Caution: JavaScript execution is disabled in your browser or for this website. You may not be able to answer all questions in this survey. Please, verify your browser parameters.

SGP_psychopharmaceuticals

Psychopharmaceuticals in children, adolescents and young adults.

One record per patient from 0 to 23 years, unless there is a change in prescription/indication.

1. Identification
(This question is mandatory)
GP code
(This question is mandatory)
Startdate of consultation week (monday)
Open date/time selector
(This question is mandatory)
1. Sex patient
(This question is mandatory)
2. Age of the patient (between 0 and 23 years old)
(This question is mandatory)
3. Which type of IDcard your patient possess?
(This question is mandatory)
4. Does the patient has access to OMNIO/BIM statute, urgent medical aid, CPAS/OCMW or other financial help?
(This question is mandatory)
5. Has the patient already been registered this year (and is there a change in prescription/indication)?
2. Psychopharmaceuticals
(This question is mandatory)
6. What type of medication was prescribed to the patient?

6a. What active substance(s) does the medication contain? (specify the molecule)

(This question is mandatory)
6b. For what indication did you prescribe antidepressants?
Please specify for which other indication you prescribed antidepressants:
(This question is mandatory)
6b. For what indication did you prescribe antipsychotics?
Please specify here for which other indication you prescribed antipsychotics:
(This question is mandatory)
6b. For what indication did you prescribe hypnotics and sedatives?
Please specify for which other indication you prescribed hypnotics and sedatives:
(This question is mandatory)
6b. For what indication did you prescribe anxiolytics?
Please specify here for which other indication you prescribed anxiolytics:
(This question is mandatory)
6b. For which indication did you prescribe psychostimulants?
Please specify for which other indication you prescribed psychostimulants:
(This question is mandatory)
6b. For what indication did you prescribe antiepileptic drugs?
Please specify here for which other indication you prescribed antiepileptic drugs:
(This question is mandatory)
6c. What type of prescription did you write?
Antidepressants
Antipsychotics
Hypnotics and sedatives
Anxiolytics
Psychostimulants
Antiepileptic drugs
(This question is mandatory)
6d.What is the duration of the prescribed treatment since the start up until now?
Antidepressants
Antipsychotics
Hypnotics and sedatives
Anxiolytics
Psychostimulants
Antiepileptic drugs
(This question is mandatory)
6e. At whose request was the prescription issued?
Antidepressants
Antipsychotics
Hypnotics and sedatives
Anxiolytics
Psychostimulants
Antiepileptic drugs
(This question is mandatory)
6f. Was the prescription made after receiving a diagnostic report?
Antidepressants
Antipsychotics
Hypnotics and sedatives
Anxiolytics
Psychostimulants
Antiepileptic drugs
(This question is mandatory)
7. Non-medicinal help for the patient:
(This question is mandatory)
7a. Which non-medicinal help?
(This question is mandatory)
8. For a diagnosis or specialised treatment of the problem, you have referred the patient to:
(This question is mandatory)
9. Has the patient been hospitalised for mental health problems in the last 6 months?