DIAGNOSIS CHECKLIST
for Psychological problems

Why: to determine if acute or chronic.

Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), feelings of worthlessness, feelings of excessive guilt, restlessness, nervousness, agitation, anxious mood, irritability, elevation of mood, disinhibition, grandiose ideas, hallucinations, delusions, paranoia, disordered thought.

Why: may assist in determining the type of depression that you have e.g. with endogenous depression you usually feel worse on waking in the morning; with reactive depression or postnatal depression usually feel worse at end of day.

Why: it is important for the doctor to know if you are a suicide risk.

Why: e.g. severe loss, such as the death of a loved one, marital separation or financial loss. Note that psychological problems may develop for no apparent reason.

Why: questions specifically about relationship, family, children, social support, occupation, general physical health and financial stresses.

Why: may help determine the severity of psychological problems.

Why: e.g. counseling, psychotherapy, antidepressants, anti-anxiety medications or electroconvulsive therapy.

Why: depression that has its onset within 3 months, and possibly up to 6 months following childbirth.

Why: e.g. depression can have bizarre features in the elderly and may be misdiagnosed as dementia or psychosis. Agitated depression is the most frequent type of depression in the elderly. Other symptoms of depression in the elderly may include histrionic behavior, delusions and disordered thinking.

Why: e.g. high blood pressure, high cholesterol, diabetes, smoking, family history - can assess risk of multi-infarct dementia as the cause of psychological symptoms.

Why: medical illness is an important precipitant of depression, especially in the elderly. Depression with chronic fatigue syndrome may follow an illness such as glandular fever or influenza or may follow an operation or childbirth.

Why: some medications may increase the risk of depression e.g. beta-blockers, anti-Parkinson drugs, corticosteroids, anti-cancer drugs, non-steroidal anti-inflammatory medications, combined oral contraceptive pill, progesterone-only contraceptives or Wernicke-Korsakoff syndrome.

Why: may help in determining whether alcoholism is the cause of depression, anxiety.

Why: may cause acute psychosis, depression or anxiety.

Why: depression, anxiety, bipolar disorder and schizophrenia tends to run in families.

Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), increase or decrease in appetite (usually decreased), weight loss or gain, insomnia or increased sleeping (usually early morning waking), fatigue, loss of energy, feelings of worthlessness, feelings of excessive guilt, poor concentration, difficulty making decisions, low libido, thoughts of death or suicide attempt.

Why: e.g. episodes of depression (often psychotic in intensity) and at other times episodes of psychotic excitement (mania or hypomania). Symptoms of psychotic excitement may include elevation of mood, increased activity, grandiose ideas, irritability, disinhibition (which affects social, sexual and financial behavior), rapid speech and racing thought, delusions (persecutory or grandiose) and sometimes hallucinations.

Why: e.g. nervousness, shakiness, tremor, restlessness, irritability, insomnia, poor concentration, heart palpitations, racing heart, sweating, dizziness, diarrhea, lump in throat and frequency of urination - anxiety and depression are very closely related and may co-exist, however anxiety may mask an underlying depression.

Why: e.g. hallucinations, delusions, disordered thought - may assist in differentiating schizophrenia and bipolar affective disorder from depression but people with severe psychotic depression may also experience these symptoms, especially delusions. Note that patients with schizophrenia may also develop pronounced depressive symptoms.

Why: may be present in schizophrenia, bipolar affective disorder, psychotic depression, paranoid delusional disorder, paranoid personality disorder, schizotypal personality disorder, brain damage, abuse of stimulant of hallucinogenic drugs, dementia and cultural isolation.

Why: e.g. headache, dementia, seizures, stroke-like symptoms - a brain tumor may present with depression.

Why: e.g. weight gain especially central abdominal, change of appearance, moon-like face, thin skin, easy bruising, excessive facial hair growth, acne, muscle weakness, lack of or rare menstrual periods, poor libido, psychosis, insomnia, frequent urination, excessive thirst - Cushing's syndrome may also present with depression.

Why: e.g. husky voice, tiredness, weight gain, constipation, cold intolerance, loss of hair - Hypothyroidism may also present with depression.

Why: e.g. loose bowel motions, intolerance to heat, sweating of hands, muscle weakness, increased appetite, weight loss, heart palpitations, emotional lability - Hyperthyroidism may also present with depression or anxiety.

Why: e.g. hot flushes, night sweats, heart palpitations, lightheadedness, dry vaginal, dry skin, headaches - Menopause may also present with depression or anxiety.

Why: e.g. impaired memory, impaired judgement and thinking, impaired verbal fluency and impaired ability to perform complex tasks. Personality may change, impulse control may be lost and personal care deteriorates. People with dementia may also have psychiatric symptoms such as delusions, paranoid ideas, hallucinations, mood disturbance and behavioral disturbance - Dementia may be confused with depression.

Why: e.g. impaired conscious level with onset over hours or days, disorientation in time and/or place, unusually quiet, drowsy, agitated, delusions, auditory hallucinations, visual hallucinations. Symptoms are typically worse in the late afternoon and at night.

Why: e.g. limb weakness or paralysis, facial muscle weakness or paralysis, difficulty with speech and swallow. Multi-infarct dementia may cause psychological problems. Multi-infarct dementia is characterized by step-wise progression in the deterioration of memory.

Why: e.g. headache, constipation, indigestion, weight loss, dry mouth, unusual pains or sensations in the chest and abdomen - not uncommonly occur with depression and tend to mask a diagnosis of depression. Depression can be associated with many illnesses but it is important to realize that these somatic symptoms may be the presentation of depressive illness.