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RESOURCES
Tools/Clincians
CMF
Self report
Tools/Everyone
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Instructions for the Clinical Self-Report Form
by Gary Sachs, M.D.
General
Instructions:
The Clinical Self Report Form was designed to systematically collect information
about the symptoms commonly experienced by patients with mood disorders.
Collecting information at each visit allows your doctor to better track the
course of your symptoms and your response to treatment. Answering standard
questions before your visit allows for more productive time with your doctor.
We strongly recommend filling one out at each visit.
What is...?
- Depressed
mood - feeling
sad, blue, down,
being unable to enjoy
most things you usually
find pleasurable
- Elevated
mood - feeling
high, up, more capable
than usual, feeling
invulnerable - out
of proportion to
circumstances
- Abnormal
irritability -
feeling more easily
annoyed, angry, or
hostile than normal
for the circumstances
- Abnormal
anxiety - feeling
more nervous, anxious,
worried than normal
for the circumstances
Click
here to download a printable
Adobe Acrobat .PDF file of
the clinical self-report form.
Click
here to download FREE Acrobat Reader, if needed.
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The
Massachusetts General Hospital
Bipolar Clinic and Research Program
50 Staniford Street, 5th Floor; Boston, MA 02114
P: (617) 726-6188 | F: (617) 726-6768
Treatment
by clinic staff or MGH-affiliated clinics and studies can
NOT be arranged through
this site or contact e-mail.
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This
web site, its contents, and contact information are designed for
informational purposes only,
and must not be substituted for professional care.
Consult a physician or primary care doctor if you
believe that you are experiencing
symptoms of any illness.
If you are experiencing an medical emergency, call
911 immediately. |