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IPDE - Extranet Systems - World Health Organization

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<strong>IPDE</strong> ICD-10 module summary scoresheet<br />

Last Name First Name Middle Initial<br />

Sex: Age: Marital Status:<br />

Education:<br />

Occupation:<br />

Examiner Date(s) Time Required for Interview<br />

Paranoid<br />

Schizoid<br />

Disrocial<br />

Emotionally unstable<br />

Impulsive type<br />

Emotionally unstable<br />

Borderline type<br />

Histrionic<br />

Anankastic<br />

Anxious<br />

Dependent<br />

Unspecified<br />

Summary<br />

Number Dimensional<br />

Diagnosis<br />

Confidence<br />

CriteriaMet Score Definite Probable Negative Rating<br />

For each disorder check one: Definite. Probable, or Negative. If using the<br />

optional scoring, indicate next to the check mark, when a Definite or Probable<br />

diagnosis is pan, late onset, or past late onset.<br />

Rate your level of confidence (l=High, 2=Moderate, 3sLow) in the validity of<br />

every diagnostic decision, using your clinical judgment the <strong>IPDE</strong> interview.<br />

and other information when available.

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