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Appearance/behaviour/attitude: Weight, dress, hygiene, speech, gait, activity, anxiety symptoms, cooperative, evasive, hostile.
Mood: Are there occasions when you have felt very low, sad, down, high? How many good/bad days in last week?
Energy: Have your activities changed in the last month? What do you normally do in a day? Do you feel more tired than usual?
Interest/Pleasure: For the activities that you are doing do you still enjoy them?
Sleep: How many hours sleep do you get on average? What time do you go to bed? What time do you wake up? Do you sleep all the way through? Is it hard to fall asleep? Do you have nightmares?
Appetite: How may meals a day? Do you enjoy your food? Have you lost/gained weight? Are you worried about your weight? Bingeing/vomiting/laxative use?
Concentration: Do you get easily distracted? Can you read a book/watch TV for half an hour or more?
Memory: Have you noticed losing, misplacing things more recently? Do you get lost in public?
Orientation: Time, Place, Person?
Irritability: Are you angered easily? Do you lose your temper? Have you been more snappy? Have you acted on it towards people or objects? (If yes complete risk assessment for violence on next page)
Unusual Experiences: Have you seen/heard things that others could not see? Have you had experiences that are unusual for you? Have you been so anxious that it feels like you have left your body?
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