Name
Kinshuk
Identifying Data
Gender
male
Identifying Data
Work or academic pressure?
yes
Risk assessment/Screening ›
Psychosocial Stressors
Financial stress?
yes
Risk assessment/Screening ›
Psychosocial Stressors
Relationship or marital problems?
no
Risk assessment/Screening ›
Psychosocial Stressors
Major life changes?
yes
Risk assessment/Screening ›
Psychosocial Stressors
Substance use in family?
no
Risk assessment/Screening ›
Family History
Psychiatric illness in family?
no
Risk assessment/Screening ›
Family History
Family conflict or instability?
no
Risk assessment/Screening ›
Family History
Stress management?
Talking to someone
Risk assessment/Screening ›
Risk Behaviors & Coping Skills
Coping style adaptive vs maladaptive?
Sometimes
Risk assessment/Screening ›
Risk Behaviors & Coping Skills
Leisure activities?
Sometimes
Risk assessment/Screening ›
Risk Behaviors & Coping Skills
Supportive family?
yes
Risk assessment/Screening ›
Protective Factors
Positive peer group?
yes
Risk assessment/Screening ›
Protective Factors
Religion or spirituality?
Very important
Risk assessment/Screening ›
Protective Factors
Healthy coping strategies?
Often
Risk assessment/Screening ›
Protective Factors
Trauma or abuse?
No
Risk assessment/Screening ›
Personal & Psychiatric History
Depression, anxiety?
No
Risk assessment/Screening ›
Personal & Psychiatric History
ADHD or other disorders?
No history of ADHD or other psychiatric disorders
Risk assessment/Screening ›
Personal & Psychiatric History
Previous psychiatric treatment?
No
Risk assessment/Screening ›
Personal & Psychiatric History
Insomnia?
yes
Risk assessment/Screening ›
Sleep & Daily Functioning
Irregular sleep?
yes
Risk assessment/Screening ›
Sleep & Daily Functioning
Daytime fatigue?
yes
Risk assessment/Screening ›
Sleep & Daily Functioning
Effect on daily functioning?
no
Risk assessment/Screening ›
Sleep & Daily Functioning
Peer pressure?
no
Risk assessment/Screening ›
Social & Environmental Factors
Community/cultural norms?
no
Risk assessment/Screening ›
Social & Environmental Factors
Exposure to substance use?
no
Risk assessment/Screening ›
Social & Environmental Factors
Impulsivity?
no
Risk assessment/Screening ›
Cognitive & Behavioral Patterns
Novelty seeking?
Sometimes
Risk assessment/Screening ›
Cognitive & Behavioral Patterns
Poor decision-making?
yes
Risk assessment/Screening ›
Cognitive & Behavioral Patterns
Aggression or risk-taking?
Yes-Risk-Taking
Risk assessment/Screening ›
Cognitive & Behavioral Patterns
Medical illnesses
No
Past History
Psychiatric illnesses
Yes- Ongoing
Past History
Past substance use
No
Past History
Substance use in family
no
Family History
Psychiatric illnesses in family
no
Family History
Family environment
Mixed (some support, some conflict)
Family History
Birth and developmental history
Significant delays or difficulties in development
Personal History
Childhood adjustment
Moderate difficulties (frequent struggles at home/school/with peers)
Personal History
Education history
Minor difficulties (occasional struggles, but completed education)
Personal History
Occupational history
Employed, some difficulties
Personal History
Marital and sexual history
Single, no sexual activity
Personal History
Social relationships
Mixed – both supportive and conflictual
Personal History
Forensic or legal history
No legal issues
Personal History
Leisure and coping
Regular leisure activities, healthy coping
Personal History
Traits
Generally introverted / reserved
Premorbid personality
Interpersonal relations
Mixed – supportive with some difficulties
Premorbid personality
Hobbies
Some hobbies/interests, occasional engagement
Premorbid personality
Appearance and behavior
Adequately groomed, generally appropriate behavior
Mental status Examination
Speech
Rapid or pressured
Mental status Examination
Mood and affect
Mildly low / anxious
Mental status Examination
Thought
Logical, coherent, and goal-directed
Mental status Examination
Perception
Occasionally distracted or preoccupied
Mental status Examination
Cognition
Mild difficulties with attention or memory
Mental status Examination
Insight
Partial insight (some awareness, but minimizes difficulties)
Mental status Examination
Judgment
Mildly impaired (occasional poor decisions)
Mental status Examination
Recently reduced or stopped
Yes – With medical supervision
Withdrawal Questions
Onset of symptoms
No symptoms noticed
Withdrawal Questions
Severity 1 to 10
1–2: Very mild, hardly noticeable
Withdrawal Questions
Time of day pattern
Sporadic / unpredictable
Withdrawal Questions
Interference with daily life
None / no interference
Withdrawal Questions
Cravings to relieve symptoms
Mild cravings (occasional, manageable)
Withdrawal Questions
Ever needed medical help
Yes, minor assistance (advice, outpatient support)
Withdrawal Questions