, to lose pattern of substance use, leading to
weight, or to change your mood? (SHOW clinically significant impairment or F1
DRUG LIST TO PATIENT AND RECORD distress, as manifested by one (or
INFORMATION ON SCORESHEET.) more) of the following occurring at any
time in the same 12-month period:
Which one caused you the most problems? INDICATE DRUG CLASS WITH HEAVIEST
IF DENIES PROBLEMS: Which one did USE/MOST PROBLEMS:
you use the most?
Page 25 of 29
IF YES TO EITHER OF ABOVE: Did you
keep on using anyway?
E21 Have you found that you needed to use a (1) Tolerance, as defined by either of ? No Yes
lot more [DRUG] in order to get the feeling the following:
you wanted than you did when you first (a) a need for markedly increased
started using it? amounts of the substance to
IF YES: How much more? achieve intoxication or desired
IF NO: What about finding that when you effect
used the same amount, it had much less (b) markedly diminished effect with
effect than before? continued use of the same amount
of the substance
E22 THE FOLLOWING MAY NOT APPLY TO (2) withdrawal, as manifested by ? No Yes
CANNABIS, HALLUCINOGENS, AND either (a) or (b):
PHENCYCLIDINE. (a) the characteristic withdrawal
Have you ever had any withdrawal syndrome for the substance (see
symptoms, that is, felt sick when you cut next page for descriptions)
down or stopped using [DRUG]? (b) the same (or closely related)
IF YES: What symptoms did you have? substance is taken to relieve or
[REFER TO LIST OF WITHDRAWAL avoid withdrawal symptoms
SYMPTOMS ON PAGE 28].
IF HAD WITHDRAWAL SYMPTOMS: After
not using [DRUG] for a few hours or more,
have you often used it to keep yourself from
getting sick with [WITHDRAWAL
SYMPTOMS]?
What about using [DRUG IN SAME CLASS]
when you were feeling sick with
[WITHDRAWAL SYMPTOMS] so that you
would feel better?
E23 IF UNKNOWN: When did [SYMPTOMS IN THE PAST 5 YEARS AT LEAST No Yes
RATED Yes ABOVE] occur? (Did they all THREE DEPENDENCE ITEMS (E16-
happen around the same time?) E22) ARE Yes AND OCCURRED E24
WITHIN THE SAME 12-MONTH
PERIOD.
(Score on SCID/Psychiatric History
source document)
Page 26 of 29
NONALCOHOLIC SUBSTANCE ABUSE CRITERIA
E24 Now Id like to ask you some more (1) recurrent substance use resulting in ? No Yes
questions about your use of [DRUG USED a failure to fulfill major role obligations
THE MOST OR CAUSED THE MOST at work, school, or home (e.g.,
PROBLEMS]. repeated absences or poor work
In the past five years have you missed work performance related to substance use;
or school because you were high or very substance-related absences,
hung over? (How often?) (What about suspensions, or expulsions from
doing a bad job at work or failing courses at school; neglect of children or
school because you used [Drug]? household).
E25 In the past five years have you used (2) recurrent substance use in ? No Yes
[DRUG] in a situation in which it might have situations in which it is physically
been dangerous? (have you ever driven hazardous (e.g., driving an automobile
when you were really too high to drive?) or operating a machine when impaired
IF YES: How often? (When?) by substance use)
E26 In the past five years has your use of (3) recurrent substance-related legal ? No Yes
[DRUG] gotten you into trouble with the problems (e.g., arrests for substance-
law? related disorderly conduct)
IF YES: How often? (When?)
E27 IF YES: Did you keep on using [DRUG] (4) continued substance use despite ? No Yes
anyway? having persistent or recurrent social or
interpersonal problems caused or
exacerbated by the effects of the
substance (e.g., arguments with
spouse about the consequences of
intoxication, physical fights)
E28 AT LEAST ONE ABUSE ITEM E24- NO YES
E27 IS Yes (MAKE A DIAGNOSIS
OF SUBSTANCE ABUSE DISORDER)
(Score on SCID/Psychiatric History
source document)
IF YES, INDICATE SUBSTANCE(S):
___marijuana
___cocaine
___opiates
___PCP
___amphetamines
___other, specify:_________________
Page 27 of 29
LIST OF WITHDRAWAL SYMPTOMS (FROM DSM-IV CRITERIA)
Listed below are the characteristic withdrawal symptoms for those classes of substances for which a
withdrawal syndrome has been identified. (NOTE: A specific withdrawal syndrome has not been
identified for cannabis and hallucinogens/PCP.) Withdrawal symptoms may occur following the cessation
of prolonged moderate or heavy use of a substance or a reduction in the amount used.
SEDATIVES, HYPNOTICS, AND ANXIOLYTICS: Two (or more) of the following, developing within
several hours to a few days after cessation (or reduction) of sedative, hypnotic, or anxiolytic use, that has
been heavy and prolonged:
1. autonomic hyperactivity (e.g. sweating or pulse rate greater than 100)
2. increased hand tremor
3. insomnia
4. nausea or vomiting
5. transient visual, tactile, or auditory hallucinations or illusions
6. psychomotor agitation
7. anxiety
8. grand mal seizures
STIMULANTS/COCAINE: Dysphoric mood AND two (or more) of the following physiological changes,
developing within a few hours to several days after cessation (or reduction of stimulant or cocaine use
that has been heavy and prolonged):
1. fatigue
2. vivid, unpleasant dreams
3. insomnia or hypersomnia
4. increased appetite
5. psychomotor retardation or agitation
OPIOIDS: Three (or more) of the following, developing within minutes to several days after cessation (or
reduction) of opioid use that has been heavy and prolonged (several weeks or longer) or after
administration of an opioid antagonist (after a period of opioid use):
1. dysphoric mood
2. nausea or vomiting
3. muscle aches
4. lacrimation or rhinorrhea
5. pupillary dilation, piloerection, or sweating
6. diarrhea
7. yawning
8. fever
9. insomnia
Page 28 of 29
DRUG LIST
Sedatives-hypnotics-anxiolytics (downers)
Quaalude (ludes), Seconal (reds), Valium, Xanax, Librium, barbituates, Miltown,
Ativan, Dalmane, Halcion, Restoril
Cannabis
Marijuana, hashish (hash), THC, pot, grass, weed, reefer
Stimulants (uppers)
Amphetamine, speed, crystal meth, dexadrine, Ritalin, diet pills, ice
Opioids
Heroin, morphine, opium, Methadone, Darvon, codeine, Percodan, Demerol, Dilaudid
Cocaine
Snorting, IV, freebase, crack, speedball
Hallucinogens (psychedelics)
LSD (acid), mescaline, peyote, psilocybin, STP, mushrooms, Extasy, MDMA
PCP (phencyclidine)
angel dust, Special K (ketamine)
Other
Steroids, glue, ethyl chloride, paint, inhalants, nitrous oxide (laughing gas), amyl or
butyl nitrate (poppers), nonprescription sleep or diet pills
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