Mood Patterns Screening Questionnaire
RMS
Name
*
First Name
Last Name
Date of Birth
*
/
Month
/
Day
Year
Date
Today's Date
*
/
Month
/
Day
Year
Date
Have there been at least 6 different periods of time (at least 2 weeks) when you felt deeply depressed?
*
Yes
No
Did you have problems with depression before the age of 18?
*
Yes
No
Have you ever had to stop or change your antidepressant because it made you highly irritable or hyper?
*
Yes
No
Have you ever had a period of at least 1 week during which you were more talkative than normal with thoughts racing in your head?
*
Yes
No
Have you ever had a period of at least 1 week during which you felt any of the following: unusually happy; unusually outgoing; or unusually energetic?
*
Yes
No
Have you ever had a period of at least 1 week which you needed much less sleep than usual?
*
Yes
No
Total Score:
*
Submit
Should be Empty: