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    PAMF Psych Adult Symptom Checklist

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    Cathlyne Apawan
    This document is an adult symptom checklist used by a psychiatry department. It contains a list of 95 potential symptoms a patient may experience, ranging from depression and anxiety to mania and psychosis. Patients are asked to rate on a scale of 1 to 5 how frequently they have experienced each symptom in the past month, with 1 being never and 5 being usually. The wide-ranging list of symptoms covers mood, sleep, cognitive functioning, physical health, substance use, and risk of harm to self or others.

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    PAMF Psych Adult Symptom Checklist

    Uploaded by

    Cathlyne Apawan
    25 views1 page
    This document is an adult symptom checklist used by a psychiatry department. It contains a list of 95 potential symptoms a patient may experience, ranging from depression and anxiety to mania and psychosis. Patients are asked to rate on a scale of 1 to 5 how frequently they have experienced each symptom in the past month, with 1 being never and 5 being usually. The wide-ranging list of symptoms covers mood, sleep, cognitive functioning, physical health, substance use, and risk of harm to self or others.

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    PAMF-psych-adult-symptom-checklist

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    This document is an adult symptom checklist used by a psychiatry department. It contains a list of 95 potential symptoms a patient may experience, ranging from depression and anxiety to mania and psychosis. Patients are asked to rate on a scale of 1 to 5 how frequently they have experienced each symptom in the past month, with 1 being never and 5 being usually. The wide-ranging list of symptoms covers mood, sleep, cognitive functioning, physical health, substance use, and risk of harm to self or others.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    25 views1 page

    PAMF Psych Adult Symptom Checklist

    Uploaded by

    Cathlyne Apawan
    This document is an adult symptom checklist used by a psychiatry department. It contains a list of 95 potential symptoms a patient may experience, ranging from depression and anxiety to mania and psychosis. Patients are asked to rate on a scale of 1 to 5 how frequently they have experienced each symptom in the past month, with 1 being never and 5 being usually. The wide-ranging list of symptoms covers mood, sleep, cognitive functioning, physical health, substance use, and risk of harm to self or others.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    of 1

    PATIENT LABEL

    DEPARTMENT OF PSYCHIATRY AND


    BEHAVIORAL HEALTH
    ADULT SYMPTOM CHECKLIST
    Patient Name: Date:
    Please check the appropriate degree of any symptoms you have experienced in the last month.
    1=Never 2=Rarely 3=Occasionally 4=Frequently 5=Usually
    Constant sadness/depressed mood 91 92 93 94 95 Fear of bridges/heights/
    Difficulty falling asleep 91 92 93 94 95 social situations 91 92 93 94 95
    Early morning awakening 91 92 93 94 95 Feelings of anxiety 91 92 93 94 95
    Waking during the middle of the night 91 92 93 94 95 Feeling on edge 91 92 93 94 95
    Increased sleep 91 92 93 94 95 Panic attacks 91 92 93 94 95
    Decreased enjoyment in formerly Trembling/shakiness 91 92 93 94 95
    pleasurable activities 91 92 93 94 95 Restlessness 91 92 93 94 95
    Feelings of guilt 91 92 93 94 95 Irritability 91 92 93 94 95
    Low self esteem 91 92 93 94 95 Shortness of breath 91 92 93 94 95
    Feelings of helplessness 91 92 93 94 95 Heart palpitations/chest pain 91 92 93 94 95
    Feelings of hopelessness 91 92 93 94 95 Sweats 91 92 93 94 95
    Fatigued/low energy 91 92 93 94 95 Dizziness 91 92 93 94 95
    Decreased concentration 91 92 93 94 95 Nausea/abdominal distress 91 92 93 94 95
    Indecisiveness/slowed thinking 91 92 93 94 95 Headaches 91 92 93 94 95
    Appetite 9 up/ 9 down 91 92 93 94 95 Feeling dissociated 91 92 93 94 95
    Weight 9 up/ 9 down
    How much?____lbs 91 92 93 94 95 Menstrual problems/changes 91 92 93 94 95
    Crying spells 91 92 93 94 95 Urinary problems 91 92 93 94 95
    Suicidal thoughts 91 92 93 94 95 Sexual problems 91 92 93 94 95
    Attempts to hurt self/cutting on self 91 92 93 94 95 Unexplained pain 91 92 93 94 95
    Diminished sex drive 91 92 93 94 95 Other physical symptoms 91 92 93 94 95
    Tendency to isolate 91 92 93 94 95
    Needing to be with others excessively 91 92 93 94 95 Decreased ability to sustain focus 91 92 93 94 95
    Difficulty with relationships Difficulty in organizing tasks 91 92 93 94 95
    (spouse, children, co-workers) 91 92 93 94 95 Forgetfulness 91 92 93 94 95
    Decreased effectiveness at work/home 91 92 93 94 95 Distractibility 91 92 93 94 95
    Overeating/Binge eating 91 92 93 94 95 Feeling "hyper", restless
    Anorexia 91 92 93 94 95 or wound up 91 92 93 94 95
    Purging food (vomiting or laxatives) 91 92 93 94 95 Impulsive 91 92 93 94 95

    Dramatic mood swings 91 92 93 94 95 Amnesia 91 92 93 94 95


    Increased energy 91 92 93 94 95 Feelings of numbness 91 92 93 94 95
    Feeling elated 91 92 93 94 95 Nightmares 91 92 93 94 95
    Racing thoughts 91 92 93 94 95
    Overspending 91 92 93 94 95 Bizarre/unusual experiences 91 92 93 94 95
    Increased sexual activities 91 92 93 94 95 Hearing/seeing things others do not 91 92 93 94 95
    Decreased need for sleep 91 92 93 94 95 Repetitive bothersome thoughts 91 92 93 94 95
    Alcohol use/abuse or dependency 91 92 93 94 95 Repetitive behaviors/compulsions 91 92 93 94 95
    Other drug use/abuse or dependency 91 92 93 94 95
    Concerns about alcohol use 91 92 93 94 95 Difficulty with control of anger 91 92 93 94 95
    Family/legal problems due to Homicidal thoughts/hurting others 91 92 93 94 95
    alcohol/drugs 91 92 93 94 95 Attempts to hurt others 91 92 93 94 95
    Have actually hurt others 91 92 93 94 95
    140701
    (04/16)

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