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Gender	Gender Male Female
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Seconed Interviewer
Date Of First Interview
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Summary	Patient is 27 years old CC: Need support managing multiple aspects No PMH, No Past psychiatric hx, No Family hx, no current meds Education: Patient graduated from Arab Academy with degree in Supply Chain on time Work: Worked first in a regular office and left because of conflict with collegues Started private business, with financial help from mother, a coffee shop in October but due to monorail construction his shop was blocked and failed with estimated loss of 2 million. Currently still closing the kiosk and no employment. “انا شاطر قوي وبعرف اقود بس مكونوش مقدرني، عارف اللي عنده امكانيات كتير قوي بس مفيش مفرص يبان” Mother: Works in the central Bank, commanding and direct and critical; “tom and Jerry with her” Father: died 1 month ago, was divorced by mother 4 years ago, married another woman in 2009 and has an Autistic daughter with her. The parents relationship was always fighting and conflicts. 2 older sisters 13 years older. 1 younger sister by 3 years. Friendships: never felt that he belongs with his colleagues in college and had few friends so he joint ISAC and Unicef as volunteer Relationships: Dated a Columbian girl, met during ISAC, with multiple break ups and he traveled to live with her in Columbia for 6 months and attempted to travel again 2 years ago but didn’t get the visa so started his coffee business. Currently she surprised him and came to Egypt with her mother but he doesn’t have any passion towards her anymore and feels guilt towards that. Sexual Hx: His first full sexual relation was with the Columbian girl but reports that he currently doesn’t feel satisfied with her and watching porn and masturbating is more satisfying. Comments: “I feel like I always want to be seen” “I smoke cigars for that reason” List of problems: Self image Relationship status Patient drinks 4-5 cups of coffee per day (10 cups before) and complaints of trouble initiating sleep, Adviced to abstain from coffee after 7pm Plan: No meds, transfer to Ms. Aya for supportive psychotherapy
Diagnosis/Notes
Social
Allergy
Family History	Family History No Yes
Follow Up

Depressive symptoms	Depressive symptoms Depressed mood Anhedonia Decrease concentration Easy fatigability Death wishes Suicidal ideations/plans/attempts Hopelessness / helplessness Sense of suffocation Significant weight loss Insomnia Psychomotor retardation Psychomotor agitation Excessive guilt
Manic symptoms	Manic symptoms Irritable/elated mood Volubility Flight of ideas Decrease need for sleep Easy distractibility Inflated self-esteem Increase goal directed activities Hyperactivity Involvement in risk activities

Delusions	Delusions General delusions Bizzare Delusion Acting out No acting out Others
Hallucinations	Hallucinations Auditory Non auditory Acting out No acting out Perception illusion Others

Sleep	Sleep Insomnia Interrupted sleep sleepiness Cataplexy Night mares Obstructive apnea/ hypopnea Sleep walking
Appetite	Appetite Decrease appetite Increase appetite Eating non-food substance Repeated regurgitation of food Restriction of eating Recurrent binge eating Recurrent compensatory behavior
Sexual symptoms	Sexual symptoms Decrease desire Increase desire Erectile dysfunction Premature ejaculation Anorgasmia Dyspareunia Paraphilia Gender incongruence

Agitation	Agitation Yes No
Aggression	Aggression Verbal Physical sexual Destruction Homicide
Obsessions/ compulsions	Obsessions/ compulsions Obsessions Compulsions Hoarding Body dysmorphia Skin picking Hair bulling
Suicide	Suicide Death wishes Ideations Plans Attempts current Prior attempts
Anxiety symptoms	Anxiety symptoms Mental symptoms Physical symptoms Ill-defined fear Specific phobias Panic attacks
PTSD Symptoms	PTSD Symptoms Intrusive memories (thoughts- feelings- images- nighmares) Hyperarousal Avoiding dissociation Negative thinking Mood changes
Somatic symptoms	Somatic symptoms Hypochondriasis Conversion Induction of disease or physical symptoms Falsification of physical/psychological symptoms
Dissociative symptoms	Dissociative symptoms Depersonalization/ derealization Others
Neurocognitive symptoms	Neurocognitive symptoms Learning / Memory Attention Language Social cognition Self care House keeping Daily activities Ambutaion?????

Speech	Speech Delay Stuttering Vocal tics Others
Intellectual functions	Intellectual functions Daily activity Social functions Cognitive ?????? Others
Restricted/repetitive behavior Angry/irritable mood	Restricted/repetitive behavior Angry/irritable mood loses temper touchy resentful Others
Argumentative/defiant behavior: Vindictiveness (Aggression)	Argumentative/defiant behavior: Vindictiveness (Aggression) aggressive impulses verbal bullying threatening physical animal People Propities Sixual Stealing Setting fire Others
Enuresis	Enuresis Primary Secondary Others
Encorporesis	Encorporesis Primary Secondary Others
Attention	Attention Attention deficit Forgetfulness Easily distracted Others
Activity	Activity Hyperactivity Hypoactivity Others
Motor	Motor Ticks Delayed motor development Soft motor skills Sleep development Gender identity Others
Personality-ClusterA	Personality-ClusterA Pervasive distrust Detachment from social relationships Odd beliefs / thinking
Personality-ClusterB	Personality-ClusterB violations of rights Impulsivity Unstable relationships Unstable sense of self DSH Dramatization Ego inflation
Personality-ClusterC	Personality-ClusterC Social inhibition Difficulty in everyday decisions without help Details oriented Perfectionism Rigidity
Anxiety & Cluster C
Substance abuse/dependence	Substance abuse/dependence Harmfull use Craving Withdrwal symptoms Unable to control use Others
Impairement of functioning	Impairement of functioning Understanding and communication Getting around Self care Getting along with people Life activities (House hold) Life activities (school /work) Participation in society Others
Severity	Severity 1 2 3 4 5 6 7 8 9 10

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