b. Who is this?
Mark box in appropriate person's column.
1[] A. Schizophrenia
1[] B. Paranoid disorder
1[] C. Manic episodes
1[] C. Manic depression
1[] D. Major depression
1[] E. Personality disorder
1[] F. Senility
1[] G. Alcohol abuse
1[] H. Drug abuse
1[] I. Mental retardation
2a. During the past 12 months, did anyone in the family have any other mental or emotional disorders? Include only those disorders which seriously interfere with a person's ability to work or attend school, or to manage their day-to-day activities.
[] Yes
[] No (Check Item 1)
b. Who is this? Anyone else?
Mark box in appropriate person's column.
1[] Other
Ask for each person with "Other" in 2b:
c. What would you call the disorder -- has?
Check Item 1
Refer to 1A-F and 2b/c.
1[] One or more entries in 1A-F or 2b/c (Check Item 2)
8[] All others (NP or Section P)
Check Item 2
Enter disorder(s) from 1A-F and 2c. Do not record G, H, or I. ________ (Check item 3)