iPsychology

 

 
Schizophrenia Advanced Diagnosis Sheet v3.0

Schizophrenia Demo ( Click Here )
Have you taken any of the following drugs in the last 30 days.
Proventil Ventolin Symmetrel Dextroamphetamine Methamphetamine
Phenmetrazine Phenylpropanolamine Speed ( Recreational Drug ) Dilantin Mysoline
Azatadine HCL Bromodiphenhydramine HCL Bromopheniramine Maleate Carbinoxamine Maleate Chlorpheniramine Maleate
Chlorpheniramine Polistirex Clemastine Fumarate Cypropeptidine HCL Dexchlorpheniramine Maleate Diphenhydramine Maleate
Diphenyl Pyraline HCL Hydroxyzine HCL Hydroxyzine Pamoate Methdilazine Phenyltolaxamine Citrate
Pynlamine Maleate Pyriamine Tannate Terfenadine promethazine HCL Trimeprazine Tartrate Triprolidine HCL
Tripelennamine Citrate Tripelennamine HCL Clonidine Hydrochloride Propranolol Timolol Maleate
Marijuana Methyl Dopa Isocarboxazid Pargyline Pheneizine
Tranylcypromine Atropine Baclofen Aprobarbital Butalbital
Butabarbital Sodium Mephobarbital Pentobarbital Sodium Phenobarbital Sodium Secobarbital
Alprazolam Chlordiazepoxide HCL Diazepam Flurazepam HCL Lorazepam
Triazolam Benztropine Mesylate Bromocriptine Cimetidine Clonazepam
Clonidine Cocaine Cortisone Perdnisone Diazepam
Digitalis Disulfiram Ephedrine Fenfluramine Hallucinogens
Amitriptyline HCL Desipramine HCL Imipramine HCL Maprotiline Nortriptyline HCL
Protriptyline HCL Trimipramine Indomethacin Levodopa Methylphenidate
Phencyclidine Procaine Penicillin Propranolol Pseudoephedrine Any Illegal Durg
General Medical Condition.  
Onset of symptoms, 
after the 40 years of age.
Onset of Symptoms  
Acute,  no history of mental illness.
Onset during major illness.
Onset while taking drug that may cause mental illness type symptoms.
History of  
Alcohol abuse
Drug abuse
Illness involving any major organ
Taking Multiple Medication types
Family History of  
Degenerative brain disease
Inheritable brain disease
Metabolic disease
Cognitive  
Altered level of consciousness
Fluctuating mental state
Cognitive impairment
Hallucinations  
Tactile
Olfactory
Visual
Physical Symptoms  
Any type of neurological symptoms
Poor muscle coordination
Slowed movements
Slowed speech
Slowed cognitive functioning
Tremors
Medical Condition  
Addison's Disease
AIDS Dementia
Alzheimer's
Brain Cancer
Creutzfeldt-Jakob Disease
Head Trauma
Huntington's Disease
Hyperadrenalism
( Cushing's Syndrome )
Hyperthyroidism
Hypoglycemia
Hypothyroidism
Intracranial Tumors
Liver Disease
Multi-infarct Dementia ( MID )
Multiple Sclerosis
Myasthenia Gravis
Pancreatic Cancer
Parkinson's Disease
Pick's Disease
Postconcussion Syndrome
Subdural Hematoma
Syphilis ( Untreated )
Systemic Lupus Erythematosus
Temporal Lobe Epilepsy
Toxins
Tubercolous Meningitis
Pernicious Anemia
( Vitamin B-12 Deficiency )
Delusion Type  
Delusion / s Cultural, but excessive.
Delusion / s With Bases, but excessive.
History of Delusion / s
Delusion / s No Bases
Delusion / s are Bizarre
Hallucination Type  
Auditory Hallucination
( One voice )
Auditory Hallucination
( Two voice )
Auditory Hallucination
( Three or more voices )
Command Hallucination
Visional Hallucination
Tactile Hallucination
Olfactory Hallucination
Sensory Hallucination
( NOT LISTED )
Continuous signs of disturbance ( Less then 6 months )  
Less then 6 months
Two or more weeks of Delusions or Hallucinations, with no Mood Disorder symptoms prominent.
Between 1 and 6 months of symptoms.
Continuous signs of disturbance 6 or more months  
Less then 1 months of symptoms in this period.
Less then 1 months of symptoms in this period, but with successfully treatment of symptoms.
1 month or more of symptoms in this period.
Symptoms:
Catatonic Behavior
Delusions
Grossly disorganized Behavior
Hallucinations
Negative symptoms
Dysfunction( Degree of Dysfunction. 1 - MILD to 4 - PROFOUND )  
Academic
Occupational
Social
Personal
Behavioral Type  
Disorganized Speech.
Flat Affect.
Inappropriate Affect
Catalepsy
Echolalia
Echopraxia
Motor Activity in Excess
Negativism in Motor Activity
Posturing
Major Depression
Manic Episode / s
Mixed Episode / s
Two or more periods or Disorder / s


 

 

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