INFOCore Mental Health Report

   Patient Tools, Inc.
Name: 
Sample Patient
 Date:  9/27/2003 4:29:58 PM
ID:
123456789
 
Primary concern(s) today:  Anxiety or worry, Mood swings, Problem with concentration or focus, Work or school difficulties
 
Have Primary Care Physician No
Need assistance at home due to serious health problem No
Need assistance at home due to needs of family member No
Suffer from following medical problems:  Back trouble, Fainting spells or blackouts, Seizures or epilepsy, Thyroid problems, PMS
Currently recovering from a surgery No
Taking prescribed, over-the-counter, or herbal remedies No
Family history of following concerns:  Cancers, Heart trouble/high blood pressure
Have ever been treated by a psychiatrist or a counselor Yes
Currently taking any psychiatric medications No
Have ever been hospitalized on a psychiatric unit Yes
Result of an involuntary hold by the Police Department Yes
Suffer from pain No
 
Marital status Married
Have children Yes
  Currently live with children Yes
Employment status Employed full-time
Events currently impacting life:  Death of a loved one, Problems with the law, Work injury, Conflicts with children, Alcohol or drug problem in family, Change in financial status or problems with debt
 

Shedler Quick PsychoDiagnostics Panel
(QPD Panel v6.0)

   Patient Tools, Inc.
Name: 
Sample Patient
 Sex: Female
ID:
123456789
 Age: 32
Date:  9/27/2003 4:29:58 PM

¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾ Diagnostic Report ¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾  

Test

Results

Reference Range

 

within range

out of range
¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾¾

Depression

18

0 - 10

Anxiety

14

0 - 10

Panic Disorder

5

0 - 8

OCD

3

0 - 3

Bulimia

5

0 - 4

Alcohol / Substance Abuse

9

0 - 2

Somatization

7

0 - 11

¾¾¾¾¾
Notes:

- Depression out of range, but patient does not appear to meet criteria for Major depressive Episode
- Anxiety out of range, but patient does not appear to meet criteria for Generalized Anxiety Disorder
- Eating Disorder score out of range, but patient does not appear to meet criteria for Bulimia Nervosa
- Likely alcohol or substance abuse

- Suicidal ideation

Disposition:

These results were reviewed and discussed with the patient. The following recommendation was made:

___ No follow-up indicated ___ Further evaluation
___  Referral ___  Medication
___ Other: _____________________________
Physician Signature: ________________________________  Date:____________
 
Shedler Quick PsychoDiagnostics Panel (QPD Panel v6.0)

ID:
P16472
Date: 9/27/2003 4:29:58 PM

Depressive Symptoms 
-depressed mood, more days than not, 2 years or longer duration
-diminished interest or pleasure in activities
-weight loss
-agitation
-fatigue, loss of energy
-feelings of worthlessness or guilt
-impaired concentration
-hopelessness
-thinks about death
-suicidal ideation: answered true to "I think about killing myself"

Anxiety Symptoms 
-excessive anxiety or worry
-feels unable to stop worrying
-restless, keyed up
-difficulty concentrating
-irritability
-muscle tension
-feels helpless and overwhelmed
-frequent cold, clammy hands or feet
-frequent heart racing or pounding
-frequent dry mouth
-frequent sweating

Bulimic Symptoms 
-eating binges with consumption of abnormal amounts of food
-"purging" through self-induced vomiting
-"purging" through use of laxatives, enemas, or fasting
-binging and purging cycles have occurred twice a week or more

Substance Abuse Symptoms 
-I occasionally drink or use "recreational" drugs heavily after a disappointment or quarrel, or after a hard time at work.
-I have noticed that I am able to handle more alcohol or drugs than I used to.
-When drinking or taking drugs with others, I sometimes try to have a few extras when others won't notice.
-I sometimes feel a little guilty about my use of alcohol or other drugs.
-I sometimes wake up the morning after drinking or using "recreational" drugs, and find I cannot remember things that happened the night before.
-I often find that I want to continue drinking or taking drugs after my friends say they have had enough.
-I often regret things I did or said while I was under the influence of alcohol or drugs.
-I have started spending more time with friends who drink or use drugs heavily, and less time with friends who do not.
-I find that when I start drinking or taking drugs, I often continue past the point that I intended.

 
Shedler Quick PsychoDiagnostics Panel (QPD Panel v6.0)

ID:
P16472
Date: 9/27/2003 4:29:58 PM


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  depression   anxiety