AGORAPHOBIA

F1 Do you feel anxious or uneasy in places or situations where you might have a panic attack NO YES or the panic-like symptoms we just spoke about, or where help might not be available or escape might be difficult: like being in a crowd, standing in a line (queue), when you are alone away from home or alone at home, or when crossing a bridge, traveling in a bus, train or car?

F2. IF NO CIRCLE NO IN

F2 Do you fear these situations so much that you avoid them, or suffer NO YES through them, or need a companion to face them?

AGORAPHOBIA CURRENT

F2 ( ) NO YES IS CURRENT AGORAPHOBIA CODED NO and PANIC DISORDER without Agoraphobia

E7 ( ) ? IS CURRENT PANIC DISORDER CODED YES CURRENT

F2 ( ) NO YES IS CURRENT AGORAPHOBIA CODED YES and PANIC DISORDER with Agoraphobia

E7 ( ) ? IS CURRENT PANIC DISORDER CODED YES CURRENT

F2 ( ) NO YES IS CURRENT AGORAPHOBIA CODED YES and AGORAPHOBIA, CURRENT without history of

E5 ( ) ? IS PANIC DISORDER LIFETIME CODED NO Panic Disorder

M.I.N.I. 5.0.0 (July 1, 2006) 12G.

G1 In the past month, were you fearful or embarrassed being watched, being the focus of attention, or fearful of being humiliated? This includes things like speaking in public, eating in public or with others, writing while someone watches, or being in social situations.

G2 Is this social fear excessive or unreasonable?

G3 Do you fear these social situations so much that you avoid them or suffer through them?

G4 Do these social fears disrupt your normal work or social functioning or cause you significant distress?

SOCIAL PHOBIA(Social Anxiety Disorder) CURRENT SUBTYPES

Do you fear and avoid 4 or more social situations?

GENERALIZED

If YES Generalized social phobia (social anxiety disorder)

NON-GENERALIZED

If NO Non-generalized social phobia (social anxiety disorder)

NOTE TO INTERVIEWER PLEASE ASSESS WHETHER THE SUBJECT'S FEARS ARE- (“ 1

”)RESTRICTED TO NON GENERALIZED ONLY OR SEVERAL SOCIAL(“ ”) .SITUATIONS OR EXTEND TO GENERALIZED MOST SOCIAL SITUATIONS“M ” 4OST SOCIAL SITUATIONS IS USUALLY OPERATIONALIZED TO MEAN OR, D -MORE SOCIAL SITUATIONS ALTHOUGH THE SM IV DOES NOT EXPLICITLY.STATE THISEXAMPLES OF SUCH SOCIAL SITUATIONSTYPICALLY INCLUDE INITIATING OR, , ,MAINTAINING A CONVERSATION PARTICIPATING IN SMALL GROUPS DATING, , ,SPEAKING TO AUTHORITY FIGURES ATTENDING PARTIES PUBLIC SPEAKING, , .EATING IN FRONT OF OTHERS URINATING IN A PUBLIC WASHROOM ETCM.I.N.I. 5.0.0 (July 1, 2006) 13H. OBSESSIVE-COMPULSIVE DISORDER( : , NO )MEANS GO TO THE DIAGNOSTIC BOX CIRCLE AND MOVE TO THE NEXT MODULE

In the past month, have you been bothered by recurrent thoughts, impulses, or NO YES↓images that were unwanted, distasteful, inappropriate, intrusive, or distressing?(For example, the idea that you were dirty, contaminated or had germs, or fear of SKIP TO H4contaminating others, or fear of

Obsessions

Obsessions can manifest in various ways, such as:

• Harming someone even though you didn't want to
• Fearing you would act on some impulse
• Fear or superstitions that you would be responsible for things going wrong
• Obsessions with sexual thoughts, images, or impulses
• Hoarding, collecting, or religious obsessions

(DO NOT INCLUDE SIMPLY EXCESSIVE WORRIES ABOUT REAL LIFE PROBLEMS. DO NOT INCLUDE OBSESSIONS DIRECTLY RELATED TO EATING DISORDERS, SEXUAL DEVIATIONS, PATHOLOGICAL GAMBLING, OR ALCOHOL OR DRUG ABUSE BECAUSE THE PATIENT MAY DERIVE PLEASURE FROM THE ACTIVITY AND MAY WANT TO RESIST IT ONLY BECAUSE OF ITS NEGATIVE CONSEQUENCES.)

Did they keep coming back into your mind even when you tried to ignore or get rid of them?

NO

YES

↓ SKIP TO H4

Do you think that these obsessions are the product of your own mind and that they are not imposed from the outside?

NO

YES

In the past month, did you do something repeatedly without being able to resist doing it, like washing or cleaning excessively, counting or

NO

YES

Checking Compulsions

Do you find yourself doing things over and over, or repeating, collecting, arranging things, or engaging in other superstitious rituals?

Is it a compulsion?

• NO
• YES

Or coded?

• YES

Did you recognize that either these obsessive thoughts or these compulsive behaviors were excessive or unreasonable?

• NO
• YES

Did these obsessive thoughts and/or compulsive behaviors significantly interfere with your normal routine, your work or school, your usual social activities, or relationships, or did they take more than one hour a day?

• NO
• YES

O.C.D. CURRENT M.I.N.I. 5.0.0 (July 1, 2006) 14

I. POSTTRAUMATIC STRESS DISORDER (optional)

( : , NO, )

MEANS GO TO THE DIAGNOSTIC BOX CIRCLE AND MOVE TO THE NEXT MODULE

I1 Have you ever experienced or witnessed or had to deal with an extremely traumatic event that included actual or threatened death or serious injury to you or someone else?

EXAMPLES OF TRAUMATIC EVENTS INCLUDE: SERIOUS ACCIDENTS, SEXUAL OR PHYSICAL ASSAULT, A TERRORIST ATTACK, BEING HELD HOSTAGE, KIDNAPPING, FIRE, DISCOVERING A BODY,

of anger? NO YES

Have you had difficulty concentrating? NO YES

Were you nervous or constantly on your guard? NO YES

Were you easily startled? NO YES

I5 ? NO YES

ARE OR MORE ANSWERS CODED YES NO YES

I6 During the past month, have these problems significantly interfered with your work or social activities, or caused significant distress? POSTTRAUMATIC STRESS DISORDER CURRENT M.I.N.I. 5.0.0 (July 1, 2006) 15

J. ALCOHOL ABUSE AND DEPENDENCE( : , NO )

MEANS GO TO DIAGNOSTIC BOXES CIRCLE IN BOTH AND MOVE TO THE NEXT MODULE

J1 In the past 12 months, have you had 3 or more alcoholic drinks within a NO YES 3 hour period on 3 or more occasions?

J2 In the past 12 months:

a Did you need to drink more in order to get the same effect that you got when NO YES you first started drinking?

b When you cut down on drinking did your hands shake, did you sweat or feel agitated? Did NO YES you drink to avoid these symptoms or to avoid being hungover, for example, "the shakes", sweating or agitation?, .IF YES

than once in any situation where you were physically at risk, NO YES for example, driving a car, riding a motorbike, using machinery, boating, etc.?

Did you have legal problems more than once because of your drinking, for example, NO YES an arrest or disorderly conduct?

Did you continue to drink even though your drinking caused problems with your NO YES family or other people? NO N/A YES

1 J3 ?ARE OR MORE ANSWERS CODED YES ALCOHOL ABUSE

CURRENT M.I.N.I. 5.0.0 (July 1, 2006) 16K. NON-ALCOHOL PSYCHOACTIVE SUBSTANCE USE DISORDERS

( : , NO , )

MEANS GO TO THE DIAGNOSTIC BOXES CIRCLE IN ALL DIAGNOSTIC BOXES AND MOVE TO THE NEXT MODULE

Now I am going to show you / read to you a list of street drugs or medicines.

K1 a In the past 12 months, did you take any of these drugs more than once, NO YES to get high, to feel better, or to change your mood?:

CIRCLE EACH DRUG TAKEN

Stimulants: amphetamines, "speed", crystal meth, "crank", "rush", Dexedrine, Ritalin, diet

pills.

Cocaine: snorting, IV, freebase, crack, "speedball".

Narcotics: heroin, morphine, Dilaudid, opium, Demerol, methadone, codeine, Percodan, Darvon, OxyContin.

Hallucinogens: LSD ("acid"), mescaline, peyote, PCP ("angel dust", "peace pill"), psilocybin, STP, "mushrooms","ecstasy", MDA, MDMA, or ketamine ("special K").

Inhalants: "glue", ethyl chloride, "rush", nitrous oxide ("laughing gas"), amyl or butyl nitrate ("poppers").

Marijuana: hashish ("hash"), THC, "pot", "grass", "weed", "reefer".

Tranquilizers: Quaalude, Seconal ("reds"), Valium, Xanax, Librium, Ativan, Dalmane, Halcion, barbiturates,Miltown, GHB, Roofinol, "Roofies".

Miscellaneous: steroids, nonprescription sleep or diet pills. Any others?( ):SPECIFY MOST USED DRUG S CHECK ONE BOX/ONLY ONE DRUG DRUG CLASS HAS BEEN USEDONLY THE IS

INVESTIGATED.MOST USED DRUG CLASSIS EXAMINED SEPARATELY ( )EACH DRUG CLASS USED K KPHOTOCOPY 2 AND 3 AS NEEDEDb / THE I THERE ISSPECIFY WHICH DRUG DRUG CLASS WILL BE EXPLORED IN NTERVIEW BELOW IF:

________________________________________

CONCURRENT OR SEQUENTIAL POLYSUBSTANCE USE

K2 Considering your use of ( ), in the past 12 months:

/NAME THE DRUG DRUG CLASS SELECTED ) NO YES

a Have you found that