Detachment Assessment Questionnaire

Why: to determine if acute or chronic.

Why: e.g. inappropriate loss of interest or involvement.

Why: may assist in determining the type of depression that you have e.g. with endogenous depression symptoms are usually feel worse on waking in the morning; postnatal depression usually feel worse at end of day.

Why: it is important for the doctor to know if you are a suicide risk.

Why: e.g. severe loss, such as the death of a loved one, marital separation or financial loss. Note that causes of detachment may develop for no apparent reason.

Why: questions specifically about relationship, family, children, social support, occupation, general physical health and financial stresses.

Why: postnatal depression has its onset within 3 months, and possibly up to 6 months following childbirth and may present with detachment.

Why: e.g. if elderly consider dementia and depression. Depression can have bizarre features in the elderly and may be misdiagnosed as dementia or psychosis. Agitated depression is the most frequent type of depression in the elderly. Other symptoms in the elderly may include histrionic behavior, delusions and disordered thinking and they can certainly appear detached and lose interest and involvement.

Why: medical illness is an important precipitant of depression, especially in the elderly. Depression with chronic fatigue syndrome may follow an illness such as glandular fever or influenza or may follow an operation or childbirth.

Why: some medications may increase the risk of depression e.g. beta-blockers, anti-Parkinson drugs, corticosteroids, anti-cancer drugs, non-steroidal anti-inflammatory medications, combined oral contraceptive pill, progesterone-only contraceptives.

Why: may help in determining whether alcoholism is the cause of depression, dementia or dysthymia.

Why: may cause depression. Marijuana is well known to cause apathy.

Why: e.g. depression, schizophrenia, bipolar affective disorder, Alzheimer's disease, Huntington's disease.

Why: e.g. depressed mood, crying spells, anhedonia (loss of interest or pleasure), increase or decrease in appetite (usually decreased), weight loss or gain, insomnia or increased sleeping (usually early morning waking), fatigue, loss of energy, feelings of worthlessness, feelings of excessive guilt, poor concentration, difficulty making decisions, low libido, thoughts of death or suicide attempt - may present with detachment.

Why: e.g. episodes of depression (often psychotic in intensity) and at other times episodes of psychotic excitement (mania or hypomania). Symptoms of psychotic excitement may include elevation of mood, increased activity, grandiose ideas, irritability, disinhibition (which affects social, sexual and financial behavior), rapid speech and racing thought, delusions (persecutory or grandiose) and sometimes hallucinations. The depression phase may present with detachment.

Why: e.g. nervousness, shakiness, tremor, restlessness, irritability, insomnia, poor concentration, heart palpitations, racing heart, sweating, dizziness, diarrhea, lump in throat and frequency of urination - may present with detachment.

Why: e.g. hallucinations, delusions, disordered thought - may suggest schizophrenia, bipolar affective disorder, severe depression, dementia or delirium - all of which may present with detachment.

Why: e.g. impaired memory, impaired judgement and thinking, impaired verbal fluency and impaired ability to perform complex tasks. Personality may change, impulse control may be lost and personal care deteriorates. People with dementia may also have psychiatric symptoms such as delusions, paranoid ideas, hallucinations, mood disturbance and behavioral disturbance - Dementia e.g. Alzheimer's disease, Huntington's disease, Pick's disease may present with detachment.

Why: e.g. symptoms follow exposure to an unusual stress such as a battle, being attacked or raped or a natural disaster. Symptoms include recurrent and intrusive recollections of the stress, recurrent distressing dreams of the event, acting or feeling as if the event was recurring, intense distress on exposure to resembling events, persistent avoidance of events that symbolize or resemble the trauma, increased arousal symptoms such as insomnia, exaggerated startle response, poor concentration and moodiness - Post-traumatic stress disorder may present with detachment.

Why: e.g. sudden, unexpected, short-lived episodes of intense anxiety. Panic disorder may present with detachment.