37 (37)    MH REPORT (601.93)

Name Value
REPORT NUMBER 37
INSTRUMENT BASIS-24
RPT
.|.|Behavior and Symptom Identification Scale - 24||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB: 
along well in social situations?|    <*Answer_5362*>|7. Feel close to another person?|    <*Answer_5363*>|8. Feel like you had someone to turn to if you needed help?|    <*Answer_5364*>|9. Feel 
confident in yourself?|    <*Answer_5365*>|10. Feel sad or depressed?|    <*Answer_5366*>|11. Think about ending your life?|    <*Answer_5367*>|12. Feel nervous?|    <*Answer_5368*>|13. Have thoughts 
racing through your head?|    <*Answer_5369*>|14. Think you had special powers?|    <*Answer_5370*>|15. Hear voices or see things?|    <*Answer_5371*>|16. Think people were watching you?|    
<*Answer_5372*>|17. Think people were against you?|    <*Answer_5373*>|18. Have mood swings?|    <*Answer_5374*>|19. Feel short-tempered?|    <*Answer_5375*>|20. Think about hurting yourself?|    
<*Answer_5376*>|21. Did you have an urge to drink alcohol or take street drugs?|    <*Answer_5377*>|22. Did anyone talk to you about your drinking or drug use?|    <*Answer_5378*>|23. Did you try to 
hide your drinking or drug use?|    <*Answer_5379*>|24. Did you have problems from your drinking or drug use?|    <*Answer_5380*>|||Information contained in this note is based on a self-report 
assessment and is not sufficient to use alone for diagnostic purposes. Assessment results should be verified for accuracy and used in conjunction with other diagnostic activities and 
procedures.||Copyright (c) 2003 McLean Hospital|    $~
<.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>||     BASIS-24 Scales|          Depression and Functioning   <-Depression and Functioning->|          Interpersonal Problems       <-Interpersonal Problems->|         
 Psychotic Symptoms           <-Psychotic Symptoms->|          Alcohol
/Drug Use             <-Alcohol/Drug Use->|          Emotional Lability
           <-Emotional Lability->|          Self-Harm                    
<-Self-Harm->|          Overall                      <-Overall->
||     Note: Lower scores indicate less frequent symptoms or difficulty |           whereas higher scores reflect more serious symptoms or difficulty.
|           Range of scores: 0 to 4. ||Questions and Answers||1. Managing your day-to-day life?|    <*Answer_5357*>|2. Coping with problems in your
 life?|    <*Answer_5358*>|3. Concentrating?|    <*Answer_5359*>|4. Get along with people in your family?|    <*Answer_5360*>|5. Get along with people outside your family?|    <*Answer_5361*>|6. Get