http://www.statistics.gov.uk/downloads/theme_health/PMA-
AdultFollowup.pdf
Common mental disorders in the week preceding
interview were assessed using the revised version of
the Clinical Interview Schedule (CIS-R) (Lewis et
al, 1992). The CIS-R can provide data on the
prevalence of 14 symptoms, six ICD-10 disorders
(depressive episode, phobias, generalised anxiety,
panic disorder, obsessive compulsive disorder,
mixed anxiety and depression), and the
distribution of total CIS-R scores, which give an
indication of severity of symptoms.
The CIS-R comprises 14 sections, each covering a
particular area of symptoms as follows:
.
Somatic symptoms.
.
Fatigue.
.
Concentration and forgetfulness.
.
Sleep problems.
. Irritability.
. Worry about physical health.
. Depression.
. Depressive ideas.
. Worry.
. Anxiety.
. Phobias.
. Panic.
. Compulsions.
. Obsessions.
Each section begins with a number of mandatory
filter questions. They establish the existence of a
particular symptom in the past month. A positive
response leads to a more detailed assessment of the
symptom in the past week: frequency, duration,
severity, and time since onset. Answers to these
questions determine the informant's score on each
section. Possible scores range from zero to 4 on
each section (except the section on depressive ideas,
which has a maximum score of 5). The example in
Figure 1.2, shows the elements that contribute to
the score for Anxiety. Any combination of the
elements produce the section score. The elements
that contribute to the scores for each of the
symptoms can be found in Appendix A of the
report.
---
The assessment of common mental disorder and alcohol problems
Appendix A
A1 Assessment of common mental disorder using the CIS-R
1. Calculation of CIS-R symptom scores
Calculation of symptom score for Somatic Symptoms
Score one for each of:
Noticed ache or pain/discomfort for four days or more in past seven days
Ache or pain/discomfort lasted more than three hours on any day in past week/on that day
Ache or pain/discomfort has been very unpleasant in past week
Ache or pain/discomfort has bothered you when you were doing something interesting in past week
Calculation of symptom score for Fatigue
Score one for each of:
Felt tired/lacking in energy for four days or more in past seven days
Felt tired for more than three hours in total on any day in past week
Felt so tired/lacking in energy that you've had to push yourself to get things done on at least one occasion during past week
Felt tired/lacking in energy when doing things you enjoy or used to enjoy at least once during past week
Calculation of symptom score for Concentration and forgetfulness
Score one for each of:
Noticed problems with concentration/memory for four days or more in past week
Could not always concentrate on a TV programme, read a newspaper article or talk to
someone without mind wandering in past week
Problems with concentration actually stopped you from getting on with things you used to do or would like to do
Forgot something important in past seven days
Calculation of symptom score for Sleep Problems
Score one for each of:
Had problems with sleep for four nights or more out of past seven nights
Spent at least 1/4 hour trying to get to sleep on the night with least sleep in the past week
Spent three or more hours trying to get to sleep on four nights or more in past week
Slept for at least 1/4 hour longer than usual sleeping on the night you slept the longest in the past week
Slept for more than three hours longer than usual on four nights or more in past week
Calculation of symptom score for Irritability Score one for each of:
Felt irritable or short tempered/angry on four days or more
Felt irritable or short tempered/angry for more than one hour on any day in past week
Felt so irritable or short tempered/angry that you wanted to shout at someone in past week (even if you hadn't actually shouted)
Had arguments, rows or quarrels or lost your temper with someone in past seven days and felt it was unjustified on at least one occasion
Calculation of symptom score for Worry about Physical Health
Score one for each of:
Worried about physical health/serious physical illness on four days or more in past seven days
Felt that you had been worrying too much, in
view of actual health
Worrying had been very unpleasant in past
week
Not able to take mind off health worries at least
once by doing something else in past week
Calculation of symptom score for Depression
Score one for each of:
Unable to enjoy or take an interest in things as
much as usual in past week
Felt sad, miserable or depressed/unable to enjoy
or take an interest in things on four days or
more in past week
Felt sad, miserable or depressed/unable to enjoy
or take an interest in things for more than three
hours in total on any day in past week
When sad, miserable or depressed did not
become happier when something nice
happened, or when in company
Calculation of symptom score for Depressive ideas
Score one for each of:
Felt guilty or blamed yourself when things went
wrong when it hasn't been your fault at least
once in past seven days
Felt that you are not as good as other people
during past week
Felt hopeless, for instance about your future,
during past seven days
Felt that life isn't worth living in past week
Thought of killing yourself in past week
Calculation of symptom score for Worry
Score one for each of:
Been worrying about things other than physical
health on four or more days out of past seven
days
Have been worrying too much in view of your
circumstances
Worrying has been very unpleasant in past week
Have worried for more than three hours in total
on any of past seven days
Calculation of symptom score for Anxiety
Score one for each of:
Felt generally anxious/nervous/tense on four or
more of past seven days
Anxiety/nervousness/tension has been very
unpleasant in past week
When anxious/nervous/tense, have had one or
more of following symptoms:
heart racing or pounding
hands sweating or shaking
feeling dizzy
difficulty getting your breath
butterflies in your stomach
dry mouth
nausea or feeling as though you wanted to
vomit
Felt anxious/nervous/tense for more than three
hours in total in any one of past seven days
Calculation of symptom score for Phobias
Score one for each of:
Felt nervous/anxious about (situation/thing)
four or more times in past seven days
On occasions when felt anxious/nervous/tense,
had one or more of following symptoms:
heart racing or pounding
hands sweating or shaking
feeling dizzy
difficulty getting your breath
butterflies in your stomach
dry mouth
nausea or feeling as though you wanted to
vomit
Avoided situation or thing because it would
have made you anxious/nervous/tense once or
more in past seven days
Calculation of symptom score for Panic
Score one for each of:
Anxiety or tension got so bad you got in a panic
(eg felt that you might collapse or lose control
unless you did something about it) once or
more in past week
Feelings of panic have been very unpleasant or
unbearable in past week
This panic/worst of these panics lasted longer
than 10 minutes
Calculation of symptom score for Compulsions
Score one for each of:
Found yourself doing things over again (that
you had already done) on four days or more in
last week
Have tried to stop repeating behaviour/doing
these things over again during past week
Repeating behaviour/doing these things over
again made you upset or annoyed with yourself
in past week
Repeated behaviour three or more times during
past week
Calculation of symptom score for Obsessions
Score one for each of:
Unpleasant thoughts or ideas kept coming into
your mind on four days or more in last week
Tried to stop thinking any of these thoughts in
past week
Became upset or annoyed with yourself when
you have had these thoughts in past week
Longest episode of having such thoughts was +
hour or longer
2. Calculating total CIS-R scores
The total CIS-R score used in this report was
obtained by summing the symptom scores
described above. This total score reflects the overall
severity of symptoms of common mental disorders
(or neurotic symptoms) and can range from zero
to 57. A score of 12 or above is considered
indicative of common mental disorder. The total
scores are further grouped into four groups:
0-5
6-11
12-17
18 and over