ASSESSMENT PROTOCOL FOR PROBLEM ON INSOMNIA: ADULT PATIENT (Logic Tree No. 16) DIRECTION: Determine/identify which of lhe following symptoms/sig_ns (S/S) or history data (Hx D) are present and follow t J1e flowchart for the appropnale plan of management. YELLOW S/S or Hx D Condition has been present for more than six months Insomnia is due to withdrawal from alcohol or drugs tor nervousness Patient is depressed, feels worthless, hopeless or guilty Patient felt some difficulty in thinking as manifested by either inability to concentrate or lack of decisiveness Loss of interest and pleasure in life with the patient withdrawing either partially or completely from work Patient is in an over enthusiastic mood getting involved in so many activities and feels little nee·d for sleep Patient has some hallucination or delusions Toothache Joint pain Tooth decay or gum swelling swelling and/or redness of a painful joint Patient looks untidy and unkept Patient is either elated or depressed Patent's emotiona l reaction is not appropriate for what he is saying or doing Patient's stream of talk is Incoherent He has sexual or religious preoccupation He is easily distracted from what he is doing or saying GREEN S/S or Hx D Itchiness of the anus at night Patient works very hard and he usually feels physically and/or mentally tired at the end of the day Sudi:len change in the daily routine like there is a newborn to be taken cared of or somebody in the family is sick There are some serious problems or pressure in school, office or at home Patient just suffered some adverse life situation like death of a loved one or loss of a job Faulty habits like taking after noon nap until late in the afternoon or going to bed hungry or immediate ly after a heavy meal or drinking coffee/tea after dinner or doing mental activity (like doing the assignment) after dinner Patient is alert and in touch with reality Redness or irritation of the anal area Patient looks tidy and clean · Patient's emotional reaction is appropriate for what he is saying or doing Patient's stream of talk is coherent Patient has no hallucination, delusion or_ Preoccupation A07 