|
subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
|
|
guid |
|
src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
|
|
sample_id_original |
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
dem_date, medhist_date, visit_survey_date |
|
interview_age |
Integer |
|
Required |
Age in months at the time of the interview/test/sampling/imaging. |
0::1440
|
Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
|
dem_age |
|
sex |
String |
20
|
Required |
Sex of subject at birth |
M;F; O; NR
|
M = Male; F = Female; O=Other; NR = Not reported
|
gender |
Query
|
strdatapt |
String |
10
|
Recommended |
Which datapoint is this test to be counted as? |
Pre;Post;Post-Post
|
|
|
Query
|
child_residence |
String |
55
|
Recommended |
Child lives with |
1. Both biological mother and father;2. Biological mother only;3. Biological father only;4. Biological mother and stepfather;5. Biological father and stepmother;6. Adoptive parents;7. Foster parents;8. Relatives;9. Other please specify; 10. Refused; Both natural parents; Natural father only; Natural father and stepmother; Natural mother only; Natural mother and stepfather; Adoptive or foster parents; Relatives - please specify; Institution - please specify
|
|
strFamilyBackground |
|
liveswithother |
String |
50
|
Recommended |
Child lives with other, specify |
|
|
strLivesWithOther |
Query
|
strrelchild1 |
String |
50
|
Recommended |
Relationship to the child of other person living in the home |
|
|
|
Query
|
strrelchild2 |
String |
50
|
Recommended |
Relationship to the child of other person living in the home |
|
|
|
|
strrelchild3 |
String |
50
|
Recommended |
Relationship to the child of other person living in the home |
|
|
|
|
strrelchild4 |
String |
50
|
Recommended |
Relationship to the child of other person living in the home |
|
|
|
|
strrelchild5 |
String |
50
|
Recommended |
Relationship to the child of other person living in the home |
|
|
|
|
strrelchild6 |
String |
50
|
Recommended |
Relationship to the child of other person living in the home |
|
|
|
Query
|
bio_mother_occupation |
String |
100
|
Recommended |
Biological Mother Occupation |
|
|
mother_job, strMomOccupation |
Query
|
mother_edu |
String |
55
|
Recommended |
Mother's Education |
No formal schooling completed; Nursery school to 4th grade; 5th or 6th grade; 7th or 8th grade; 9th grade; 10th grade;11th grade; 12th grade, no diploma; High School Graduate/GED or equivalent; Some college credit, but less than 1 year; Technical college/vocational school; Associate degree; Bachelors's degree; Master's degree; Professional degree; Doctorate degree;Refused; Some elementary; Elementary; Some Middle School; Middle School; Some High School; GED; High School; Trade School/Certification Program; Some College; Undergraduate Degree; Some Graduate School; Less than 7th grade; Junior High; Some High School; High School Graduate; Some College; Special Training After High School; College Graduate; Graduate/Professional Training; Some Grade School
|
|
strMomEducationLevel |
Query
|
bio_father_occupation |
String |
100
|
Recommended |
Biological Father Occupation |
|
|
father_job, strFatherOccupation |
Query
|
father_edu |
String |
55
|
Recommended |
Father's Education |
No formal schooling completed; Nursery school to 4th grade; 5th or 6th grade; 7th or 8th grade; 9th grade; 10th grade;11th grade; 12th grade, no diploma; High School Graduate/GED or equivalent; Some college credit, but less than 1 year; Technical college/vocational school; Associate degree; Bachelors's degree; Master's degree; Professional degree; Doctorate degree;Refused; Some elementary; Elementary; Some Middle School; Middle School; Some High School; GED; High School; Trade School/Certification Program; Some College; Undergraduate Degree; Some Graduate School;Less than 7th grade; Junior High; Some High School; High School Graduate; Some College; Special Training After High School; College Graduate; Graduate/Professional Training;Some Grade School
|
|
strFatherEducationLevel |
Query
|
ques_age1 |
Integer |
|
Recommended |
Age -Sibling 1(in months) |
0 :: 1200
|
|
strAgeChild1 |
Query
|
ques_gender1 |
String |
50
|
Recommended |
Gender -Sibling 1 |
|
M = Male; F = Female; 1= Male; 2= Female; 3= Transgender
|
strSexChild1 |
Query
|
ques_gradal1 |
String |
50
|
Recommended |
Last grade completed -Sibling 1 |
|
|
strGradeLvlChild1 |
Query
|
strdiagconcernschild1 |
String |
50
|
Recommended |
First sibling diagnoses or Concerns |
|
|
|
Query
|
ques_age2 |
Integer |
|
Recommended |
Age -Sibling 2(in months) |
0 :: 1200
|
|
strAgeChild2 |
Query
|
ques_gender2 |
String |
50
|
Recommended |
Gender -Sibling 2 |
|
M = Male; F = Female; 1= Male; 2= Female; 3= Transgender
|
strSexChild2 |
Query
|
ques_gradal2 |
String |
50
|
Recommended |
Last grade completed -Sibling 2 |
|
|
strGradeLvlChild2 |
Query
|
strdiagconcernschild2 |
String |
50
|
Recommended |
Second sibling diagnoses or Concerns |
|
|
|
Query
|
ques_age3 |
Integer |
|
Recommended |
Age -Sibling 3(in months) |
0 :: 1200
|
|
strAgeChild3 |
Query
|
ques_gender3 |
String |
50
|
Recommended |
Gender -Sibling 3 |
|
M = Male; F = Female; 1= Male; 2= Female; 3= Transgender
|
strSexChild3 |
|
ques_gradal3 |
String |
50
|
Recommended |
Last grade completed -Sibling 3 |
|
|
strGradeLvlChild3 |
|
strdiagconcernschild3 |
String |
50
|
Recommended |
Third sibling diagnoses or Concerns |
|
|
|
Query
|
ques_age4 |
Integer |
|
Recommended |
Age -Sibling 4(in months) |
0 :: 1200
|
|
strAgeChild4 |
Query
|
ques_gender4 |
String |
50
|
Recommended |
Gender -Sibling 4 |
|
M = Male; F = Female; 1= Male; 2= Female; 3= Transgender
|
strSexChild4 |
|
ques_gradal4 |
String |
50
|
Recommended |
Last grade completed -Sibling 4 |
|
|
strGradeLvlChild4 |
|
strdiagconcernschild4 |
String |
50
|
Recommended |
Fourth sibling diagnoses or Concerns |
|
|
|
Query
|
ques_age5 |
Integer |
|
Recommended |
Age -Sibling 5(in months) |
0 :: 1200
|
|
strAgeChild5 |
Query
|
ques_gender5 |
String |
50
|
Recommended |
Gender -Sibling 5 |
|
M = Male; F = Female; 1= Male; 2= Female; 3= Transgender
|
strSexChild5 |
|
ques_gradal5 |
String |
50
|
Recommended |
Last grade completed -Sibling 5 |
|
|
strGradeLvlChild5 |
|
strdiagconcernschild5 |
String |
50
|
Recommended |
Fifth sibling diagnoses or Concerns |
|
|
|
Query
|
ques_age6 |
Integer |
|
Recommended |
Age -Sibling 6(in months) |
0 :: 1200
|
|
strAgeChild6 |
Query
|
ques_gender6 |
String |
50
|
Recommended |
Gender -Sibling 6 |
|
M = Male; F = Female; 1= Male; 2= Female; 3= Transgender
|
strSexChild6 |
|
ques_gradal6 |
String |
50
|
Recommended |
Last grade completed -Sibling 6 |
|
|
strGradeLvlChild6 |
|
strdiagconcernschild6 |
String |
50
|
Recommended |
Sixth sibling diagnoses or Concerns |
|
|
|
Query
|
strconaut |
String |
5
|
Required |
Does the child have Autism, PDD, Asperger's? |
|
|
|
Query
|
strotherfamdiag |
String |
255
|
Recommended |
Any other Family members diagnosed on EITHER side? Please specify |
|
|
|
Query
|
treatment_name |
String |
200
|
Recommended |
treatment name |
|
|
strTxReceivedAut |
Query
|
child_seizure |
String |
50
|
Required |
Has she/he ever been to a doctor for any of these things…Epilepsy or Seizures /Epilepsia o convulsiones |
|
Now I'd like to ask you about your child's use of health services during the past year and throughout his/her whole life.
|
medhx_3, strConSeizures |
Query
|
strseizuresinfancy |
String |
5
|
Required |
Seizures, convulsions, epilepsy: Infancy only? |
Yes; No;999
|
|
|
Query
|
rev_headfebseiz |
String |
50
|
Recommended |
Febrile Seizures |
|
NK= Not known; NS = Not sure
|
strSeizuresFebrile |
Query
|
strseizurestreat |
String |
5
|
Recommended |
Seizures, convulsions, epilepsy: Treated and resolved? |
Yes; No
|
|
|
Query
|
strseizuresongoing |
String |
5
|
Required |
Seizures, convulsions, epilepsy: Ongoing issue? |
Yes; No;999
|
|
digs_epilepsy |
|
strtxreceivedseizures |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_cerpalsy |
String |
50
|
Required |
Does (did) the Child have Cerebral Palsy? |
|
NK= Not known; NS = Not sure
|
strConCPalsy |
|
strcpalsyadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedcpalsy |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_cancer |
String |
50
|
Recommended |
Does the Child have Cancer? |
|
|
digs_cancer, medhx_14, strConCancer |
|
child_cancer_cmt |
String |
255
|
Recommended |
Specify Child's Cancer type |
|
|
medhx_14_txt, strCancerAdditional |
|
strtxreceivedcancer |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconmuscularweak |
String |
5
|
Recommended |
Does the child have Muscular Weakness? |
|
|
|
|
strmuscularweakadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedmuscularweak |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconmotordelay |
String |
5
|
Recommended |
Does the child have motor delays or slow motor development? |
|
|
|
|
strmotordelayadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedmotordelay |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
chi_def |
Integer |
|
Recommended |
please indicate if your child has any deformity |
|
0 = No; 1 = Yes
|
strConDeformities |
|
strdeformitiesadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceiveddeformities |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
rev_eyeimpair |
String |
50
|
Recommended |
Visual impairments |
|
NK = Not known
|
strConSevVisImp |
Query
|
strsevvisimpadditional |
String |
10
|
Recommended |
Additional Information |
Born with;Acquired
|
|
|
|
strtxreceivedsevvisimp |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
hear_loss |
String |
10
|
Required |
Deafness or significant hearing loss |
|
NK = Not known
|
strConHearLoss |
Query
|
strhearlossadditional |
String |
10
|
Recommended |
Additional Information |
Born with;Acquired
|
|
|
|
strtxreceivedhearloss |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_speechdelay |
String |
50
|
Recommended |
Does (did) the Child have a Speech/Language Delay? |
|
NK= Not known; NS = Not sure
|
strConSpeechProb |
|
strspeechprobadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
Query
|
strtxreceivedspeechprob |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconsigcogdelay |
String |
5
|
Recommended |
Does the child have significant cognitive delays? |
|
|
|
|
strsigcogdelayadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedsigcogdelay |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconbraindamage |
String |
5
|
Recommended |
Does the child have brain damage? |
|
|
|
Query
|
strbraindamageadditional |
String |
10
|
Recommended |
Additional Information |
Born with;Acquired
|
|
|
|
strtxreceivedbraindamage |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
ques_devdelaya |
String |
50
|
Recommended |
Had or has a developmental delay -Child with Autism/Study Participant |
|
NA = Not answered
|
strConDevDelay |
|
strdevdelayadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
Query
|
strtxreceiveddevdelay |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_learndis |
String |
50
|
Required |
Does (did) the Child have a Learning Disability? |
|
NK= Not known; NS = Not sure
|
strConLearnDis |
|
strlearndisadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedlearndis |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
condition_emotion |
String |
5
|
Recommended |
Emotional Disturbance or Serious Behavioral Difficulities |
|
|
strConEmoBehaProb |
|
stremobehaprobadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
Query
|
strtxreceivedemobehaprob |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
attentiondisorder |
Integer |
|
Recommended |
Does (did) the subject have Attention Deficit Disorder +/- Hyperactivity? |
|
0 = No/False; 1 = Yes/True; 2 = Unknown
|
strConADD |
|
straddadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedadd |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_otherpsychdis |
String |
50
|
Recommended |
Does (did) the Child have a Psychiatric Disorder? |
|
|
strConPsycDis |
|
child_otherpsychdis_cmt |
String |
255
|
Recommended |
Specify Child's Psychiatric Disorder |
|
|
strPsycDisAdditional |
|
strtxreceivedpsycdis |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
touret |
String |
10
|
Required |
Tourette Syndrome |
|
NK= Not known; NS = Not sure
|
medhist_9c, strConTourette |
|
strtouretteadditional |
String |
50
|
Recommended |
Additional Information |
|
|
medhist_9c_desc |
|
strtxreceivedtourette |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconneurofib |
String |
5
|
Required |
Does the child have Neurofibromatosis? |
|
999=NA/missing
|
|
|
strneurofibadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedneurofib |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_tuberscl |
String |
50
|
Required |
Does (did) the Child have Tuberous Sclerosis? |
|
NK= Not known; NS = Not sure
|
medhx_4, strConTScler |
|
strtscleradditional |
String |
50
|
Recommended |
Additional Information |
|
|
medhx_4_txt |
|
strtxreceivedtscler |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
cfmh_chd_fragilex |
Integer |
|
Required |
Does (did) the Child have Fragile X? |
|
0 = No; 1 = Yes
|
strConFragX |
|
strfragxadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedfragx |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
rev_endodiabetes |
String |
50
|
Required |
Diabetes |
|
NK = Not known
|
digs_diabetes, medhist_12a, medhx_11, strConDiabetes |
Query
|
rev_endodiabetestype |
String |
50
|
Required |
Diabetes: Type |
I;II;NA
|
|
medhist_12a_desc, medhx_11_txt, strDiabetesAdditional |
|
strtxreceiveddiabetes |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconimmuneprob |
String |
5
|
Recommended |
Does the child have immune system problems? |
|
|
|
|
strimmuneprobadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedimmuneprob |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
child_thyroiddis |
String |
50
|
Required |
Does the Child have Thyroid Disease? |
|
999=NA/missing
|
digs_thyroid, strConThyroid |
|
strthyroidadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedthyroid |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconkidney |
String |
5
|
Recommended |
Does the child/patient have kidney disease? |
|
|
|
|
strkidneyadditional |
String |
50
|
Recommended |
Additional Information |
|
|
|
|
strtxreceivedkidney |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconheartdis |
String |
5
|
Required |
Does the child/patient have heart disease? |
|
Ref=refused; 999=NA/NK/missing
|
dem_heart_prob, medhx_12 |
|
strheartdisadditional |
String |
50
|
Recommended |
Additional Information - specify |
|
|
medhx_12_txt |
|
strtxreceivedheartdis |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconallergies |
String |
5
|
Recommended |
Does the subject have allergies? |
|
|
medhist_1b |
|
strallergiesadditional |
String |
50
|
Recommended |
Additional Information - specify |
|
|
medhist_1b_other |
|
strtxreceivedallergies |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
strconother |
String |
5
|
Recommended |
Other condition? |
|
|
medhx_20 |
|
strotheradditional |
String |
50
|
Recommended |
Additional Information - specify |
|
|
medhx_20_txt |
|
strtxreceivedother |
String |
255
|
Recommended |
What treatment was/is received? |
|
|
|
Query
|
info_gest |
String |
50
|
Recommended |
No. Weeks Gestation (G.A.) |
|
|
intGestAge |
Query
|
strnicu |
String |
3
|
Recommended |
Did the child spend any time in the NICU? |
Yes; No; NA
|
NA=Not Applicable
|
|
Query
|
strnicureasondur |
String |
255
|
Recommended |
If yes, please specify the reason for and the duration of the NICU stay. |
|
|
|
Query
|
hospitalizations |
String |
200
|
Recommended |
has the subject had any hospitalisations |
|
|
medhx_19, strHospital |
|
dtmstarthosp1 |
String |
100
|
Recommended |
Date 1st hospitalization began |
|
|
date_nphosp1, date_phosp1 |
|
dtmendhosp1 |
Date |
|
Recommended |
Date 1st hospitalization ended |
|
|
|
Query
|
strdurhosp1 |
String |
255
|
Recommended |
If dates not given, duration of 1st hospitalization |
|
|
|
Query
|
strreasonhosp1 |
String |
50
|
Recommended |
Reason for 1st hospitalization. |
|
|
medhx_19_txt |
Query
|
stroutcomehosp1 |
String |
50
|
Recommended |
Outcome of 1st hospitalization. |
|
|
|
|
dtmstarthosp2 |
String |
100
|
Recommended |
Date 2nd hospitalization began |
|
|
date_nphosp2, date_phosp2 |
|
dtmendhosp2 |
Date |
|
Recommended |
Date 2nd hospitalization ended |
|
|
|
|
strdurhosp2 |
String |
255
|
Recommended |
If dates not given, duration of 2nd hospitalization |
|
|
|
|
strreasonhosp2 |
String |
50
|
Recommended |
Reason for 2nd hospitalization. |
|
|
|
|
stroutcomehosp2 |
String |
50
|
Recommended |
Outcome of 2nd hospitalization. |
|
|
|
|
dtmstarthosp3 |
String |
100
|
Recommended |
Date 3rd hospitalization began |
|
|
date_nphosp3, date_phosp3 |
|
dtmendhosp3 |
Date |
|
Recommended |
Date 3rd hospitalization ended |
|
|
|
|
strdurhosp3 |
String |
255
|
Recommended |
If dates not given, duration of 3rd hospitalization |
|
|
|
|
strreasonhosp3 |
String |
50
|
Recommended |
Reason for 3rd hospitalization. |
|
|
|
|
stroutcomehosp3 |
String |
50
|
Recommended |
Outcome of 3rd hospitalization. |
|
|
|
|
dtmstarthosp4 |
String |
100
|
Recommended |
Date 4th hospitalization began |
|
|
date_nphosp4, date_phosp4 |
|
dtmendhosp4 |
Date |
|
Recommended |
Date 4th hospitalization ended |
|
|
|
|
strdurhosp4 |
String |
255
|
Recommended |
If dates not given, duration of 4th hospitalization |
|
|
|
|
strreasonhosp4 |
String |
50
|
Recommended |
Reason for 4th hospitalization. |
|
|
|
|
stroutcomehosp4 |
String |
50
|
Recommended |
Outcome of 4th hospitalization. |
|
|
|
|
strillness1 |
String |
100
|
Recommended |
Date of 1st illness |
|
|
dtmIllness1 |
|
strage1 |
String |
50
|
Recommended |
Child's age at 1st illness |
|
|
intAge1 |
Query
|
strtx1 |
String |
250
|
Recommended |
Treatment received |
|
|
mtxh_curtreatname1 |
|
stroutcome1 |
String |
50
|
Recommended |
Outcome |
|
|
|
|
strillness2 |
String |
100
|
Recommended |
Date of 2nd illness |
|
|
dtmIllness2 |
|
strage2 |
String |
50
|
Recommended |
Child's age at 2nd illness |
|
|
intAge2 |
|
strtx2 |
String |
50
|
Recommended |
Treatment received |
|
|
mtxh_curtreatname2 |
|
stroutcome2 |
String |
50
|
Recommended |
Outcome |
|
|
|
|
strillness3 |
String |
100
|
Recommended |
Date of 3rd illness |
|
|
dtmIllness3 |
|
strage3 |
String |
50
|
Recommended |
Child's age at 3rd illness |
|
|
intAge3 |
|
strtx3 |
String |
50
|
Recommended |
Treatment received |
|
|
mtxh_curtreatname3 |
|
stroutcome3 |
String |
50
|
Recommended |
Outcome |
|
|
|
|
strillness4 |
String |
100
|
Recommended |
Date of 4th illness |
|
|
dtmIllness4 |
|
strage4 |
String |
50
|
Recommended |
Child's age at 4th illness |
|
|
intAge4 |
|
strtx4 |
String |
50
|
Recommended |
Treatment received |
|
|
mtxh_curtreatname4 |
|
stroutcome4 |
String |
50
|
Recommended |
Outcome |
|
|
|
Query
|
medication1_name |
String |
500
|
Recommended |
Name first medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_curmedname1, nonpsych_medname1, psych_medname1, strMed1 |
|
strmedstart1 |
Date |
|
Recommended |
What was the start date? |
|
|
dtmMedStart1, mtxh_curmed_start_mo1 |
|
strmedend1 |
Date |
|
Recommended |
What was the end date? |
|
|
dtmMedEnd1 |
Query
|
strreason1 |
String |
500
|
Recommended |
Reason for prescription 1 |
|
|
nonpsych_purpose1, psych_purpose1 |
Query
|
strwork1 |
String |
50
|
Recommended |
Did it work? |
|
|
|
|
medication2_name |
String |
500
|
Recommended |
Name second medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_curmedname2, strMed2 |
|
strmedstart2 |
Date |
|
Recommended |
What was the start date? |
|
|
dtmMedStart2, mtxh_curmed_start_mo2 |
|
strmedend2 |
Date |
|
Recommended |
What was the end date? |
|
|
dtmMedEnd2 |
Query
|
strreason2 |
String |
350
|
Recommended |
Reason for prescription 2 |
|
|
|
Query
|
strwork2 |
String |
50
|
Recommended |
Did it work? |
|
|
|
Query
|
medication3_name |
String |
500
|
Recommended |
Name third medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_curmedname3, nonpsych_medname3, psych_medname3, strMed3 |
|
strmedstart3 |
Date |
|
Recommended |
What was the start date? |
|
|
dtmMedStart3, mtxh_curmed_start_mo3 |
|
strmedend3 |
Date |
|
Recommended |
What was the end date? |
|
|
dtmMedEnd3 |
Query
|
strreason3 |
String |
350
|
Recommended |
Reason for prescription 3 |
|
|
nonpsych_purpose3, psych_purpose3 |
|
strwork3 |
String |
50
|
Recommended |
Did it work? |
|
|
|
Query
|
medication4_name |
String |
500
|
Recommended |
Name fourth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_curmedname4, nonpsych_medname4, psych_medname4, strMed4 |
|
strmedstart4 |
Date |
|
Recommended |
What was the start date? |
|
|
dtmMedStart4, mtxh_curmed_start_mo4 |
|
strmedend4 |
Date |
|
Recommended |
What was the end date? |
|
|
dtmMedEnd4 |
Query
|
strreason4 |
String |
255
|
Recommended |
Reason for prescription 4 |
|
|
nonpsych_purpose4, psych_purpose4 |
|
strwork4 |
String |
50
|
Recommended |
Did it work? |
|
|
|
Query
|
medication5_name |
String |
500
|
Recommended |
Name fifth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_pastmedname1, nonpsych_medname5, psych_medname5, strMed5 |
|
strmedstart5 |
Date |
|
Recommended |
What was the start date? |
|
|
dtmMedStart5 |
|
strmedend5 |
Date |
|
Recommended |
What was the end date? |
|
|
dtmMedEnd5 |
Query
|
strreason5 |
String |
255
|
Recommended |
Reason for prescription 5 |
|
|
nonpsych_purpose5, psych_purpose5 |
|
strwork5 |
String |
50
|
Recommended |
Did it work? |
|
|
|
|
medication6_name |
String |
500
|
Recommended |
Name sixth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_pastmedname2, nonpsych_medname6, psych_medname6, strMed6 |
|
strmedstart6 |
Date |
|
Recommended |
What was the start date? |
|
|
|
|
strmedend6 |
Date |
|
Recommended |
What was the end date? |
|
|
|
|
strreason6 |
String |
500
|
Recommended |
Reason for prescription 6 |
|
|
nonpsych_purpose6, psych_purpose6 |
|
strwork6 |
String |
50
|
Recommended |
Did it work? |
|
|
|
|
medication7_name |
String |
500
|
Recommended |
Name seventh medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_pastmedname3, nonpsych_medname7, psych_medname7, strMed7 |
|
strmedstart7 |
Date |
|
Recommended |
What was the start date? |
|
|
|
|
strmedend7 |
Date |
|
Recommended |
What was the end date? |
|
|
|
|
strreason7 |
String |
500
|
Recommended |
Reason for prescription 7 |
|
|
nonpsych_purpose7, psych_purpose7 |
|
strwork7 |
String |
50
|
Recommended |
Did it work? |
|
|
|
|
medication8_name |
String |
500
|
Recommended |
Name eighth medication that the participant has taken |
|
0 = No medication; 999= Legitimately skipped
|
mtxh_pastmedname4, nonpsych_medname8, psych_medname8, strMed8 |
|
strmedstart8 |
Date |
|
Recommended |
What was the start date? |
|
|
|
|
strmedend8 |
Date |
|
Recommended |
What was the end date? |
|
|
|
|
strreason8 |
String |
500
|
Recommended |
Reason for prescription 8 |
|
|
nonpsych_purpose8, psych_purpose8 |
|
strwork8 |
String |
50
|
Recommended |
Did it work? |
|
|
|
Query
|
strviolence |
String |
3
|
Recommended |
Has the child ever been exposed to violence, abuse, or neglect? |
Yes; No
|
|
|
|
strviolencedesc |
String |
50
|
Recommended |
If yes, please describe. |
|
|
|
Query
|
strbeginconcern |
String |
50
|
Recommended |
When did you first begin to have concerns about the child? |
|
|
|
Query
|
fsymc |
String |
4,000
|
Recommended |
FIRST SYMPTOMS TO AROUSE PARENTAL CONCERN |
|
|
strThingsNoticed |
Query
|
diag_ageatdiag |
Integer |
|
Recommended |
Age at diagnosis(in months) |
|
|
strAgeDiag |
Query
|
asd_details |
String |
200
|
Recommended |
Details of ASD diagnosis |
|
|
strDiag |
Query
|
strdiagchanged |
String |
3
|
Recommended |
Has this diagnosis changed since it was orginally given? |
Yes; No
|
|
strDiagChanged |
|
current_diagnosis |
String |
255
|
Recommended |
Present Classification/Diagnosis |
|
|
strCurDiag |
Query
|
milestone_age_mo_smile |
Integer |
|
Recommended |
Age in which the participant accomplished the following milestone in months: smiled |
|
|
strAgeSmiled |
Query
|
milestone_age_mo_walkalone |
Integer |
|
Recommended |
Age in which the participant accomplished the following milestone in months: walked alone |
|
|
strAgeWalkedAlone |
Query
|
stragerodetri |
Integer |
|
Recommended |
Age at which the child accomplished riding a tricycle.(0=not yet accomplished) in months |
|
|
strAgeRodeTri |
Query
|
earlydev_bowel |
Integer |
|
Recommended |
Acquisition of bowel control (in months) |
0 :: 900;993;994;995;996;997;998;999
|
993 = Achieved bowel control for a period of 12 months but has relapsed and now regularly soils; 994 = Never achieved continence; 995 = Still not reached, i.e., continent for period of less than 12 months; 996 = N/K but apparently normal; 997 = N/K but apparently delayed; 998 = N/A; 999 = N/K or not asked
|
strAgeBowelDay |
Query
|
stragetiedshoe |
Integer |
|
Recommended |
Age at which the child accomplished tying shoelaces.(0=not yet accomplished) in months |
|
|
strAgeTiedShoe |
|
stragealpha |
String |
50
|
Recommended |
Age at which the child accomplished saying the alphabet in order.(0=not yet accomplished) |
|
|
strAgeAlpha |
Query
|
stragesatwosup |
Integer |
|
Recommended |
Age at which the child accomplished sitting without support. (0=not yet accomplished) in months |
|
|
strAgeSatWOSup |
Query
|
stragespoke1st |
Integer |
|
Recommended |
Age at which the child accomplished speaking 1st words. (0=not yet accomplished) in months |
|
|
strAgeSpoke1st |
Query
|
earlydev_drydz |
Integer |
|
Recommended |
Acquisition of bladder control: Daytime (in months) |
0 :: 600;993;994;995;996;997;998;999
|
993 = Successfully toilet trained for a period of 12 months but has relapsed and now regularly wets; 994 = Never achieved continence; 995 = Still not reached; 996 = N/K but apparently normal; 997 = N/K but apparently delayed; 998 = N/A; 999 = N/K or not asked
|
strAgeBladderDay |
Query
|
earlydev_drynz |
Integer |
|
Recommended |
Acquisition of bladder control: Night (in months) |
0 :: 600;993;994;995;996;997;998;999
|
993 = Successfully toilet trained for a period of 12 months but has relapsed and now regularly wets; 994 = Never achieved continence; 995 = Still not reached, i.e., continent for period of less than 12 months; 996 = N/K but apparently normal; 997 = N/K but apparently delayed; 998 = N/A; 999 = N/K or not asked
|
strAgeBladderNight |
Query
|
toilet_train_night |
Integer |
|
Recommended |
9. Acquisition of bladder control: nighttime |
0 :: 120;993;994;995;996;997;998;999
|
993 = Successfully toilet trained for a period of 12 months but has relapsed and now regularly wets; 994 = Never achieved continence; 995 = Still not reached; 996 = N/K but apparently normal; 997 = N/K but apparently delayed; 998 = N/A; 999 = N/K or not asked
|
strBowelNight |
Query
|
stragecolors |
Integer |
|
Recommended |
Age at which the child accomplished naming colors. (0=not yet accomplished) in months |
|
|
|
|
strageread |
String |
50
|
Recommended |
Age at which the child accomplished beginning to read. (0=not yet accomplished) in months |
|
|
|
Query
|
milestone_age_mo_crawl |
Integer |
|
Recommended |
Age in which the participant accomplished the following milestone in months: crawled |
|
|
strAgeCrawled |
Query
|
stragesentence |
Integer |
|
Recommended |
Age at which the child spoke a sentence. (0=not yet accomplished) in months |
|
|
|
Query
|
stragebutton |
Integer |
|
Recommended |
Age at which the child accomplished buttoning clothing. (0=not yet accomplished) in months |
|
|
|
Query
|
stragecircle |
Integer |
|
Recommended |
Age at which the child drew a circle. (0=not yet accomplished) in months |
|
|
|
Query
|
stragetrainwheel |
Integer |
|
Recommended |
Age at which the child rode a bicycle without training wheels. (0=not yet accomplished) in months |
|
|
|
Query
|
medhx_sleep_prob |
String |
50
|
Recommended |
Does subject have sleep problems? |
|
|
strSleepProb |
Query
|
strsleepagestart |
Integer |
|
Recommended |
Age when issues began. In months |
|
|
|
Query
|
strsleepageend |
Integer |
|
Recommended |
Age when issues ended. In months |
|
|
|
Query
|
medhx_sleep_prob_note |
String |
255
|
Recommended |
Note regarding sleep problems |
|
|
strSleepDesc |
Query
|
streatprob |
String |
5
|
Recommended |
Does your child have issues with eating? |
|
|
|
Query
|
streatagestart |
Integer |
|
Recommended |
Age when issues began. In months |
|
|
|
Query
|
streatageend |
Integer |
|
Recommended |
Age when issues ended.In months |
|
|
|
Query
|
streatdesc |
String |
255
|
Recommended |
Describe issues eating. |
|
|
|
Query
|
strtoiletprob |
String |
5
|
Recommended |
Does your child have issues with toilet training? |
|
|
|
Query
|
strtoiletagestart |
Integer |
|
Recommended |
Age when issues began. In months |
|
|
|
Query
|
strtoiletageend |
Integer |
|
Recommended |
Age when issues ended.In months |
|
|
|
Query
|
strtoiletdesc |
String |
255
|
Recommended |
Describe issues toilet training. |
|
|
|
Query
|
strspec1 |
String |
50
|
Recommended |
Provider Speciality |
|
|
|
Query
|
strspec2 |
String |
50
|
Recommended |
Provider Speciality |
|
|
|
Query
|
strspec3 |
String |
50
|
Recommended |
Provider Speciality |
|
|
|
Query
|
strspec4 |
String |
50
|
Recommended |
Provider Speciality |
|
|
|
Query
|
strspec5 |
String |
50
|
Recommended |
Provider Speciality |
|
|
|
|
strspec6 |
String |
50
|
Recommended |
Provider Speciality |
|
|
|
|
strschooltype1 |
String |
50
|
Recommended |
School Type |
|
|
|
Query
|
stryears1 |
String |
50
|
Recommended |
Years Attended |
|
|
|
Query
|
strgrades1 |
String |
50
|
Recommended |
Which Grades? |
|
|
|
Query
|
strservices1 |
String |
50
|
Recommended |
Services Provided |
|
|
|
|
strschooltype2 |
String |
50
|
Recommended |
School Type |
|
|
|
Query
|
stryears2 |
String |
50
|
Recommended |
Years Attended |
|
|
|
Query
|
strgrades2 |
String |
50
|
Recommended |
Which Grades? |
|
|
|
Query
|
strservices2 |
String |
50
|
Recommended |
Services Provided |
|
|
|
|
strschooltype3 |
String |
50
|
Recommended |
School Type |
|
|
|
Query
|
stryears3 |
String |
50
|
Recommended |
Years Attended |
|
|
|
Query
|
strgrades3 |
String |
50
|
Recommended |
Which Grades? |
|
|
|
Query
|
strservices3 |
String |
50
|
Recommended |
Services Provided |
|
|
|
|
strschooltype4 |
String |
50
|
Recommended |
School Type |
|
|
|
|
stryears4 |
String |
50
|
Recommended |
Years Attended |
|
|
|
|
strgrades4 |
String |
50
|
Recommended |
Which Grades? |
|
|
|
|
strservices4 |
String |
50
|
Recommended |
Services Provided |
|
|
|
|
strschooltype5 |
String |
50
|
Recommended |
School Type |
|
|
|
|
stryears5 |
String |
50
|
Recommended |
Years Attended |
|
|
|
|
strgrades5 |
String |
50
|
Recommended |
Which Grades? |
|
|
|
|
strservices5 |
String |
50
|
Recommended |
Services Provided |
|
|
|
|
strschooltype6 |
String |
50
|
Recommended |
School Type |
|
|
|
|
stryears6 |
String |
50
|
Recommended |
Years Attended |
|
|
|
|
strgrades6 |
String |
50
|
Recommended |
Which Grades? |
|
|
|
|
strservices6 |
String |
50
|
Recommended |
Services Provided |
|
|
|
|
comments_misc |
String |
4,000
|
Recommended |
Miscellaneous comments on study, interview, methodology relevant to this form data |
|
|
medhist_notes, strNotes |
Query
|
sample_taken |
String |
50
|
Recommended |
Was a sample taken at this interview/during this project time |
Yes;No
|
|
|
Query
|
sample_description |
String |
3,500
|
Recommended |
Sample description: tissue type, i.e. blood, saliva, brain etc. |
whole blood; saliva; brain; urine; serum; plasma; CSF; IPS; Fibroblast; Neuronal Progenitor; skin biopsy; temporal cortex; lymphoblastoid cell line; unknown; semen; frontal cortex; parietal cortex; basal ganglia; Placenta; hair; occipital visual cortex; cerebellum; spleen; stool; muscle; kidney; liver; heart; cord blood; nasal swab; DNA; RNA; breastmilk; buccal; oral cells; rectal swab; cervicovaginal swab
|
|
|
|
biorepository_name |
String |
100
|
Recommended |
Biorepository where sample is stored |
|
|
|
|
patient_id_biorepository |
String |
100
|
Recommended |
Biorepository Patient ID |
|
|
|
Query
|
race |
String |
30
|
Recommended |
Race of study subject |
|
|
|
Query
|
ethnicity |
String |
30
|
Recommended |
Ethnicity of participant |
|
|
dem_ethnicity |
Query
|
efamno |
String |
25
|
Recommended |
Study family ID as assigned by Genetic Contributions of Negative Valence Systems to Internalizing Pathways study staff |
|
|
|
|
clcontactid |
String |
20
|
Recommended |
Study family ID as assigned by Mid Atlantic Twin Registry staff |
|
|
|
Query
|
pair_number |
Integer |
|
Recommended |
Twin pair birth order |
|
|
|
Query
|
relation |
Integer |
|
Recommended |
Twin individual birth order |
|
|
|
|
version_form |
String |
121
|
Recommended |
Form used/assessment name |
|
|
|
Query
|
phenotype |
String |
200
|
Required |
Phenotype/diagnosis for the subject |
|
|
group |
Query
|
phenotype_description |
String |
4,000
|
Required |
Description of the phenotype for the subject |
|
|
subgroup |
|
ethnic_group |
String |
255
|
Recommended |
Ethnic group |
|
|
ethnicityspec |
Query
|
educat |
Float |
|
Recommended |
Number of years in formal education |
|
999=Unknown/Missing
|
education |
|
grade_highed |
String |
50
|
Recommended |
Grade/Highest education |
|
1= Less than 6th grade; 2= Some high school; 3= High school diploma or GED; 4= Some college, no degree; 5= Associates degree; 6= Bachelors degree; 7= Some graduate school; 8= Masters degree and above; 9= Some post-graduate training, no degree; 10= Completed 8th grade, no high school; 11= High school; 12= College or University; 13= Graduate school; 14= Other; 15= Less than high school; 99= Information not available
|
ged |
Query
|
demo_resp_status |
Integer |
|
Recommended |
respondent's marital status |
1::13
|
1 = Married; 2 = Remarried; 3 = Live with partner (not married); 4 = Separated; 5 = Divorced; 6 = Single (never married); 7 = Widowed; 8=Married or Living Together;9 = Missing/Not Applicable; 10 = Other; 11=Refused to answer; 12= Engaged; 13=Civil union
|
marital_status |
Query
|
d1b |
Integer |
|
Recommended |
Number of times legally married including common law |
|
|
times_married |
|
haschildren |
String |
3
|
Recommended |
If participant has children |
|
N/No = No children, Y/Yes = Yes
|
children |
Query
|
numchild |
Integer |
|
Recommended |
number of children |
|
|
childrennum |
|
demo_income_other |
String |
100
|
Recommended |
Income source: specify |
|
|
occupation |
|
desc_worklength |
String |
100
|
Recommended |
Work duration |
|
|
yrs_employed |
|
fammember_sz |
String |
3
|
Recommended |
If any family members are diagnosed with schizophrenia |
|
N/No = No family members with SZ, Y/Yes = Yes family member(s) with SZ
|
|
|
fammember_sz_spec |
String |
250
|
Recommended |
Free response of which family members had schizophrenia |
|
|
|
|
hastwin |
String |
3
|
Recommended |
If participant has a twin |
|
N/No = Not a twin, Y/Yes = Yes a twin
|
twin |
|
handedness |
String |
29
|
Recommended |
handedness |
|
R = Right; L = Left; B = Both; 999= No Answer; 888= Skipped; 777= Condition Skipped; 555= Missing
|
|
|
dtmstarthosp5 |
Date |
|
Recommended |
Date 5th hospitalization began |
|
|
date_nphosp5, date_phosp5 |
|
date_phosp6 |
Date |
|
Recommended |
Date of 6th Visit to Hospital for Psychiatric reasons |
|
MM/DD/YYYY
|
date_nphosp6 |
|
date_phosp7 |
Date |
|
Recommended |
Date of 7th Visit to Hospital for Psychiatric reasons |
|
MM/DD/YYYY
|
date_nphosp7 |
|
date_phosp8 |
Date |
|
Recommended |
Date of 8th Visit to Hospital for Psychiatric reasons |
|
MM/DD/YYYY
|
date_nphosp8 |
|
nonpsyc_hosp |
String |
3
|
Recommended |
If participant has stayed in a hospital overnight for physical complaints |
|
N/No = No, Y/Yes = Yes
|
psych_hospital |
Query
|
therapist |
Integer |
|
Recommended |
Have you seen a therapist in the past month? |
0;1
|
0= No; 1= Yes
|
|
|
therapistdatesreason |
String |
250
|
Recommended |
Reason for seeking a mental health professional |
|
|
|
Query
|
smoker |
Integer |
|
Recommended |
Smoker? |
0 :: 4; 9
|
0=No; 1=Yes; 2= Yes, but not regularly (less than 10 per day); 3= Yes, regularly (10 or more a day); 4= Former smoker; 9=NK/missing
|
|
Query
|
cig_smoking |
Integer |
|
Recommended |
Have you ever smoked part or all of a cigarette? PX030601_Cigarette_Smoking |
1;2;97
|
1=Yes; 2=No; 97=Don't Know/Refused
|
cigarettes |
|
cigars |
String |
3
|
Recommended |
Tobacco product(s) used |
|
Y/Yes = smokes cigars, Off = does not smoke cigars
|
|
Query
|
first_nicotine_3 |
Integer |
|
Recommended |
Have you ever used smokeless tobacco like chew, dip, or snus? |
1 ; 2 ; 0
|
1 = Yes; 2 = No; 0 = No
|
chewtobacco |
Query
|
smkamt |
Integer |
|
Recommended |
About how many cigarettes smoke per day |
|
|
num_cigarettes |
|
scid_diagnosis |
String |
250
|
Recommended |
Diagnoses according to SCID-V |
|
Schizophrenia; Schizophreniform Disorder; Schizoaffective Disorder- Bipolar; Schizoaffective Disorder- Depressive; Delusional Disorder; Brief Psychotic Disorder; Attenuated Psychosis Syndrome; Bipolar I Disorder; Bipolar II Disorder; Cyclothymic Disorder; Paranoid Personality Disorder; Schizotypal Personality Disorder; Schizoid Personality Disorder
|
|
|
diagnosis_severity |
String |
8
|
Recommended |
If meets criteria during the past month, indicate current severity |
|
Mild; Moderate; Severe
|
severity |
|
symptoms |
String |
20
|
Recommended |
If no current symptoms |
|
In full remission; Prior history
|
|
Query
|
age_1st_sx |
Integer |
|
Recommended |
Age of onset of psychiatric symptoms (years) |
|
|
onsetage |
Query
|
scidmodc13f |
Integer |
|
Recommended |
C13f. Number of episodes or exacerbations |
|
|
episodes |
|
course_specifier |
String |
50
|
Recommended |
Illness course |
|
First episode, currently in acute episode; First episode, currently in partial remission; First episode, currently in full remission; Multiple episodes, currently in acute episode; Multiple episodes, currently in partial remission; Multiple episodes, currently in full remission; Continuous; Unspecified; With catatonia
|
|
|
mood_specifier |
String |
20
|
Recommended |
Current mood state |
|
Depressive; Euthymic; Hypomanic; Manic; Mixed
|
|
Query
|
scidv_d4 |
Integer |
|
Recommended |
Bipolar Disorder; type of current (or most recent) episode |
1::4 ; -7; -9
|
1 = manic; 2 = hypomanic; 3 = major depressive; 4 = unspecified; -7 = N/A; -9 = missing or not reported
|
bipolar_episode |
|
bipolar_specifier |
String |
25
|
Recommended |
Bipolar specifier, if diagnosed bipolar |
|
N/A; Anxious Distress; Atypical Features; Melancholic Features; Mixed Features; Mood Congruent Psychotic Features; Mood Incongruent Psychotic Features; Peripartum Onset; Rapid Cycling; Seasonal Pattern
|
|
|
bips_course |
String |
25
|
Recommended |
If diagnosed as Brief Intermittent Psychotic Syndrome using SIPS interview |
|
N/A; Current progression; Current persistence; Current partial remission; Current full remission
|
|
|
apss_course |
String |
25
|
Recommended |
If diagnosed as Attenuated Positive Symptom Syndrome using SIPS interview |
|
N/A; Current progression; Current persistence; Current partial remission; Current full remission
|
|
|
grd_course |
String |
25
|
Recommended |
If diagnosed as Genetic Risk and Deterioration syndrome using SIPS interview |
|
N/A; Current progression; Current persistence; Current partial remission; Current full remission
|
|
|
relation1diag |
String |
255
|
Recommended |
Likely Diagnosis 1 |
|
|
scid_diagnosis_1 |
|
relation2diag |
String |
255
|
Recommended |
Likely Diagnosis 2 |
|
|
scid_diagnosis_2 |
|
relation3diag |
String |
255
|
Recommended |
Likely Diagnosis 3 |
|
|
scid_diagnosis_3 |
|
relation4diag |
String |
255
|
Recommended |
Likely Diagnosis 4 |
|
|
scid_diagnosis_4 |
|
relation5diag |
String |
255
|
Recommended |
Likely Diagnosis 5 |
|
|
scid_diagnosis_5 |
|
ch_41_04_oth |
String |
250
|
Recommended |
Please describe the type of diagnosis they received: |
|
; -7= Skipped or not answered due to skip logic; -7= Skipped or not answered due to skip logic; -8= I don't know the answer to the question; -9= I don't want to answer the question
|
scid_diagnosis_6 |
|
cepisp |
String |
500
|
Recommended |
Current diagnosis specify |
|
|
scid_diagnosis_7 |
Query
|
nonpsych_nomed |
Integer |
|
Recommended |
If participant has no medications prescribed |
1
|
1 = No medications
|
psych_nomed |
Query
|
cmd001 |
Integer |
|
Recommended |
Medication number |
|
-9=Unknown
|
nonpsych_medn1, psych_medn1 |
|
route1 |
String |
50
|
Recommended |
route 1 |
|
|
nonpsych_route1, psych_route1 |
|
medication1_dosage |
String |
150
|
Recommended |
First medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_curmeddose1, nonpsych_dosage1, psych_dosage1 |
|
medication1_unit |
String |
100
|
Recommended |
Units of medication #1: |
|
|
nonpsych_units1, psych_units1 |
Query
|
freq1 |
Integer |
|
Recommended |
frequency medication 1 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq1, psych_freq1 |
Query
|
nonpsych_medn2 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn2 |
|
route2 |
String |
50
|
Recommended |
route 2 |
|
|
nonpsych_route2, psych_route2 |
|
medication2_dosage |
String |
100
|
Recommended |
Second medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_curmeddose2, nonpsych_dosage2, psych_dosage2 |
|
medication2_unit |
String |
100
|
Recommended |
Units of medication #2: |
|
|
nonpsych_units2, psych_units2 |
Query
|
freq2 |
Integer |
|
Recommended |
frequency medication 2 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq2, psych_freq2 |
Query
|
nonpsych_medn3 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn3 |
|
route3 |
String |
50
|
Recommended |
route 3 |
|
|
nonpsych_route3, psych_route3 |
|
medication3_dosage |
String |
100
|
Recommended |
Third medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_curmeddose3, nonpsych_dosage3, psych_dosage3 |
|
medication3_unit |
String |
100
|
Recommended |
Units of medication #3: |
|
|
nonpsych_units3, psych_units3 |
Query
|
freq3 |
Integer |
|
Recommended |
frequency medication 3 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq3, psych_freq3 |
Query
|
nonpsych_medn4 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn4 |
|
route4 |
String |
50
|
Recommended |
route 4 |
|
|
nonpsych_route4, psych_route4 |
|
medication4_dosage |
String |
100
|
Recommended |
Fourth medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_curmeddose4, nonpsych_dosage4, psych_dosage4 |
|
medication4_unit |
String |
100
|
Recommended |
Units of medication #4: |
|
|
nonpsych_units4, psych_units4 |
Query
|
freq4 |
Integer |
|
Recommended |
frequency medication 4 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq4, psych_freq4 |
Query
|
nonpsych_medn5 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn5 |
|
route5 |
String |
50
|
Recommended |
route 5 |
|
|
nonpsych_route5, psych_route5 |
|
medication5_dosage |
String |
100
|
Recommended |
Fifth medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_pastmeddose1, nonpsych_dosage5, psych_dosage5 |
|
medication5_unit |
String |
100
|
Recommended |
Units of medication #5: |
|
|
nonpsych_units5, psych_units5 |
Query
|
freq5 |
Integer |
|
Recommended |
frequency medication 5 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq5, psych_freq5 |
Query
|
nonpsych_medn6 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn6 |
|
route6 |
String |
50
|
Recommended |
route 6 |
|
|
nonpsych_route6, psych_route6 |
|
medication6_dosage |
String |
100
|
Recommended |
Sixth medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_pastmeddose2, nonpsych_dosage6, psych_dosage6 |
|
medication6_unit |
String |
100
|
Recommended |
Units of medication #6: |
|
|
nonpsych_units6, psych_units6 |
Query
|
freq6 |
Integer |
|
Recommended |
frequency medication 6 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq6, psych_freq6 |
Query
|
nonpsych_medn7 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn7 |
|
route7 |
String |
50
|
Recommended |
route 7 |
|
|
nonpsych_route7, psych_route7 |
|
medication7_dosage |
String |
100
|
Recommended |
Seventh medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_pastmeddose3, nonpsych_dosage7, psych_dosage7 |
|
rx7dosu |
String |
100
|
Recommended |
Prescription 7, dosage units |
|
|
nonpsych_units7, psych_units7 |
Query
|
freq7 |
Integer |
|
Recommended |
frequency medication 7 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq7, psych_freq7 |
Query
|
nonpsych_medn8 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn8 |
|
route8 |
String |
50
|
Recommended |
route 8 |
|
|
nonpsych_route8, psych_route8 |
|
medication8_dosage |
String |
100
|
Recommended |
Eighth medication dosage |
|
0 = No medication; 999 = Missing
|
mtxh_pastmeddose4, nonpsych_dosage8, psych_dosage8 |
|
rx8dosu |
String |
100
|
Recommended |
Prescription 8, dosage units |
|
|
nonpsych_units8, psych_units8 |
Query
|
freq8 |
Integer |
|
Recommended |
frequency medication 8 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq8, psych_freq8 |
Query
|
nonpsych_medn9 |
Integer |
|
Recommended |
Medication number |
|
|
psych_medn9 |
|
medication9_name |
String |
500
|
Recommended |
Name ninth medication that the participant has taken |
|
|
nonpsych_medname9, psych_medname9 |
|
strreason9 |
String |
255
|
Recommended |
Reason for prescription 9 |
|
|
nonpsych_purpose9, psych_purpose9 |
|
route9 |
String |
50
|
Recommended |
route 9 |
|
|
nonpsych_route9, psych_route9 |
|
medication9_dosage |
String |
100
|
Recommended |
Ninth medication dosage |
|
|
nonpsych_dosage9, psych_dosage9 |
|
medication9_unit |
String |
100
|
Recommended |
Units of medication #9 |
|
|
nonpsych_units9, psych_units9 |
Query
|
freq9 |
Integer |
|
Recommended |
frequency medication 9 |
10;71::73;91::93
|
10 = Taken Daily; 71 = Q2wk, every 2 weeks; 72 = Q3wk, every 3 weeks; 73 = Q4wk, every 4 weeks; 91 = QOD, every other day; 92 = PRN, as needed; 93 = Other
|
nonpsych_freq9, psych_freq9 |
Query
|
tbi1 |
Integer |
|
Recommended |
Have you ever had a head injury or concussion? |
0; 1; -5; -7; -8; -9
|
0=No; 1=Yes; -9=Not applicable or missing; -8=DON'T KNOW; -7=REFUSED; -5=Presented, not answered
|
digs_head_injury, medhist_10, medhx_1a |
|
medhistory_1a_txt |
String |
250
|
Recommended |
Description of head injury or concussion |
|
|
digs_head_injury_details, medhist_10_desc, medhx_1a_txt |
Query
|
tbi4 |
Integer |
|
Recommended |
Did you receive any kind of medical attention/treatment for a head injury? |
0;1
|
1=Yes; 0=No
|
medhx_1b |
|
medhistory_1b_txt |
String |
250
|
Recommended |
Description of treatment for head injury |
|
|
medhx_1b_txt |
Query
|
tbi2 |
Integer |
|
Recommended |
Did you ever get knocked out or lose consciousness as a result of a head injury? |
0; 1; -5; -7; -8
|
0=No; 1=Yes; -8=DON'T KNOW; -7=REFUSED; -5=Presented, not answered
|
dem_lost_consciousness, medhx_1c |
|
medhistory_1c_txt |
String |
250
|
Recommended |
Description of consciousness loss as a result of head injury |
|
|
medhx_1c_txt |
Query
|
medhistory_1d |
Integer |
|
Recommended |
If so, for how long (knocked out or lose consciousness as a result of a head injury)? |
|
|
medhx_1d |
Query
|
medhistory_1e |
Integer |
|
Recommended |
Did you experience any headaches or other side effects? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_1e |
|
medhistory_1e_txt |
String |
250
|
Recommended |
Description of headache or other side effects |
|
|
medhx_1e_txt |
Query
|
medhistory_1f |
Integer |
|
Recommended |
If so, for how long (experience any headaches or other side effects)? |
|
|
medhx_1f |
Query
|
medhistory_1g |
Integer |
|
Recommended |
How much work or school did you miss? |
|
|
medhx_1g |
Query
|
seizures |
Integer |
|
Recommended |
Does (did) the subject have Seizures? |
0;1;2;999
|
0 = No; 1 = Yes; 2 = Unknown; 999 =NA/missing
|
dem_seizure, medhx_2 |
|
medhistory_2_txt |
String |
250
|
Recommended |
Description of fits or seizures |
|
|
medhist_9a, medhx_2_txt |
|
medhistory_3_txt |
String |
250
|
Recommended |
Description of seizure disorder/ epilepsy |
|
|
digs_epilepsy_details, medhist_9a_desc, medhx_3_txt |
Query
|
mh_park |
Integer |
|
Recommended |
Parkinson's disease |
0; 1
|
0=No; 1=Yes
|
medhx_5 |
|
medhistory_5_txt |
String |
250
|
Recommended |
Description of Parkinson's disease |
|
|
medhx_5_txt |
Query
|
exalz |
Integer |
|
Recommended |
Current diagnosis of dementia Alzheimer |
0;1
|
0=No;1=Yes
|
digs_alzheimer, medhist_9b, medhx_6 |
|
medhistory_6_txt |
String |
250
|
Recommended |
Description of Alzheimer's disease |
|
|
digs_alzheimer_details, medhist_9b_desc, medhx_6_txt |
Query
|
baseline_k_006 |
Integer |
|
Recommended |
Stroke |
0;1; -888; -999
|
0=No; 1=Yes; -888=Not Applicable; -999=Missing;
|
dem_stroke, medhx_7 |
|
medhistory_7_txt |
String |
250
|
Recommended |
Description of stroke |
|
|
digs_stroke_details, medhx_7_txt |
Query
|
medhistory_8 |
Integer |
|
Recommended |
Brain tumor |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_8 |
|
medhistory_8_txt |
String |
250
|
Recommended |
Description of brain tumor |
|
|
medhx_8_txt |
Query
|
aaq_5e |
Integer |
|
Recommended |
Dizziness |
0;1
|
0=No; 1=Yes
|
medhx_9 |
|
medhistory_9_txt |
String |
250
|
Recommended |
Description of dizziness |
|
|
medhx_9_txt |
Query
|
medhistory_10 |
Integer |
|
Recommended |
High blood sugar |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_10 |
|
medhistory_10_txt |
String |
250
|
Recommended |
Description of high blood sugar |
|
|
medhx_10_txt |
|
quesmoth_probhighbp |
String |
50
|
Recommended |
Hypertension (High blood pressure) |
Yes;No;Don't Know
|
|
dem_hbp, medhist_3b, medhistory_13, medhx_13 |
|
sshbpr00_spec |
String |
20
|
Recommended |
High blood pressure comments |
|
|
digs_hbp_details, medhist_3b_desc, medhistory_13_txt, medhx_13_txt |
|
rev_headmeningitis |
String |
50
|
Recommended |
Meningitis |
|
NK= Not known; NS = Not sure
|
medhx_15 |
|
medhistory_15_txt |
String |
250
|
Recommended |
Description of meningitis |
|
|
medhx_15_txt |
|
rev_headencephalitis |
String |
50
|
Recommended |
Encephalitis |
|
NK= Not known; NS = Not sure
|
medhx_16 |
|
medhistory_16_txt |
String |
250
|
Recommended |
Description of encephalitis |
|
|
medhx_16_txt |
Query
|
midihist_026 |
Integer |
|
Recommended |
Infectious Disease |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_16, medhx_17 |
|
medhistory_17_txt |
String |
250
|
Recommended |
Description of infectious disease |
|
|
medhx_17_txt |
Query
|
medhistory_18 |
Integer |
|
Recommended |
Been diagnosed with sleep apnea? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_18 |
|
medhistory_18_txt |
String |
250
|
Recommended |
Description of sleep apnea |
|
|
medhx_18_txt |
Query
|
medhistory_20a |
Integer |
|
Recommended |
Have you ever participated in a Transcranial Magnetic Stimulation (TMS) study? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_20a |
|
medhistory_20a_txt |
String |
250
|
Recommended |
Description of Transcranial Magnetic Stimulation study |
|
|
medhx_20a_txt |
Query
|
medhistory_20b |
Integer |
|
Recommended |
If yes, how long ago (been in a TranscranialMagnetic Stimulation (TMS) study)? |
|
|
medhx_20b |
Query
|
medhistory_21a |
Integer |
|
Recommended |
(Control participants only) Do you currently have a condition or have ever had a condition that required treatment with antidepressant, anti-anxiety, or antipsychotic medications? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_21a |
|
medhistory_21a_txt |
String |
250
|
Recommended |
Description of condition that required antidepressant, anti-anxiety, or antipsychotic medications |
|
|
medhx_21a_txt |
|
medication_name |
String |
255
|
Recommended |
Name of medication |
|
|
medhistory_21b, medhx_21b |
|
medhistory_21b_txt |
String |
250
|
Recommended |
Description of antidepressant, anti-anxiety, or antipsychotic medications |
|
|
medhx_21b_txt |
Query
|
medhistory_21c |
Integer |
|
Recommended |
Are you currently taking the medication? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_21c |
|
medhistory_21d |
String |
250
|
Recommended |
When did you most recently take the medication? |
|
|
medhx_21d |
Query
|
scidv_pdepre |
Integer |
|
Recommended |
Has there ever been another time when you were feeling depressed or down most of the day nearly every day? |
0;1
|
1 = Yes; 0 = No
|
medhx_21e |
|
medhistory_21e_txt |
String |
250
|
Recommended |
Description of time when you were feeling depressed or down most of the day nearly every day |
|
|
medhx_21e_txt |
Query
|
medhistory_21f |
Integer |
|
Recommended |
If Yes, did it last as long as 2 wks (feeling depressed or down most of the day nearly every day)? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_21f |
Query
|
medhistory_21g |
Integer |
|
Recommended |
What about losing interest or pleasure in things you usually enjoyed? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_21g |
|
medhistory_21g_txt |
String |
250
|
Recommended |
Description of lost interest or pleasure in things you usually enjoyed |
|
|
medhx_21g_txt |
Query
|
medhistory_21h |
Integer |
|
Recommended |
If Yes, did it last as long as 2 wks (losing interest or pleasure in things you usually enjoyed)? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_21h |
Query
|
medhistory_22 |
Integer |
|
Recommended |
When you were in school, were you in special education classes? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_22 |
Query
|
medhistory_23 |
Integer |
|
Recommended |
Do you have a learning disability or dyslexia? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
dem_learning_disability, medhx_23 |
|
medhistory_23_txt |
String |
250
|
Recommended |
Description of learning disability or dyslexia |
|
|
medhx_23_txt |
Query
|
cast39_adhd |
Integer |
|
Recommended |
Has s/he ever been diagnosed with hyperactivity/attention deficit disorder (ADHD)? |
0; 1;999
|
0 = No; 1 = Yes
|
medhx_24 |
|
medhistory_24_txt |
String |
250
|
Recommended |
Description of hyperactivity/ attention deficit disorder |
|
|
medhx_24_txt |
Query
|
clrblind |
Integer |
|
Recommended |
Is the participant colorblind |
0;1
|
0=No; 1=Yes
|
dem_colorblind, medhistory_25, medhx_25 |
|
medhistory_25_txt |
String |
250
|
Recommended |
Description of colorblindness |
|
|
medhx_25_txt |
Query
|
medhistory_26a |
Integer |
|
Recommended |
Do you need glasses or contacts to see the computer screen? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_26a |
|
medhistory_26a_txt |
String |
250
|
Recommended |
Description visual impairment |
|
|
medhx_26a_txt |
Query
|
medhistory_26b |
Integer |
|
Recommended |
Do you have glasses or contacts with you |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_26b |
|
medhistory_26b_txt |
String |
250
|
Recommended |
Description of glasses or contacts |
|
|
medhx_26b_txt |
Query
|
eyel |
Float |
|
Recommended |
Visual acuity left eye 20/_ |
|
|
medhx_26c |
Query
|
eyer |
Float |
|
Recommended |
Visual acuity right eye 20/_ |
|
|
medhx_26d |
Query
|
mri_metfr |
Integer |
|
Recommended |
Presence of: Any metallic fragment or foreign body |
0;1
|
0=No; 1=Yes
|
medhx_27 |
|
medhistory_27_txt |
String |
250
|
Recommended |
Description of metallic object in body |
|
|
medhx_27_txt |
Query
|
q21_8a |
Integer |
|
Recommended |
Drink alcohol |
0; 1; -7; -8; -9; 999
|
Field should not be left blank. If missing, please use -7, 8, -9.
|
medhx_28a |
Query
|
combod1 |
Integer |
|
Recommended |
During the past 30 days; how many days per week or per month did you have at least one drink of any alcoholic beverage? |
1::30
|
|
medhx_28b |
Query
|
yrbs16_total |
Integer |
|
Recommended |
How many total times have you had a drink of alcohol? |
|
|
medhx_28c |
|
medhistory_28d |
String |
20
|
Recommended |
What type of alcohol did you drink? |
|
|
medhx_28d |
Query
|
medhistory_28e |
Integer |
|
Recommended |
Is this typical of your usual pattern of alcohol use in the past 6 months? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_28e |
Query
|
medhistory_29a |
Integer |
|
Recommended |
Sometimes people take medicines like amphetamines, barbiturates, psychedelics, methadone, heroin, codeine, cocaine, marijuana, or other drugs just to see how they work or enjoy the feeling. Have you used any of these in the past 6 months? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_29a |
|
medhistory_29b |
String |
250
|
Recommended |
If yes, which have you tried (drugs)? |
|
|
medhx_29b |
|
medhistory_29c |
String |
20
|
Recommended |
When was the last time you used one of these drugs? |
|
|
medhx_29c |
Query
|
medhistory_29d |
Integer |
|
Recommended |
How many times per month do you use one of these drugs? |
|
|
medhx_29d |
Query
|
medhistory_29e |
Integer |
|
Recommended |
Is this typical of your usual pattern of drug use in the past 6 months? |
0;1;9
|
0 = No; 1 = Yes; 9 = Not evaluated
|
medhx_29e |
Query
|
q19_a1d |
Integer |
|
Recommended |
Height: Centimeters |
61 :: 198; -7; -8; -9
|
Field should not be left blank. If missing, please use -7,8, -9.
|
|
Query
|
q53_a3c |
Integer |
|
Recommended |
Weight kgs |
-7;-8;-9; 9 :: 113
|
Field should not be left blank. If missing, please use -7,8, -9.
|
|
Query
|
ccc2english |
Integer |
|
Recommended |
Does the subject speak English as a primary language? |
0;1;-9
|
0 = No; 1 = Yes; -9 = Missing value
|
dem_primary_lang |
Query
|
demo_learn_eng_age |
Integer |
|
Recommended |
If English is not your first language, age that you learned English |
|
-9=N/A
|
|
Query
|
hosp_mh |
Integer |
|
Recommended |
32. Has your child ever been hospitalized for: (choice=Mental Health) |
0;1
|
0=Unchecked; 1=Checked
|
|
|
thi_a9admitdate2 |
Date |
|
Recommended |
Last Hospitalization (overall) - Admission Date |
|
|
|
Query
|
psych_family |
Integer |
|
Recommended |
Do you have a history of psychological problems in your family? |
0;1
|
0= No; 1= Yes
|
|
|
psych_family_describe |
String |
100
|
Recommended |
Describe psychological problems. |
|
|
|
Query
|
phys_family |
Integer |
|
Recommended |
Do you have any physical problems (e.g. high blood pressure, high cholesterol, diabetes, etc.)? |
0;1
|
0= No; 1= Yes
|
|
|
phys_family_describe |
String |
100
|
Recommended |
Describe physical problems. |
|
|
|
Query
|
psdem16 |
Integer |
|
Recommended |
Have you ever had any neurological problems (e.g. epileptic seizures or coma) |
0;1
|
0=No; 1=Yes
|
digs_neuro_prob |
|
medhx19a |
String |
100
|
Recommended |
If yes, please describe neurological problems: |
|
|
|
Query
|
atrq_02ect |
Integer |
|
Recommended |
Electro-convulsive treatment (ECT) |
0;1
|
0=No; 1=Yes
|
|
Query
|
shock_treat_list |
Integer |
|
Recommended |
List the total number of shock treatments that you've received |
|
|
|
|
shock_treat_date |
Date |
|
Recommended |
Give the date of the most recent shock treatment that you've received |
|
MM/DD/YYYY
|
|
|
hear_prob_spfy |
String |
1,020
|
Recommended |
Notes about hearing |
|
|
|
Query
|
want_participate |
Integer |
|
Recommended |
Do you have a parent, child, or sibling that might also be interested in participating in research studies? |
0;1
|
0= No; 1= Yes
|
|
Query
|
pot_mentalhealth |
Integer |
|
Recommended |
If so, have these individuals been diagnosed with any mental health conditions? |
0;1
|
0= No; 1= Yes
|
|
|
mhcomm |
String |
100
|
Recommended |
Mental Health Other/Comments |
|
|
|
Query
|
txmeds |
Integer |
|
Recommended |
taken prescription medication |
0;1;-7
|
0=No; 1=Yes; -7=Refused
|
|
|
med1_time |
String |
10
|
Recommended |
medication 1 time taken |
|
HH:MM military time
|
|
|
med2_time |
String |
10
|
Recommended |
medication 2 time taken |
|
HH:MM military time
|
|
|
med3_time |
String |
10
|
Recommended |
medication 3 time taken |
|
HH:MM military time
|
|
|
med4_time |
String |
10
|
Recommended |
medication 4 time taken |
|
HH:MM military time
|
|
|
med5_time |
String |
10
|
Recommended |
medication 5 time taken |
|
HH:MM military time
|
|
|
stim1_name |
String |
50
|
Recommended |
Name of Stimulant 1 |
|
|
|
|
stim2_name |
String |
50
|
Recommended |
Name of Stimulant 2 |
|
|
|
|
stim3_name |
String |
50
|
Recommended |
Name of Stimulant 3 |
|
|
|
|
stim4_name |
String |
50
|
Recommended |
Name of Stimulant 4 |
|
|
|
|
stim5_name |
String |
50
|
Recommended |
Name of Stimulant 5 |
|
|
|
Query
|
stim1_amount |
Integer |
|
Recommended |
Amount taken of Stimulant 1 |
|
in ounces
|
|
Query
|
stim2_amount |
Integer |
|
Recommended |
Amount taken of Stimulant 2 |
|
in ounces
|
|
Query
|
stim3_amount |
Integer |
|
Recommended |
Amount taken of Stimulant 3 |
|
in ounces
|
|
Query
|
stim4_amount |
Integer |
|
Recommended |
Amount taken of Stimulant 4 |
|
in ounces
|
|
Query
|
stim5_amount |
Integer |
|
Recommended |
Amount taken of Stimulant 5 |
|
in ounces
|
|
|
stim1_time |
String |
10
|
Recommended |
Time taken for Stimulant 1 |
|
HH:MM military time
|
|
|
stim2_time |
String |
10
|
Recommended |
Time taken for Stimulant 2 |
|
HH:MM military time
|
|
|
stim3_time |
String |
10
|
Recommended |
Time taken for Stimulant 3 |
|
HH:MM military time
|
|
|
stim4_time |
String |
10
|
Recommended |
Time taken for Stimulant 4 |
|
HH:MM military time
|
|
|
stim5_time |
String |
10
|
Recommended |
Time taken for Stimulant 5 |
|
HH:MM military time
|
|
Query
|
prescan_008 |
Integer |
|
Recommended |
Have you consumed alcohol in the last 24 hours? |
|
|
|
|
cbcl1_2_text |
String |
500
|
Recommended |
Describe alcohol use |
|
Touching in patterns (Current)
|
|
|
marital_status_specify |
String |
255
|
Recommended |
Other marital status - Please describe: |
|
|
|
|
respondent |
String |
20
|
Recommended |
Respondent |
Mother;Father;Parent;Guardian;Teacher;Child;Self;Caregiver;Partner;Other
|
|
medhist_relation |
|
medhist_relation_other |
String |
250
|
Recommended |
What is the relationship? |
|
|
|
Query
|
mhx001aa |
Integer |
|
Recommended |
History of: Allergies - Drugs |
1;2; 9
|
1=No; 2=Yes; 9=not evaluated
|
medhist_1a |
|
mhx001ab |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Allergies - Drugs |
|
|
medhist_1a_desc |
|
mhx001b |
String |
250
|
Recommended |
Allergies. Other (Specify:) |
|
|
digs_allergies_details, medhist_1b_desc |
Query
|
mhheente |
Integer |
|
Recommended |
HEENT Disorder |
1::4;-9;9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown;4=Yes; 9=not evaluated
|
medhist_2 |
|
midihist_003a |
String |
250
|
Recommended |
HEENT Disorder explain or describe |
|
|
medhist_2_desc |
Query
|
mhxa1c |
Integer |
|
Recommended |
Coronary artery disease |
0;1; -9
|
0=No; 1=Yes; -9 =NK
|
medhist_3a |
|
corartdis_desc |
String |
250
|
Recommended |
Coronary artery disease description |
|
|
|
|
midihist_010a |
String |
250
|
Recommended |
Hypertension describe |
|
|
|
|
rev_cardiomalfunc |
String |
50
|
Required |
Cardiac Malformation |
Yes;No;NK
|
NK = Not known
|
medhist_3c |
|
rev_cardioother |
String |
255
|
Recommended |
Cardiac Other/Comments |
|
|
medhist_3c_desc |
Query
|
exc_17c |
Integer |
|
Recommended |
Known history or current episode of syncopal event within the past year |
1;2
|
1=Yes; 2=No
|
medhist_3d |
|
medhx17a |
String |
100
|
Recommended |
If yes, please describe problems with fainting: |
|
|
medhist_3d_desc |
Query
|
mhx004a |
Integer |
|
Recommended |
History of: Cardiovascular disorder |
1::3;9
|
1=No; 2=Yes; 3=Yes, Inactive;9=not evaluated
|
medhist_3e |
|
mhx004b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Cardiovascular disorder |
|
|
medhist_3e_desc |
Query
|
othcarddis |
Integer |
|
Recommended |
Other Cardiovascular Disorder |
0;1
|
0= No; 1= Yes
|
|
|
othcarddis_name |
String |
250
|
Recommended |
Cardiovascular Disorder Name |
|
|
|
|
othcarddis_desc |
String |
250
|
Recommended |
Cardiovascular Disorder Describe |
|
|
|
Query
|
midihist_012 |
Integer |
|
Recommended |
Renal Disorder |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_4 |
|
midihist_012a |
String |
250
|
Recommended |
Renal Disorder describe |
|
|
medhist_4_desc |
Query
|
midihist_013 |
Integer |
|
Recommended |
Hepatic Disorder |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_5 |
|
midihist_013a |
String |
250
|
Recommended |
Hepatic Disorder describe |
|
|
medhist_5_desc |
Query
|
midihist_014 |
Integer |
|
Recommended |
Pulmonary Disorder |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_6 |
|
midihist_014a |
String |
250
|
Recommended |
Pulmonary Disorder describe |
|
|
medhist_6_desc |
Query
|
midihist_015 |
Integer |
|
Recommended |
Gastrointestinal Disorder |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_7 |
|
midihist_015a |
String |
250
|
Recommended |
Gastrointestinal Disorder describe |
|
|
medhist_7_desc |
Query
|
midihist_016 |
Integer |
|
Recommended |
Musculoskeletal Disorder |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_8 |
|
midihist_016a |
String |
250
|
Recommended |
Musculoskeletal Disorder describe |
|
|
medhist_8_desc |
Query
|
medhx_fetalcohol |
Integer |
|
Recommended |
Fetal Alcohol Syndrome |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
medhist_19 |
|
fetalalcohol_desc |
String |
250
|
Recommended |
Fetal Alcohol Syndrome Describe |
|
|
|
Query
|
mhdermae |
Integer |
|
Recommended |
Dermatologic Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
medhist_11 |
|
midihist_018a |
String |
250
|
Recommended |
Dermatologic Disorder describe |
|
|
medhist_11_desc |
Query
|
midihist_019 |
Integer |
|
Recommended |
Hyperlipidemia/hypertriglyceridemia |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_12b |
|
midihist_019a |
String |
250
|
Recommended |
Hyperlipidemia/hypertriglyceridemia describe |
|
|
medhist_12b_desc |
Query
|
mhmetabe |
Integer |
|
Recommended |
Metabolic Disorder |
1::4;-9;9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown;4=Yes; 9=not evaluated
|
medhist_12c |
|
mhx014b |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: Metabolic disorder |
|
|
medhist_12c_other |
|
mhx011b_1 |
String |
250
|
Recommended |
Explain Metabolic disorder history |
|
|
medhist_12c_desc |
Query
|
cfmh_othr_sicklecell |
Integer |
|
Recommended |
Sickle cell anemia |
1;0
|
0 = No; 1 = Yes
|
dem_sickle_cell, digs_anemia, medhist_13a |
|
cmedhx31a |
String |
100
|
Recommended |
Details about anemia |
|
|
digs_anemia_details, medhist_13a_desc |
Query
|
mhendoce |
Integer |
|
Recommended |
Endocrine Disorder |
1::3; -9; 9
|
1=No history 2=Yes, excludes;3=Yes, does not exclude; -9 =unknown; 9=not evaluated
|
medhist_14 |
|
endocmt |
String |
250
|
Recommended |
Endocrine/Diabetes comments |
|
|
digs_diabetes_details, medhist_14_desc |
Query
|
midihist_025 |
Integer |
|
Recommended |
Genitourinary Disorder |
1;2;9;-999
|
1=No History; 2=Yes; 9=Not evaluated; -999= Don't know/Missing Data
|
medhist_15 |
|
midihist_025a |
String |
250
|
Recommended |
Genitourinary Disorder describe |
|
|
medhist_15_desc |
|
midihist_026a |
String |
250
|
Recommended |
Infectious Disease describe |
|
|
medhist_16_desc |
Query
|
mhxs_q17a |
Integer |
|
Recommended |
Other 3 History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
medhist_17 |
|
mhxs_q17 |
String |
30
|
Recommended |
Other 3 Name |
|
|
medhist_17_other |
|
mhxs_q17b |
String |
250
|
Recommended |
Other 3 Description |
|
|
medhist_17_desc |
Query
|
mhxs_q18a |
Integer |
|
Recommended |
Other 4 History |
1::3
|
1=No; 2=Yes; 3=Yes, Inactive
|
medhist_18 |
|
mhxs_q18 |
String |
30
|
Recommended |
Other 4 Name |
|
|
medhist_18_other |
|
mhxs_q18b |
String |
250
|
Recommended |
Other 4 Description |
|
|
medhist_18_desc |
|
mtxh_pasttreatname1 |
String |
250
|
Recommended |
Past Treatment #1 - Name |
|
|
|
|
mtxh_pasttreatname2 |
String |
250
|
Recommended |
Past Treatment #2 - Name |
|
|
|
|
mtxh_pasttreatname3 |
String |
250
|
Recommended |
Past Treatment #3 - Name |
|
|
|
|
mtxh_pasttreatname4 |
String |
250
|
Recommended |
Past Treatment #4 - Name |
|
|
|
|
mtxh_curmedconsistency1 |
String |
250
|
Recommended |
Medication 1. In a typical week, on how many days out of 7 does the participant follow his/her dose schedule? |
|
|
|
|
mtxh_curmedconsistency2 |
String |
250
|
Recommended |
Medication 2. In a typical week, on how many days out of 7 does the participant follow his/her dose schedule? |
|
|
|
|
mtxh_curmedconsistency3 |
String |
250
|
Recommended |
Medication 3. In a typical week, on how many days out of 7 does the participant follow his/her dose schedule? |
|
|
|
|
mtxh_curmedconsistency4 |
String |
250
|
Recommended |
Medication 4. In a typical week, on how many days out of 7 does the participant follow his/her dose schedule? |
|
|
|
Query
|
mtxh_pasttreatagestopped |
Integer |
|
Recommended |
At what age was non-medication treatment stopped if it is no longer being received? |
|
years
|
|
|
injsev |
Integer |
|
Recommended |
In your opinion, how severe are your injuries? |
1::7
|
1= Not at all; 7= Extremely
|
|
|
injdes |
Integer |
|
Recommended |
How distressing was the injury/hospital experience for you? |
1::7
|
1= Not at all; 7= Extremely
|
|
|
injdpar |
Integer |
|
Recommended |
How distressing was the injury/hospital experience for you parent? |
1::7
|
1= Not at all; 7= Extremely
|
|
|
cmedhx38 |
Integer |
|
Recommended |
Any other medical problems? |
0;1;-9
|
0=No; 1=Yes; -9 = missing/not reported
|
med_physical_ment_probs |
|
dem_tranq_sleeping |
Integer |
|
Recommended |
Do you ever take tranquilizers or sleeping pills? |
0;1;-8;-9
|
0= No; 1= Yes; -8= NA; -9= Missing
|
|
|
dem_tranq_sleeping_y |
String |
100
|
Recommended |
Do you ever take tranquilizers or sleeping pills? If yes, please specify: |
|
|
|
|
dem_surgeries |
String |
100
|
Recommended |
What surgeries have you had? Please list all of them: |
|
|
|
|
coma_yn |
Integer |
|
Recommended |
Coma diagnosis |
0; 1
|
0= No; 1= Yes
|
dem_coma |
|
med_cur |
String |
500
|
Recommended |
Medications taking currently |
|
Current medications
|
dem_meds |
|
med_prev |
String |
500
|
Recommended |
Medications taken previously |
|
Previous medications
|
dem_past_meds |
|
medhx_2d |
Integer |
|
Recommended |
Has she/he ever been to a doctor for any of these things…Bronchitis /Bronquitus |
1 ; 0
|
1 = Yes; 0 = No // Now I'd like to ask you about your child's use of health services during the past year and throughout his/her whole life.
|
digs_bronchitis |
|
hi_3b |
Integer |
|
Recommended |
Past two years. Emphysema |
0;1
|
0=No; 1=Yes
|
digs_emphysema |
|
digs_emphysema_age |
Integer |
|
Recommended |
Emphysema |
|
Age (in Years)
|
|
|
digs_emphysema_details |
String |
100
|
Recommended |
Emphysema |
|
|
|
|
mh_owt |
Integer |
|
Recommended |
Overweight |
0; 1
|
0=No; 1=Yes
|
digs_overweight |
|
mh_fbrmy |
Integer |
|
Recommended |
Fibromyalgia |
0; 1
|
0=No; 1=Yes
|
digs_fibromyalgia |
|
digs_fibromyalgia_age |
Integer |
|
Recommended |
Fibromyalgia |
|
Age (in Years)
|
|
|
digs_alzheimer_age |
Integer |
|
Recommended |
Alzheimer Disease |
|
Age (in Years)
|
|
|
digs_arthritis_details |
String |
500
|
Recommended |
Arthritis (Specify Additional Details) |
|
Additional Details
|
|
|
digs_bronchitis_age |
Integer |
|
Recommended |
Chronic Bronchitis |
|
Age (in Years)
|
|
|
digs_bronchitis_details |
String |
100
|
Recommended |
Chronic Bronchitis |
|
|
|
|
digs_heart_fail_age |
Integer |
|
Recommended |
Congestive heart failure |
|
Age (in Years)
|
|
|
digs_heart_fail_details |
String |
100
|
Recommended |
Congestive heart failure |
|
|
|
|
dem_eyesight |
Integer |
|
Recommended |
Do you wear: |
1::4
|
1= glasses; 2= bifocals; 3= reading glasses; 4= contact lenses
|
|
|
digs_thyroid_details |
String |
100
|
Recommended |
Goiter/thyroid disease (Specify) |
|
|
|
|
digs_head_injury_age |
Integer |
|
Recommended |
Head injury |
|
Age (in Years)
|
|
|
digs_angina_details |
String |
100
|
Recommended |
Heart attack/angina |
|
|
|
|
elig_18 |
Integer |
|
Recommended |
Liver disease |
0;1
|
0=No; 1=Yes
|
digs_liver |
|
digs_liver_details |
String |
100
|
Recommended |
Liver condition (Specify) |
|
|
|
|
migraine_age |
Integer |
|
Recommended |
Migraine age of onset |
|
About how old were you when you first had this condition?
|
digs_migraine_age |
|
digs_migraine_details |
String |
100
|
Recommended |
Migraine headaches (Aura?) |
|
|
|
|
mhxa14b |
Integer |
|
Recommended |
Musculoskeletal: Osteoporosis |
0;1
|
0=No; 1=Yes
|
digs_osteo |
|
digs_osteo_age |
Integer |
|
Recommended |
Osteoporosis/brittle bones |
|
Age (in Years)
|
|
|
digs_osteo_details |
String |
100
|
Recommended |
Osteoporosis/brittle bones |
|
|
|
|
rev_eyeoter |
String |
255
|
Recommended |
Eyes Other/Comments: |
|
|
dem_eye_restrictions_spec |
|
digs_overweight_age |
Integer |
|
Recommended |
Overweight |
|
Age (in Years)
|
|
|
digs_overweight_details |
String |
100
|
Recommended |
Overweight |
|
|
|
|
medhx31a |
String |
100
|
Recommended |
If yes, please describe stomach or dudenal ulcer problems: |
|
|
digs_ulcer_details |
|
digs_neuro_prob_age |
Integer |
|
Recommended |
Other neurological problems |
|
Age (in Years)
|
|
|
neurologic_problem_details |
String |
200
|
Recommended |
Details of the other neurologic problem(s) |
|
|
digs_neuro_prob_details |
|
tts_20 |
String |
60
|
Recommended |
Do you have any current or chronic physical illnesses that interferes with sleep such as chronic fatigue syndrome, chronic pain syndrome, fibromyalgia, GERD? If yes, please describe: |
|
|
digs_fibromyalgia_details |
|
rev_skinother |
String |
255
|
Recommended |
Skin Other/Comments |
|
|
digs_skin_con_details |
|
rev_pulasthma |
String |
50
|
Recommended |
Asthma |
Yes;No;NK
|
NK = Not known
|
digs_asthma |
|
mhx007bb |
String |
250
|
Recommended |
If YES, Enter onset/resolved date indicate ongoing with treatment or not. If NOT EVALUATED, explain or describe below: History of Asthma |
|
|
digs_asthma_details |
|
mhxa1e |
Integer |
|
Recommended |
Heart attack/ myocardial infarction |
0;1;9;-9
|
0=No; 1=Yes; 9=not evaluated; -9=unknown
|
digs_angina |
|
dem_rx_eyes |
Integer |
|
Recommended |
Is the prescription for one of the eyes much stronger than the other? |
0; 1
|
0= No; 1= Yes
|
|
|
cfmh_othr_migraine |
Integer |
|
Recommended |
Migraine headaches |
0;1; -9
|
0 = No; 1 = Yes; -9=unknown
|
digs_migraine |
|
medcon_dx4 |
Integer |
|
Recommended |
Arthritis or rheumatism |
0;1
|
0=No; 1=Yes
|
digs_arthritis |
|
arg_age |
Integer |
|
Recommended |
Arthritis, rheumatism, or gout age of onset |
|
About how old were you when you first had this condition?
|
digs_arthritis_age |
|
digs_asthma_age |
Integer |
|
Recommended |
Asthma Age |
|
Age (in Years)
|
|
|
rev_endodiabetesage |
Integer |
|
Recommended |
Diabetes: Age(in months) |
0 :: 1200
|
|
digs_diabetes_age |
|
hypthy_age |
Integer |
|
Recommended |
Hypo- or Hyper-thyroidism age of onset |
|
About how old were you when you first had this condition?
|
digs_thyroid_age |
|
hbp_age |
Integer |
|
Recommended |
High blood pressure age of onset |
|
About how old were you when you first had this condition?
|
digs_hbp_age |
|
stroke_age |
Integer |
|
Recommended |
A stroke or Cerebrovascular accident age of onset |
|
About how old were you when you first had this condition?
|
digs_stroke_age |
|
heartatk_age |
Integer |
|
Recommended |
Heart attack age of onset |
|
About how old were you when you first had this condition?
|
digs_angina_age |
|
othmem_cancer_cmt |
String |
255
|
Recommended |
Cancer. Specify Type |
|
|
digs_cancer_details |
|
visual_left_rx |
String |
20
|
Recommended |
Prescription of Left Eye |
|
|
dem_left_eye_rx |
|
cancer_age |
Integer |
|
Recommended |
Cancer age of onset |
|
About how old were you when you first had this condition?
|
digs_cancer_age |
|
liver_age |
Integer |
|
Recommended |
Liver problems age of onset |
|
About how old were you when you first had this condition?
|
digs_liver_age |
|
medhx_ulc |
Integer |
|
Recommended |
Ulcerative Colitis |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
digs_ulcer |
|
medhx_ulc_age |
Integer |
|
Recommended |
Ulcerative Colitis: Age diagnosed/onset (in months) |
|
|
digs_ulcer_age |
|
anemia_age |
Integer |
|
Recommended |
Anemia age of onset |
|
About how old were you when you first had this condition?
|
digs_anemia_age |
|
skin_age |
Integer |
|
Recommended |
Skin condition age of onset |
|
About how old were you when you first had this condition?
|
digs_skin_con_age |
|
batlq26_age |
String |
100
|
Recommended |
Have you ever been hospitalized or seen in an emergency room for because of: Seizures? If yes: Age |
|
|
digs_epilepsy_age |
|
allergies_age |
Integer |
|
Recommended |
Allergies age of onset |
|
About how old were you when you first had this condition?
|
digs_allergies_age |
|
visual_right_rx |
String |
20
|
Recommended |
Prescription of Right Eye |
|
|
dem_right_eye_rx |
|
dem_astigmatism |
Integer |
|
Recommended |
Do you have a bad astigmatism? |
|
|
|
|
medhx_respprob |
Integer |
|
Recommended |
Respiratory Problems |
0::2
|
0 = No, 1 = Yes, 2 = Not sure
|
dem_respiratory |
|
dem_meds_nerves |
Integer |
|
Recommended |
Have you ever taken any medications for your nerves or psychological medications? |
0; 1
|
0= No; 1= Yes
|
|
|
dem_meds_nerves_2 |
String |
500
|
Recommended |
Which medications have you taken for your nerves or psychopathology |
|
|
|
|
dem_func_impair |
String |
500
|
Recommended |
How much do any of the problems you mentioned interfere with your daily activities? |
|
|
|
|
dem_emergency_room |
String |
500
|
Recommended |
Please describe any and all visits to the emergency room. Please include any visits you made as a child, and visits you may not find to be important: |
|
|
|
|
dem_add_issues |
String |
500
|
Recommended |
Please describe all additional medical issues: |
|
|
|
|
dem_relative_mental_yn |
Integer |
|
Recommended |
Do you have a first degree relative (parent or brother or sister) with serious mental illness? |
0; 1
|
0= No; 1= Yes
|
|
|
dem_relative_mental_list |
String |
500
|
Recommended |
If yes, which illness? Bipolar, psychosis, schizophrenia , major depression, or other? Please list: |
|
|
|
|
dem_eye_restrictions |
Integer |
|
Recommended |
Do you have any other restrictions with your eyesight? |
0; 1
|
0= No; 1= Yes
|
|
|
dem_hear_restriction |
Integer |
|
Recommended |
Do you have any restrictions with your hearing? |
0; 1
|
0= No; 1= Yes
|
|
|
dem_hear_restriction_spec |
String |
500
|
Recommended |
If you have restrictions with your hearing please describe: |
|
|
|
|
dem_overallhealth |
String |
500
|
Recommended |
Overall Health |
|
|
|
|
gmhr01 |
Integer |
|
Recommended |
General Medical Health Rating |
1;2;3;4
|
1 = Poor; 2 = Fair; 3 = Good; 4 = Excellent to Very Good
|
dem_general_health |
|
dem_cataracts |
Integer |
|
Recommended |
Cataracts: had them removed? |
0; 1
|
0= No; 1= Yes
|
|
|
dem_glaucoma |
Integer |
|
Recommended |
Glaucoma, Macular degeneration |
0; 1
|
0= No; 1= Yes
|
|
|
cortisol18 |
Integer |
|
Recommended |
Have you been diagnosed with diabetes |
0;1
|
0= No; 1= Yes, please explain
|
dem_diabetes |
|
lhq_msj |
Integer |
|
Recommended |
Arthritis, back pain, rheumatic fever or musculoskeletal/joint problems |
0;1
|
0=No; 1=Yes
|
dem_arthritis |
|
bilingual |
Integer |
|
Recommended |
Raised bilingual? |
0 :: 1
|
0= no; 1 = yes
|
dem_biling |
|
dem_park_alzheim |
Integer |
|
Recommended |
Parkinson's or Alzheimer's |
0; 1
|
0= No; 1= Yes
|
|
|
dem_brain_damage |
Integer |
|
Recommended |
Ever had brain damage? |
0; 1
|
0= No; 1= Yes
|
|
|
dem_cataracts_prob |
String |
500
|
Recommended |
If you have had any problems with your cataracts, please specify: |
|
|
|
|
dem_heart_meds |
String |
500
|
Recommended |
If you take medications for heart disease, please list them: |
|
|
|
|
dem_hbp_meds |
String |
500
|
Recommended |
If you take medications for high blood pressure, please list them: |
|
|
|
|
dem_lbp_meds |
String |
500
|
Recommended |
If you take medications for low blood pressure or anemia, please list them: |
|
|
|
|
dem_diabetes_meds |
String |
500
|
Recommended |
If you take medications for diabetes, please list them: |
|
|
|
|
dem_arthritis_meds |
String |
500
|
Recommended |
If you take medications for arthritis or problems with your hands or back, please list them: |
|
|
|
|
neurologist |
Integer |
|
Recommended |
Has the subject ever seen a neurologist? |
0;1
|
0=No; 1=Yes
|
dem_neurologist |
|
acnlvs |
Integer |
|
Recommended |
any-visit to psychologist |
0;1
|
0=No; 1=Yes
|
dem_psychologist |
|
dem_occupation_retired |
Integer |
|
Recommended |
If retired, what year did you retire? |
|
|
|
|
amhivs |
Integer |
|
Recommended |
any visit to psychiatrist |
0;1
|
0=No; 1=Yes
|
dem_psychiatrist |
|
sqalcoholamt |
String |
50
|
Recommended |
Amount of alcohol (drinks per week) |
|
|
dem_drinks |
|
dem_school_prob |
Integer |
|
Recommended |
Do you (or did you) have any problems in school? |
0; 1
|
0= No; 1= Yes
|
|
|
academic_probspecfy |
String |
500
|
Recommended |
Any academic or other problems in school, specify |
|
|
dem_school_prob_2 |
|
dem_occ_scale_self |
Integer |
|
Recommended |
Please mark the category that best describes your current occupation |
1::7
|
1= Unskilled employees; 2= Machine operators and semiskilled employees; 3= Skilled manual employees; 4= Clerical and sales workers, technicians, and owners of little businesses; 5= Administrative personnel, owners of small businesses, and minor professionals; 6= Business managers, proprietors of medium-sized businesses, and lesser professionals; 7= Higher executives of large concerns, proprietors, and major professionals
|
|
|
dem_occ_scale_mother |
Integer |
|
Recommended |
Please mark the category that best describes your mother?s current occupation |
1::7
|
1= Unskilled employees; 2= Machine operators and semiskilled employees; 3= Skilled manual employees; 4= Clerical and sales workers, technicians, and owners of little businesses; 5= Administrative personnel, owners of small businesses, and minor professionals; 6= Business managers, proprietors of medium-sized businesses, and lesser professionals; 7= Higher executives of large concerns, proprietors, and major professionals
|
|
|
dem_occ_scale_father |
Integer |
|
Recommended |
Please mark the category that best describes your father?s current occupation |
1::7
|
1= Unskilled employees; 2= Machine operators and semiskilled employees; 3= Skilled manual employees; 4= Clerical and sales workers, technicians, and owners of little businesses; 5= Administrative personnel, owners of small businesses, and minor professionals; 6= Business managers, proprietors of medium-sized businesses, and lesser professionals; 7= Higher executives of large concerns, proprietors, and major professionals
|
|
|
dem_lbp |
Integer |
|
Recommended |
Low blood pressure or anemia |
0;1
|
0= No; 1= Yes
|
|
|
treat01_child |
Integer |
|
Recommended |
Type of treatment child has received since last visit (or lifetime if at baseline) |
1::4
|
1 = no treatment; 2 = medication only; 3 = psychosocial only; 4 = both medication and psychosocial
|
|
|
scapi_stim1 |
Integer |
|
Recommended |
Current stimulant medication?#1 |
1::19
|
1 = Adderall; 2 = Adderall XR; 3 = Concerta; 4 = Cylert; 5 = Daytrana Patch; 6 = Desoxyn; 7 = Dexedrine Tablets; 8 = Dexedrine Capsules; 9 = DextroStat; 10 = Focalin Tablets; 11 = Metadate CD Capsules; 12 = Metadate ER Capsules; 13 = Methylin ER Tablets; 14 = Methylin Tablets; 15 = Ritalin HCl; 16 = Ritalin LA; 17 = Vyvanse; 18 = Other (excludes Strattera); 19 = Quillavant
|
|
|
scapi_stim2 |
Integer |
|
Recommended |
Current stimulant medication?#2 |
1::19
|
1 = Adderall; 2 = Adderall XR; 3 = Concerta; 4 = Cylert; 5 = Daytrana Patch; 6 = Desoxyn; 7 = Dexedrine Tablets; 8 = Dexedrine Capsules; 9 = DextroStat; 10 = Focalin Tablets; 11 = Metadate CD Capsules; 12 = Metadate ER Capsules; 13 = Methylin ER Tablets; 14 = Methylin Tablets; 15 = Ritalin HCl; 16 = Ritalin LA; 17 = Vyvanse; 18 = Other (excludes Strattera); 19 = Quillavant
|
|
|
scapi_stim3 |
Integer |
|
Recommended |
Current stimulant medication?#3 |
1::19
|
1 = Adderall; 2 = Adderall XR; 3 = Concerta; 4 = Cylert; 5 = Daytrana Patch; 6 = Desoxyn; 7 = Dexedrine Tablets; 8 = Dexedrine Capsules; 9 = DextroStat; 10 = Focalin Tablets; 11 = Metadate CD Capsules; 12 = Metadate ER Capsules; 13 = Methylin ER Tablets; 14 = Methylin Tablets; 15 = Ritalin HCl; 16 = Ritalin LA; 17 = Vyvanse; 18 = Other (excludes Strattera); 19 = Quillavant
|
|
|
cu_scapi_psymed1 |
Integer |
|
Recommended |
Current psychoactive medication?#1 |
1::102
|
1 = Abilify; 7 = Ambien; 8 = Anafranil; 11 = Ativan; 14 = Benadryl; 15 = Buspar; 16 = Catapres; 20 = Clonidine; 22 = Cymbalta; 28 = Depakote; 30 = Effexor; 31 = Elavil/Endep; 32 = Emsam Patch; 33 = Eskalith ER; 36 = Geodon; 38 = Haldol; 40 = Keppra; 41 = Klonopin; 42 = Lamictil; 43 = Lexapro; 45 = Lithobid; 48 = Luvox; 53 = Nardil; 55 = Navane; 58 = Norpramine; 60 = Pamelor; 61 = Parnate; 62 = Paxil; 69 = Provigil; 70 = Prozac; 72 = Remeron; 73 = Risperdal; 76 = Seroquel; 77 = Serzone; 80 = Sonata; 81 = Strattera; 83 = Tegretol; 84 = Tenex; 86 = Tofranil; 87 = Topamax; 88 = Trazadone; 90 = Valium; 93 = Wellbutrin; 94 = Xanax; 97 = Zoloft; 99 = Zyprexa; 101 = Other; 102 = Guanfacine/Intuniv
|
|
|
cu_scapi_psymed2 |
Integer |
|
Recommended |
Current psychoactive medication?#2 |
1::102
|
1 = Abilify; 7 = Ambien; 8 = Anafranil; 11 = Ativan; 14 = Benadryl; 15 = Buspar; 16 = Catapres; 20 = Clonidine; 22 = Cymbalta; 28 = Depakote; 30 = Effexor; 31 = Elavil/Endep; 32 = Emsam Patch; 33 = Eskalith ER; 36 = Geodon; 38 = Haldol; 40 = Keppra; 41 = Klonopin; 42 = Lamictil; 43 = Lexapro; 45 = Lithobid; 48 = Luvox; 53 = Nardil; 55 = Navane; 58 = Norpramine; 60 = Pamelor; 61 = Parnate; 62 = Paxil; 69 = Provigil; 70 = Prozac; 72 = Remeron; 73 = Risperdal; 76 = Seroquel; 77 = Serzone; 80 = Sonata; 81 = Strattera; 83 = Tegretol; 84 = Tenex; 86 = Tofranil; 87 = Topamax; 88 = Trazadone; 90 = Valium; 93 = Wellbutrin; 94 = Xanax; 97 = Zoloft; 99 = Zyprexa; 101 = Other; 102 = Guanfacine/Intuniv
|
|
|
cu_scapi_psymed3 |
Integer |
|
Recommended |
Current psychoactive medication?#3 |
1::102
|
1 = Abilify; 7 = Ambien; 8 = Anafranil; 11 = Ativan; 14 = Benadryl; 15 = Buspar; 16 = Catapres; 20 = Clonidine; 22 = Cymbalta; 28 = Depakote; 30 = Effexor; 31 = Elavil/Endep; 32 = Emsam Patch; 33 = Eskalith ER; 36 = Geodon; 38 = Haldol; 40 = Keppra; 41 = Klonopin; 42 = Lamictil; 43 = Lexapro; 45 = Lithobid; 48 = Luvox; 53 = Nardil; 55 = Navane; 58 = Norpramine; 60 = Pamelor; 61 = Parnate; 62 = Paxil; 69 = Provigil; 70 = Prozac; 72 = Remeron; 73 = Risperdal; 76 = Seroquel; 77 = Serzone; 80 = Sonata; 81 = Strattera; 83 = Tegretol; 84 = Tenex; 86 = Tofranil; 87 = Topamax; 88 = Trazadone; 90 = Valium; 93 = Wellbutrin; 94 = Xanax; 97 = Zoloft; 99 = Zyprexa; 101 = Other; 102 = Guanfacine/Intuniv
|
|
|
pa_scapi_psymed1 |
Integer |
|
Recommended |
Psychoactive medication?#1?since last visit (or lifetime if at baseline) |
1::102
|
1 = Abilify; 7 = Ambien; 8 = Anafranil; 11 = Ativan; 14 = Benadryl; 15 = Buspar; 16 = Catapres; 20 = Clonidine; 22 = Cymbalta; 28 = Depakote; 30 = Effexor; 31 = Elavil/Endep; 32 = Emsam Patch; 33 = Eskalith ER; 36 = Geodon; 38 = Haldol; 40 = Keppra; 41 = Klonopin; 42 = Lamictil; 43 = Lexapro; 45 = Lithobid; 48 = Luvox; 53 = Nardil; 55 = Navane; 58 = Norpramine; 60 = Pamelor; 61 = Parnate; 62 = Paxil; 69 = Provigil; 70 = Prozac; 72 = Remeron; 73 = Risperdal; 76 = Seroquel; 77 = Serzone; 80 = Sonata; 81 = Strattera; 83 = Tegretol; 84 = Tenex; 86 = Tofranil; 87 = Topamax; 88 = Trazadone; 90 = Valium; 93 = Wellbutrin; 94 = Xanax; 97 = Zoloft; 99 = Zyprexa; 101 = Other; 102 = Guanfacine/Intuniv
|
|
|
pa_scapi_psymed2 |
Integer |
|
Recommended |
Psychoactive medication?#2?since last visit (or lifetime if at baseline) |
1::102
|
1 = Abilify; 7 = Ambien; 8 = Anafranil; 11 = Ativan; 14 = Benadryl; 15 = Buspar; 16 = Catapres; 20 = Clonidine; 22 = Cymbalta; 28 = Depakote; 30 = Effexor; 31 = Elavil/Endep; 32 = Emsam Patch; 33 = Eskalith ER; 36 = Geodon; 38 = Haldol; 40 = Keppra; 41 = Klonopin; 42 = Lamictil; 43 = Lexapro; 45 = Lithobid; 48 = Luvox; 53 = Nardil; 55 = Navane; 58 = Norpramine; 60 = Pamelor; 61 = Parnate; 62 = Paxil; 69 = Provigil; 70 = Prozac; 72 = Remeron; 73 = Risperdal; 76 = Seroquel; 77 = Serzone; 80 = Sonata; 81 = Strattera; 83 = Tegretol; 84 = Tenex; 86 = Tofranil; 87 = Topamax; 88 = Trazadone; 90 = Valium; 93 = Wellbutrin; 94 = Xanax; 97 = Zoloft; 99 = Zyprexa; 101 = Other; 102 = Guanfacine/Intuniv
|
|
|
pa_scapi_psymed3 |
Integer |
|
Recommended |
Psychoactive medication?#3?since last visit (or lifetime if at baseline) |
1::102
|
1 = Abilify; 7 = Ambien; 8 = Anafranil; 11 = Ativan; 14 = Benadryl; 15 = Buspar; 16 = Catapres; 20 = Clonidine; 22 = Cymbalta; 28 = Depakote; 30 = Effexor; 31 = Elavil/Endep; 32 = Emsam Patch; 33 = Eskalith ER; 36 = Geodon; 38 = Haldol; 40 = Keppra; 41 = Klonopin; 42 = Lamictil; 43 = Lexapro; 45 = Lithobid; 48 = Luvox; 53 = Nardil; 55 = Navane; 58 = Norpramine; 60 = Pamelor; 61 = Parnate; 62 = Paxil; 69 = Provigil; 70 = Prozac; 72 = Remeron; 73 = Risperdal; 76 = Seroquel; 77 = Serzone; 80 = Sonata; 81 = Strattera; 83 = Tegretol; 84 = Tenex; 86 = Tofranil; 87 = Topamax; 88 = Trazadone; 90 = Valium; 93 = Wellbutrin; 94 = Xanax; 97 = Zoloft; 99 = Zyprexa; 101 = Other; 102 = Guanfacine/Intuniv
|
|
|
psychmed01 |
Integer |
|
Recommended |
Using psychoactive medication since last visit (or lifetime if at baseline)? |
1;3
|
1 = No; 3 = Yes
|
|
|
y1_agestim |
Integer |
|
Recommended |
Baseline assessment of how old child was when they first began taking a stimulant ADHD medication |
|
|
|
|
current_adhdmed |
Integer |
|
Recommended |
Currently using ADHD medication at time of visit? |
1;3
|
1 = No; 3 = Yes
|
|
|
current_stimmed |
Integer |
|
Recommended |
Currently using stimulant medication at time of visit? |
1;3
|
1 = No; 3 = Yes
|
|
|
current_psychmed |
Integer |
|
Recommended |
Currently using psychoactive medication at time of visit? |
1;3
|
1 = No; 3 = Yes
|
|
|
adhdmed |
Integer |
|
Recommended |
Using ADHD medication since last visit (or lifetime if at baseline)? |
1;3
|
1 = No; 3 = Yes
|
|
|
stimmed |
Integer |
|
Recommended |
Using stimulant medication since last visit (or lifetime if at baseline)? |
1;3
|
1 = No; 3 = Yes
|
|
|
visit_year |
Integer |
|
Recommended |
Year of visit |
|
|
|