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Anamnese - História Do Uso de Drogas - Codependente
Anamnese - História Do Uso de Drogas - Codependente
Nome ________________________________________________________________________________________
Data do atendimento: __________________________________________________________________________
1
ROTINA DE VIDA E CONSUMO
Atividades diárias
- manhã ______________________________________________________________________________________
- tarde ________________________________________________________________________________________
- noite ________________________________________________________________________________________
Rotina de consumo
- 1º consumo do dia / quantidade __________________________________________________________________
- Substância / quantidade de consumo por dia ________________________________________________________
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- locais preferenciais de uso _____________________________________________________________________
- Preferência do uso: solitário ou acompanhado______________________________________________________
- motivações do uso _____________________________________________________________________________
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- estado mental após o consumo ___________________________________________________________________
GESTAÇÃO E PARTO
COMPLICAÇÕES CLÍNICAS
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2
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Internações clínicas
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COMORBIDADES PSIQUIÁTRICAS
3
Relação com consumo (comorbidades) _____________________________________________________________
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Anotações ____________________________________________________________________________________
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PERSONALIDADE
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- parentes _____________________________________________________________________________________
4
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- amigos ______________________________________________________________________________________
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- chefes, professores e/ou autoridades ______________________________________________________________
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- a si mesmo________________________________________________________________________________
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- aos outros ___________________________________________________________________________________
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Autocontrole ___________________________________________________________________________________
Impulsividade __________________________________________________________________________________
Irritabilidade ___________________________________________________________________________________
Conformismo __________________________________________________________________________________
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Ambição ______________________________________________________________________________________
Determinação __________________________________________________________________________________
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5
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HISTÓRIA OCUPACIONAL
Relação entre a mudança de emprego e o consumo de álcool e/ou outras drogas ____________________________
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Assiduidade ___________________________________________________________________________________
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6
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HISTÓRICO LEGAL
ANTECEDENTES FAMILIARES
Pais
Idade ________________________________________________________________________________________
Morte ________________________________________________________________________________________
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Qualidade do relacionamento na história do casal _____________________________________________________
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Irmãos
7
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AMBIENTE NA INFÂNCIA
Separações ___________________________________________________________________________________
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DOENÇAS FAMILIARES
8
Pais, irmãos, tios, avós, primos ____________________________________________________________________
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Elytanya Vasconcelos
Psicóloga CRP 15/4146