PMHNP HPI only

History of Presenting Illness:[text name="name" memo="Patient name" size="20"] is a [text memo="age" size="2"]-year-old,[select name= value="African American|white|Asian|Hispanic|mixed ethnicity"],[checkbox value="single|married|divorced|partnered"][checkbox value="cis-gender female|cis-gender male|transgender female|transgender male|gender non-binary individual"][text memo="other gender" value="20"]
[var name="name"] that [select value="presents via telehealth|presents in this outpatient appointment "][select value="alone|with family |with significant other |with DHHS worker |with case manager |by police|"][text memo="names" size="20"][select value=" for an initial evaluation and management of | due to reports of |"][checkbox value="depression|anxiety|cognitive impairment|impulsivity|mood lability|ptsd|ADHD|hypomania|irritability|flashbacks|paranoia|hallucination|eating Distress|Addiction|suicidal ideation|innatentiveness|Low Self-Esteem|sleep disturbance|Relationship Issues|depressed mood|loss of interest/pleasure|weight loss|weight gain|insomnia| hypersomnia|psychomotor retardation|psychomotor agitation|fatigue|feelings of worthlessness/excessive or inappropriate guilt|decreased concentration/indecisiveness|thoughts of death/suicide|excessive anxiety and worry|finds it difficult to control the worry|anxiety and worry are associated with restlessness or feeling keyed up or on edge|being easily fatigued|dificulty concentrating or mind going blank|irritability|muscle tension|sleep disturbance|panic attacks"] [textarea memo="other" default="" rows="1"
Pt, presenting with: [checkbox value="acute mental health distress|multiple complex psychosocial issues|a developmental disorder|schizophrenia spectrum disorder|a situational crisis|thoughts of suicide|thoughts of harm to others|thoughts of self-harm|bipolar disorder|depressive disorder|anxiety disorder|OCD|a trauma and stress related disorder|a dissociative disorder|a somatic symptom disorder|a feeding and eating related disorder|an elimination related disorder|a sleep-wake disorder|sexual dysfunction|gender dysphoria|impulse control related disorder|substance related disorder|a neurocognitive disorder|a personality disorder"] [textarea default=""], which per pt reported the symptoms are characterised by : [checkbox value="fear and worry|panic|behavioural avoidance|clinging and neediness|pacing|anxiety|irritability|low mood|sadness|inner emptiness|anhedonia|poor concentration|disturbed sleep cycle|guilt|low self-worth|hopelessness|thoughts of suicide|disturbed sleep|dissociation|provocative behaviours|compulsions|domineering others|eccentricities|emotional detachment|negativism|denial|projection|splitting|passivity|loss of appetite|increase in appetite|lethargy|euphoria|excessive energy|talkativeness|racing thoughts|grandiosity|impulsivity|insomnia|decreased need for sleep|flashbacks|nightmares|intrusive thoughts|heightened threat sensitivity|perceptual disturbance|disorganised thinking|disorganised behaviours|agitation|cognitive difficulties|speech difficulties|hallucinations|delusions|vulnerabilty to exploitation|social withdrawal|amotivation|impaired reality-testing|unhealthy weight loss|unhealthy weight gain|medical problems associated with low BMI|body dysmorphia|alexithymia|medical problems associated with high BMI|family discord|purging|unhealthy weight loss techniques|preoccupation with food|over-valued body ideals|inattention|distractibility|hyperactivity|intellectual difficulties|social difficulties|obsessions|unhealthy preoccupations|cognitive inflexibility|poor social reciprocity|language difficulties|insightlessness|treatment refusal|poor medication adherence|legal difficulties|debts|reputational damage|housing difficulties|unemployment|poverty|unhealthy lifestyle choices|financial stress|oppositional behaviours|substance misuse|alcohol dependence|opiate dependence|autism spectrum disorder"]
Which per pt reports it started [text memo="number of" value="20"][checkbox name="variable_1" value="weeks|months|years"]
with the first age of symptom onset being their: [select name="symptom_onset_age" value="Childhood|Adolescence|Adulthood"]
[select value="The patient reports |The family reports |The Guardian reports |The case manager reports |Electronic records indicate |Police report indicates |"][select value="a past history of|no history of mental health concerns until |no history of mental health concerns|"][textarea memo="Mental health history" rows="2"]. [checkbox name="depression" memo="depression" value=""][checkbox name="anxiety" memo="anxiety" value=""][checkbox name="sleep" memo="sleep" value=""][checkbox name="mood" memo="mood" value=""][checkbox name="ptsd" memo="ptsd" value=""][checkbox name="adhd" memo="adhd" value=""][checkbox name="autism" memo="autism" value=""][conditional field="depression" condition="(depression).is('')"]
[var name="name"]'s depression is characterized as [checkbox value="little interest or pleasure in doing things|hopelessness|helplessness|sleeping too much|difficulty getting to sleep|difficulty staying asleep|feeling tired or having little energy|poor appetite|overeating|feelings of inadequacy|irritability|poor concentration|psychomotor retardation|psychomotor agitation|suicidal ideation"]. [select value="Depressive symptoms are present most of the day, nearly every day|Depressive symptoms are mostly present |"][text size="20"][select value=", are exacerbated by |"][text size="20][select value=", are improved by |"][text size="20]. [select value="Depressive symptoms impact|"][select value=" social/work functioning by | "][textarea rows="1"].
Client rates depression [select value="1|2|3|4|5|6|7|8|9|10"]/10 with 10 being the worst.[textarea memo="Additional Depression information" rows="5"][/conditional]

[conditional field="anxiety" condition="(anxiety).is('')"]
[var name="name"]'s anxiety generally presents as [checkbox value="feeling nervous or on edge|worry|difficulty relaxing|feeling restless|difficulty getting to sleep|difficulty staying asleep|irritability|poor appetite|overeating"][text size="20]. [select value="Anxiety is present |"][select value="in the context of multiple different situations/events such as |primarily in social situations such as | "][textarea rows="1"]. [select value="Anxiety usually last for approximately |Anxiety is present most of the time on most days"][text size="20"][select value=", is brought on by |"][text size="20][select value=", is relieved by |"][text size="20]. Client rates anxiety [select value="1|2|3|4|5|6|7|8|9|10"]/10 with 10 being the worst. [textarea memo="Additional Anxiety information" rows="5"][/conditional][conditional field="mood" condition="(mood).is('')"]

[select value=" Mood instability has been an issue since |"][text size="20"]. [select value="Disordered mood can present as |"][checkbox value="euphoria|excessive energy|excessive self-confidence|insomnia|irritability|agitation|racing thoughts|impulsive behavior|risk taking behavior|paranoia|delusions of grandeur|auditory hallucinations|visual hallucinations|depression|apathy|hopelessness|helplessness|suicidal thoughts|no motivation|hypersomnia"]. [select value="Mood lability is exacerbated by |There are no identified precipitating factors to mood lability|"][textarea rows="1"]. [textarea memo="additional information of mood lability" rows="4"][/conditional][conditional field="autism" condition="(autism).is('')"]

[select value="Per patient,|Per family,|Per record,|"][text size="20"][select value=" they have been | patient has been |"][select value="diagnosed|undiagnosed|"][text size="20"][select value=" autism spectrum disorder "][textarea memo="details of diagnosis/symptom timeframe" rows="4"]. [var name="name"]'s symptoms present as persistent difficulty, in multiple contexts, with social communication and interaction including: [checkbox value="abnormal or failed back and forth conversation|failure to initiate or respond to social interactions|reduced sharing of interests/emotions|limited emotional affect|limited/incongruent nonverbal communication|difficulty with developing/maintaining/understanding relationships|difficulty sharing imaginative play|limited or absent interest in peers"]. They have demonstrated restricted/repetitive patterns of behavior, interests, or activities including: [checkbox value="repetitive motor movements|repetitive speech|infexible adherence to routines|ritualized patterns of verbal or nonverbal behavior|significant difficulty with transitions|rigid thinking patterns|highly restricted and fixated interests|hyper-reactivity to sensory input|hyporeactivity to some sensory input"]. Presentation is [select value="without|with"] intellectual impairment, and [select value="without|with"] language impairment. [textarea rows="4"][/conditional][conditional field="adhd" condition="(adhd).is('')"]

[var name="name"] has a pattern of [checkbox name=addtype value="inattention and hyperactivity/impulsivity|inattention|hyperactivity/impulsivity"] that interferes with functioning. [/conditional][conditional field="addtype" condition="(addtype).is('inattention and hyperactivity/impulsivity')||(addtype).is('inattention')"] Inattention manifests as [checkbox memo="At least 6 for ADHD" value="poor attention to details or careless mistakes in work or activities|difficulty sustaining attention|not seeming to listen when spoken to directly|not following through on instructions or failing to finish tasks|having difficulty organizing tasks and activities|avoiding tasks that require sustained mental effort|frequently losing things necessary for tasks|often easily distracted by extraneous stimuli|forgetfulness in daily activities"].[/conditional] [conditional field="addtype" condition="(addtype).is('inattention and hyperactivity/impulsivity')||(addtype).is('hyperactivity/impulsivity')"] [var name="name"]'s hyperactivity/impulsivity presents as [checkbox memo="six or more for ADHD" value="frequent fidgeting or squirming|often leaving seat when remaining seated is expected|frequently restless|difficulty engaging in leisure activities quietly|often seeming to be on the go or difficult to keep up with|excessive talking|blurting out answers before a question has been completed|difficulty waiting for their turn|interrupting or intruding on others"].[/conditional][conditional field="adhd" condition="(adhd).is('')"] These symptoms have been present since [text memo="before 12yo" size="20"], and are recognized in multiple settings including [text memo="2 or more" size="20"]. [textarea rows="3"]

[/conditional][conditional field="sleep" condition="(sleep).is('')"]
Sleep is reported to be generally [select name="sleepq" value="poor |fair |good.|erratic |inconsistent |excessive|"][select value="with difficulty initiating sleep and staying asleep due to |with difficulty initiating sleep due to |with difficulty maintaining sleep due to |"][textarea rows="2"]. They estimate getting approximately [text size="4"] hours of [select value="broken |solid |"]sleep per night. [select value="Disturbed sleep has been an issue for |Disturbed sleep is a new issue within the last |"][textarea rows="1"]. [select value="There has been no workup for Sleep Apnea|There was a past workup for sleep apnea which indicated |"][textarea rows="1"]. [select value="Current attempts at improving sleep include |The patient is currently attempting no interventions to improve sleep|Current quality of sleep is dependent on |"][textarea rows="2"]. [select value="Past unsuccessful attempts at improving sleep include |There have been no past attempts at improving sleep|"][textarea rows="2"].[/conditional]
*Interval History*
Patient reports that the presenting symptoms of [comment memo="SYMPTOM"][checkbox value="depressed|anxious|aggressive|impulsive|inattentive|irritable|withdrawn|unable to sleep|delusional|auditory hallucinations|visual hallucinations"] [textarea memo="other" default="" rows="1"]
Which is described as[comment memo="SEVERITY "][checkbox value=" the same as it has been| better| somewhat worse than it has been| significantly worse than it has been"] [textarea memo="other" default="" rows="1"]
The patient notices that it is sometimes improved by [comment memo="Modifying factors "][checkbox value="talking to someone|being alone|doing something physical like walking|doing something that is distracting| being on medications"] [textarea memo="other" default="" rows="1"]
pt also reports symptoms aggravation due to [textarea name="variable_1" default="sample text"]
per pt the symptoms come on[checkbox name="variable_1" value="Suddenly|Gradually"]
where the pt reports that the symptoms interfere with daily life[checkbox name="variable_1" value="Do|Do not"] [textarea name="variable_1" default="what areas the s/sx interfer"]