Diagnosis Sheet I Schizophrenia Advanced

Schizophrenia Demo ( Click Here )

Have you taken any of the following drugs in the last 30 days.

Proventil	Ventolin	Symmetrel	Dextroamphetamine	Methamphetamine
Phenmetrazine	Phenylpropanolamine	Speed ( Recreational Drug )	Dilantin	Mysoline
Azatadine HCL	Bromodiphenhydramine HCL	Bromopheniramine Maleate	Carbinoxamine Maleate	Chlorpheniramine Maleate
Chlorpheniramine Polistirex	Clemastine Fumarate	Cypropeptidine HCL	Dexchlorpheniramine Maleate	Diphenhydramine Maleate
Diphenyl Pyraline HCL	Hydroxyzine HCL	Hydroxyzine Pamoate	Methdilazine	Phenyltolaxamine Citrate
Pynlamine Maleate	Pyriamine Tannate	Terfenadine promethazine HCL	Trimeprazine Tartrate	Triprolidine HCL
Tripelennamine Citrate	Tripelennamine HCL	Clonidine Hydrochloride	Propranolol	Timolol Maleate
Marijuana	Methyl Dopa	Isocarboxazid	Pargyline	Pheneizine
Tranylcypromine	Atropine	Baclofen	Aprobarbital	Butalbital
Butabarbital Sodium	Mephobarbital	Pentobarbital Sodium	Phenobarbital Sodium	Secobarbital
Alprazolam	Chlordiazepoxide HCL	Diazepam	Flurazepam HCL	Lorazepam
Triazolam	Benztropine Mesylate	Bromocriptine	Cimetidine	Clonazepam
Clonidine	Cocaine	Cortisone	Perdnisone	Diazepam
Digitalis	Disulfiram	Ephedrine	Fenfluramine	Hallucinogens
Amitriptyline HCL	Desipramine HCL	Imipramine HCL	Maprotiline	Nortriptyline HCL
Protriptyline HCL	Trimipramine	Indomethacin	Levodopa	Methylphenidate
Phencyclidine	Procaine Penicillin	Propranolol	Pseudoephedrine	Any Illegal Durg

General Medical Condition.
Onset of symptoms,  after the 40 years of age.
Onset of Symptoms
Acute,  no history of mental illness.
Onset during major illness.
Onset while taking drug that may cause mental illness type symptoms.
History of
Alcohol abuse
Drug abuse
Illness involving any major organ
Taking Multiple Medication types
Family History of
Degenerative brain disease
Inheritable brain disease
Metabolic disease
Cognitive
Altered level of consciousness
Fluctuating mental state
Cognitive impairment
Hallucinations
Tactile
Olfactory
Visual
Physical Symptoms
Any type of neurological symptoms
Poor muscle coordination
Slowed movements
Slowed speech
Slowed cognitive functioning
Tremors
Medical Condition
Addison's Disease
AIDS Dementia
Alzheimer's
Brain Cancer
Creutzfeldt-Jakob Disease
Head Trauma
Huntington's Disease
Hyperadrenalism ( Cushing's Syndrome )
Hyperthyroidism
Hypoglycemia
Hypothyroidism
Intracranial Tumors
Liver Disease
Multi-infarct Dementia ( MID )
Multiple Sclerosis
Myasthenia Gravis
Pancreatic Cancer
Parkinson's Disease
Pick's Disease
Postconcussion Syndrome
Subdural Hematoma
Syphilis ( Untreated )
Systemic Lupus Erythematosus
Temporal Lobe Epilepsy
Toxins
Tubercolous Meningitis
Pernicious Anemia ( Vitamin B-12 Deficiency )

Delusion Type
Delusion / s Cultural, but excessive.
Delusion / s With Bases, but excessive.
History of Delusion / s
Delusion / s No Bases
Delusion / s are Bizarre

Hallucination Type
Auditory Hallucination ( One voice )
Auditory Hallucination ( Two voice )
Auditory Hallucination ( Three or more voices )
Command Hallucination
Visional Hallucination
Tactile Hallucination
Olfactory Hallucination
Sensory Hallucination ( NOT LISTED )

Continuous signs of disturbance ( Less then 6 months )
Less then 6 months
Two or more weeks of Delusions or Hallucinations, with no Mood Disorder symptoms prominent.
Between 1 and 6 months of symptoms.
Continuous signs of disturbance 6 or more months
Less then 1 months of symptoms in this period.
Less then 1 months of symptoms in this period, but with successfully treatment of symptoms.
1 month or more of symptoms in this period.

Symptoms:

Catatonic Behavior

Delusions

Grossly disorganized Behavior

Hallucinations

Negative symptoms

Dysfunction( Degree of Dysfunction. 1 - MILD to 4 - PROFOUND )
Academic
Occupational
Social
Personal

Behavioral Type
Disorganized Speech.
Flat Affect.
Inappropriate Affect
Catalepsy
Echolalia
Echopraxia
Motor Activity in Excess
Negativism in Motor Activity
Posturing
Major Depression
Manic Episode / s
Mixed Episode / s
Two or more periods or Disorder / s