AMPS SCREENING

Anxiety Mood Psychosis Substance

This approach is easily used in the primary care setting as a starting point to develop a reasonable differential diagnosis

SYMPTOM

SCREENING QUESTIONS

SCALE

Anxiety

Is anxiety or nervousness a problem for you?

GAD-7

Mood

Depression: Over the last few weeks, have you been feeling depressed, sad, or hopeless? Have you engaged in pleasurable activities?

PHQ-9

Bipolar: Have you ever felt the complete opposite of depressed where family and friends were worried about you because you were too happy or unreasonably irritable? Have you ever had excessive amounts of energy running through your body, to the point where you did not need to sleep for days?

MDQ

Psychosis

Do you see or hear things that other people do not? Do you have thoughts that people are trying to follow, hurt, or spy on you?

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Substance

How much alcohol do you drink in a day?

AUDIT-C

Have you been using any cocaine, methamphetamines, heroin, marijuana, PCP, LSD, ecstasy, or other drugs?

DAST

MENTAL STATUS EXAM

The MSE is the mental health equivalent of a physical exam, should be observed in all patients, and documented when abnormal

Appearance

Speech

Mood

Affect

Thought process

Thought content

Perceptions

Cognition

Insight

Judgment

Grooming, dress, and behavior

Rate, rhythm, volume, and intensity

A direct quote from the patient (eg, “terrible”)

Observed emotions and variation during interview

How the patient is thinking (eg, how well connected is one thought to the next)

What the patient is thinking (eg, obsessions, delusions, or suicidal/homicidal ideation)

Presence of illusions or hallucinations

Attention, awareness, cognition, and memory

Understanding of symptoms and circumstances

Ability to make reasonable decisions