Descriptive Psychopathology: The Signs and Symptoms of ...

123 Appendix 5.1: Questions for past illness“When you got depressed, did you lose interest in activities that are usually fun for you? . . .did you get overly pessimistic, like the glass is always ‘half empty’ . . . did you lose all yourenergy and desire to do things . . . did you feel you let people down?”Mania and hypomania 2“Have you ever experienced periods where for days or weeks you had unusual energy, were fullof ideas, were thinking faster than usual, talked a lot and could do a lot with little sleep? . . .If I had seen you then, would I have noticed a ‘hyper’ sort of a person?”“During those periods of increased energy, were your thoughts racing? . . . Were you always‘on the go’? . . . Did you have lots of plans? . . . Looking back on it, were some of those plansunrealistic, or did they get you into financial or other difficulties? . . . In those periods did youfind yourself feeling that you had special abilities or powers other people do not have?”“Were there periods where for days or weeks when your emotions got the better of you andyou were too emotional, too hyper, too high, but were not drunk or using drugs?Manic-depressive patients may not recognize past manias, but they will rememberthe consequences of their behavior. Helpful questions are:“When that [the episode] happened, were people upset, angry or frightened of you . . . were thepolice called . . . did they bring you to the hospital . . . did they put you in restraints?”“Do you have periods where for days or weeks you become short-tempered and moreaggressive than usual, even yelling and arguing with people or getting into fights? . . . Werefriends and family members frightened by the way you were?”Psychosis 3 “In the past have you ever been troubled by suspicions that you were somehow in danger . . .that people were talking about you behind your back or plotting to hurt you?”“In the past have you ever experienced seeing or hearing things that didn’t make sense or werestrange or unusual, like hearing voices when no one was nearby, seeing visions or frighteningthings that seemed real, but others said were from your imagination ‘playing tricks on you’?”Sleep disorder 4Sleep disorders are common, particularly in persons over 50 years of age. Sleepapnea, restless leg syndrome, and non-REM sleep stereotypy impact general healthand are associated with mood disorders and neurologic disease, complicatingmanagement of many behavioral conditions. Questions include:“Have your present difficulties affected your sleep? How is your sleep when you are otherwisefeeling well?“Do you snore loudly? How does your [bed partner] awaken you? 5 Do you fall asleep duringthe day at work, or when driving your car?”