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ENTREVISTA

DE

AVALIAO CLNICA

1. Razo do Pedido
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2.
A) Ansiedade Inicial
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B) Ansiedade de Rotina
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C) Ansiedade Elevada
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3. Razo do Pedido/Problema apresentado


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4. Histria do Problema
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5. Avaliao de Perigo Imediato


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6. Outros Problemas vida social, famlia e relaes conjugais, stress interior
e sade
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7. Condies de Vida
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8. Histria Pessoal e do Desenvolvimento


Nascimento _____________________________________________________________
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Desenvolvimento Escolar _________________________________________________
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Adolescncia ____________________________________________________________
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Histria Adulta __________________________________________________________
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9. Histria Psiquitrica
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10. Histria Psiquitrica Familiar


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11. Histria Mdica


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12. Sumrio de Concluses


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AVALIAO

DO

HUMOR

Qualidade Afectiva ____________________________________________________


Labilidade Afectiva ____________________________________________________
Mudanas bruscas do humor ____________________________________________
Variao do Humor ____________________________________________________
Adequao do Humor __________________________________________________

AVALIAO

DA

COMUNICAO VERBAL

Associaes _____________________________________________________________
Associaes frouxas ______________________________________________________
Pensamentos ou palavras idiossincrticas ___________________________________
Neologismos ____________________________________________________________
Ecolalia _________________________________________________________________
Bloqueio ________________________________________________________________
Aumento da latncia _____________________________________________________
Circunstancialidade ______________________________________________________
Pensamento Tangencial __________________________________________________
Fuga de Ideias __________________________________________________________
Discurso rpido ou apressado _____________________________________________
Discurso lento ou retardado ______________________________________________
Muito Falador(a) ________________________________________________________
Pouco falador)(a) _______________________________________________________

CONTEDO

DO

PENSAMENTO

Irradiao de Pensamento _______________________________________________


Delrio de Controlo ______________________________________________________
Pensamentos muito rpidos ______________________________________________
Pensamentos Confusos __________________________________________________
Ideias de Referncia ____________________________________________________
Pensamento Mgico _____________________________________________________
Delrios ________________________________________________________________
Fobias e Evitamento Fbico _______________________________________________
Obsesses ______________________________________________________________
Ideias Suicidas ou homicidas ______________________________________________