What do you include as part of your outpatient intake form?

[Dopamemes]

Specifically I mean what rating scales but open to general things you include as well. I've been including a PHQ-9, GAD-7, ASRS, Epworth, and PCL-5. Wondering if others use more or less and if so, what do you use?

---

Members don't see this ad.

 

[nexus73]

I might include a mcclain borderline screener

 

[clausewitz2]

I might include a mclean borderline screener

FTFY

 

[clausewitz2]

Specifically I mean what rating scales but open to general things you include as well. I've been including a PHQ-9, GAD-7, ASRS, Epworth, and PCL-5. Wondering if others use more or less and if so, what do you use?

OCI-R
MDQ
DAST

I also have a cobbled together brief screen for psychosis and another for eating disorders based on questions that seem to have good ROC for this purpose that have been published and are in the public domain.

EDIT: in addition to everything above except ASRS, that is.

 

[Sushirolls]

PHQ
GAD
+/- WURS
+/- ADULT ADHD Rating scale

That's it.

 

[splik]

Depends on the pt. but selected from the following: PHQ-9, GAD, PHQ-15, AUDIT, DAST, TAS-20, DES-II, NSI, ASRS, WURS, AQ, RAADS-R, YSQ-R, YPI, LEC, PCL-5, YBOCS, GSAQ, HCL-32, MDQ, SCID-PD-SPQ, McLean

 

[Celexa]

Still in the planning stages but my plan so far for *pre-visit* paperwork:

GAD7
PHQ9
MDQ
Life Events Checklist for DSM - 5
SCOFF
OCI-R
CAGE
CUDIT

No ASRS bc it's too suggestive.
I may then pull out other instruments in the first visit depending on what they say.

 

[annoyedpsychiatrist]

in residency we did not include the mclean, but since ive been an attending i regularly incorporate it When patients check yes to every question, and they're like "hey this all describes me!".

 

[ObsequiousAplomb]

I do GAD-7, PHQ-9, and maybe an ADHD scale. I never had any pre-visit forms in residency.

 

[clozareal]

I've started using the Sydney Bipolar Questionnaire rather than the MDQ.

At intake, I do GAD-7, PHQ-9 (±modified for adolescents), ASRS or Vanderbilt (for kids), SCARED (again for kids), AQ or ASSQ for autism or sometimes CARS-2 or SDQ or CAT-Q, PCL-5 with LEC, OCI-R sometimes SCID-PD depending on the phone screen. I try not to overwhelm the patient with all of these. I usually print it out and have them fill it out on paper in my office if they don't do them.

After intake, it really depends on the chief complaint. For sleep: Epworth or peds ESS, PSQI, CSHQ for kids, ISI, sleep diary. Chronic pain/fatigue: michigan body map & fatigue symptom inventory. Dissociation: DES-II or CDS. Sexual side effects: CSFQ or ASEX. Substance: CRAFFT.

 

[annoyedpsychiatrist]

I've started using the Sydney Bipolar Questionnaire rather than the MDQ.

At intake, I do GAD-7, PHQ-9 (±modified for adolescents), ASRS or Vanderbilt (for kids), SCARED (again for kids), AQ or ASSQ for autism or sometimes CARS-2 or SDQ or CAT-Q, PCL-5 with LEC, OCI-R sometimes SCID-PD depending on the phone screen. I try not to overwhelm the patient with all of these. I usually print it out and have them fill it out on paper in my office if they don't do them.

After intake, it really depends on the chief complaint. For sleep: Epworth or peds ESS, PSQI, CSHQ for kids, ISI, sleep diary. Chronic pain/fatigue: michigan body map & fatigue symptom inventory. Dissociation: DES-II or CDS. Sexual side effects: CSFQ or ASEX. Substance: CRAFFT.

i hate the MDQ because the wording is too vague. "have you ever had a time where you were..more irritable..interested in sex..etc". Most people end up putting yes to questions like this. And people often look at individual symptoms during different time periods rather than the symptoms occuring together. They give it out at my clinic but i just briefly glance at it because i have never found it overly useful.

 

[clausewitz2]

I've started using the Sydney Bipolar Questionnaire rather than the MDQ.

At intake, I do GAD-7, PHQ-9 (±modified for adolescents), ASRS or Vanderbilt (for kids), SCARED (again for kids), AQ or ASSQ for autism or sometimes CARS-2 or SDQ or CAT-Q, PCL-5 with LEC, OCI-R sometimes SCID-PD depending on the phone screen. I try not to overwhelm the patient with all of these. I usually print it out and have them fill it out on paper in my office if they don't do them.

After intake, it really depends on the chief complaint. For sleep: Epworth or peds ESS, PSQI, CSHQ for kids, ISI, sleep diary. Chronic pain/fatigue: michigan body map & fatigue symptom inventory. Dissociation: DES-II or CDS. Sexual side effects: CSFQ or ASEX. Substance: CRAFFT.

Is the Sydney questionnaire in the public domain somewhere?

 

[clozareal]

Is the Sydney questionnaire in the public domain somewhere?

I created my own based off of this Carlat issue.

TCPR_NovDec2021_The_Sydney_Bipolar_Screener.pdf

 

[brazilianpsych]

Damm, I had no idea y'all liked questionnaires so much. My program only uses GAD and PHQ, and I have to admit I don't like questionnaires that much. I have attendings who don't like them at all.

In the future I don't plan on using them much, except for maybe a huge question "do you want free benzos/adderall?", if pt votes yes he cannot proceed with the intake. That would be great.

 

[annoyedpsychiatrist]

Damm, I had no idea y'all liked questionnaires so much. My program only uses GAD and PHQ, and I have to admit I don't like questionnaires that much. I have attendings who don't like them at all.

In the future I don't plan on using them much, except for maybe a huge question "do you want free benzos/adderall?", if pt votes yes he cannot proceed with the intake. That would be great.

they're just good purely as a way to save a few minutes asking questions about specific symptoms or looking at trends sometimes for a patient. Sometimes if a patient is a bad historian it helps having him compare GAD 7s just to get an idea of how he/she feels. As a whole, i definitely don't rely on them, they're just supplemental data. I never diagnose anyone off a questionare that's for sure.

The ASRS questionnaire.I know if they put "very often" to every symptom then they're probably fishing for adderrall. If they put never to everything, they probably have no reason to lie about that, and theres a good chance they dont have ADHD. So I only use it for that purpose but still dont use it routinely.

 

[TexasPhysician]

I’ve dropped all established questionnaires from my intake as on average I’ve found them to be worthless and agitate/fatigue patients.

Even electronically, patients have to read and sign documents to be a patient. This is the case everywhere including hipaa stuff, rules, cancellation policies, etc. Then there is also demographics, med lists, allergies, and other gen medical issues they need to fill out. The average patient in my practice (almost no psychosis) is already worn out from questions. Toward the end, patients start not answering questions, providing minimal responses, or even use sarcasm in the paperwork.

Patients barely read full sentences within questionnaires before answering and often they draw a line down the page as a single response. I initially used questionnaires and would ask questions about positive responses. More often than not, the patient didn’t actually have the symptom they said yes too. Utilizing the questionnaires became a waste of my time.

Patients view initial patient paperwork in America to be a standard barrier that keeps them from seeing their new physician. Few see it as an opportunity to give the physician additional information. This is reinforced by many non-psychiatrist physicians never reading the paperwork. I myself find that I’ll often answer the same questions with a new doctor that were in the paperwork.

Real world is much different than the prep that goes into having study patients complete paperwork when building a questionnaire.

I do use 0-1 questionnaires on follow-up patients to help track progress, reinforce a diagnosis, or find new symptoms. Effort is much higher once patients realize that I read the intake and care about their mental health.

 

[When is graduation again?]

I'm starting a private practice with an opening date of October/November. My plan is to have a practice that focuses on short-term care that is ACT-based, so I was planning to do 5-6 short answer questions to get a sense of goals/values. Ideally, the questions would make the patients think about what they want out of care and screen out people who aren't a good fit or are drug seeking.

 

[Candidate2017]

I’ve dropped all established questionnaires from my intake as on average I’ve found them to be worthless and agitate/fatigue patients.

Offer one free Adderall and one free Xanax with every intake form. That should do the trick.

Toward the end, patients start not answering questions, providing minimal responses, or even use sarcasm in the paperwork.

This is the actual purpose of intake forms... to screen for personality issues. But if you are employed or work for third party payors (i.e., take on all comers), then yes, there's no real point in making people do intake forms.

 

[clausewitz2]

I'm starting a private practice with an opening date of October/November. My plan is to have a practice that focuses on short-term care that is ACT-based, so I was planning to do 5-6 short answer questions to get a sense of goals/values. Ideally, the questions would make the patients think about what they want out of care and screen out people who aren't a good fit or are drug seeking.

You might be surprised how many otherwise high-functioning people actually find it difficult to answer questions about values. There is a reason ACT often employs whole sessions, or even multiple sessions, with helping people elucidate these. Not sure a screener will do what you are hoping it will do.

 

[annoyedpsychiatrist]

Annoyedpsychiatrist patented screener for screening out drug seeking:

1. Have you ever taken adderall from your friend or other sources and noticed that all of your awful symptoms went away?
2. Is xanax/ativan/valium the only medicaitons that work for you, rather than all those antidepressants and therapy?
3. Have you found that every other doctor doesnt listen or hear you correctly, and you're just not being heard?
4. Do you feel strongly that marijuana is the best medicine for depression?

Answering yes to any of these questions predicts 99% chance of drug seeking

 

[When is graduation again?]

You might be surprised how many otherwise high-functioning people actually find it difficult to answer questions about values. There is a reason ACT often employs whole sessions, or even multiple sessions, with helping people elucidate these. Not sure a screener will do what you are hoping it will do.

Maybe, maybe not. I plan to keep the questions pretty simple, so I don't think it'll be an issue. Either way I'll learn something from the experiment or uncover a better method. At the very least patient will begin the process of thinking about what they're hoping to get from treatment and they'll get a glimpse of what we will explore in treatment.

 

[clausewitz2]

Maybe, maybe not. I plan to keep the questions pretty simple, so I don't think it'll be an issue. Either way I'll learn something from the experiment or uncover a better method. At the very least patient will begin the process of thinking about what they're hoping to get from treatment and they'll get a glimpse of what we will explore in treatment.

Out of curiosity, what are the questions? I end up doing a lot of ACT-y stuff myself and would be interested to hear how you approach this.

 

[ObsequiousAplomb]

Offer one free Adderall and one free Xanax with every intake form. That should do the trick.



This is the actual purpose of intake forms... to screen for personality issues. But if you are employed or work for third party payors (i.e., take on all comers), then yes, there's no real point in making people do intake forms.

If you think apathy and frustration as a response to filling out needless forms is indicative of a personality disorder, I wonder what you don't consider a personality disorder.

 

[When is graduation again?]

Out of curiosity, what are the questions? I end up doing a lot of ACT-y stuff myself and would be interested to hear how you approach this.

I haven't finalized them, but I'm aiming for 5 questions. 2 are goals related. The first asks what the person's current life goals are and provides several typical examples. The second asks how their current mental block or distress interferes with the goal(s) they mentioned. 2 other questions are meant to get some basic treatment history and the last question is more of a statement that I'm not giving out scheduled drugs.

My main goal with these questions is to screen our people I'm not interested in working with. I'm trying to be selective in the patients I take upfront, so I can tailor the practice to what I'll most enjoy. My biggest issue throughout training and my current job has been having to treat patients that are inappropriate for the treatment provided or have little motivation for improvement, so I'm trying to avoid this. Of course, there is a risk that it may stall my practice from filling as quickly or may not work, but those are acceptable risks for me.

 

[Sushirolls]

I mostly do PHQ / GAD.
Questionnaires can be billed for, see this thread.

 

[Candidate2017]

This is the actual purpose of intake forms... to screen for personality issues.

If you think apathy and frustration as a response to filling out needless forms is indicative of a personality disorder, I wonder what you don't consider a personality disorder.

No. I am referring to personality issues regarding potential patients "not answering questions, providing minimal responses, or even use sarcasm in the paperwork."

I'm not asking you to do calculus. And it's ok if you don't the exact dosage of your Amlodipine, the phone number of your PCP, or whether your aunt had issues with alcohol. But if you are seeking professional help from me but resort to sarcasm, when everyone else is able to put in a good faith effort, then yes, there's a chance you have certain personality issues that bleed into many aspects of your life and relationships.

And many wise psychologists use only paper intake forms because you can physically see so much more on paper and ink (i.e., scrawling all over the page, or filling up every line, or small controlled writing, or barely legible writing, or soiled pages, etc).