Rapid Mood Screener
RMS
Patient Name:
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
*
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Month
-
Day
Year
Date
Have there Been at least 6 different periods of time (at least 2 weeks) when you felt deeply depressed?
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Yes
No
Did you have a problem with depression before the age of 18?
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Yes
No
Have you ever had to stop or change your antidepressant because it made you highly irritable or hyper?
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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?
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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 during which you needed much less sleep than usual?
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Yes
No
Submit
Should be Empty: