Rating Scales in Psychiatry

ls -la /tmp/workspace/ 2>/dev/null || mkdir -p /tmp/workspace && echo "workspace ready"

mkdir -p /tmp/workspace/rating-scales-pdf && cat > /tmp/workspace/rating-scales-pdf/generate_pdf.py << 'PYEOF' from reportlab.lib.pagesizes import A4 from reportlab.lib.styles import getSampleStyleSheet, ParagraphStyle from reportlab.lib.units import cm, mm from reportlab.lib import colors from reportlab.platypus import ( SimpleDocTemplate, Paragraph, Spacer, Table, TableStyle, HRFlowable, PageBreak, KeepTogether ) from reportlab.lib.enums import TA_CENTER, TA_LEFT, TA_JUSTIFY from reportlab.platypus import BaseDocTemplate, Frame, PageTemplate OUTPUT = "/tmp/workspace/rating-scales-pdf/Rating_Scales_in_Psychiatry.pdf" # ── Page layout ───────────────────────────────────────────────────────────── doc = SimpleDocTemplate( OUTPUT, pagesize=A4, leftMargin=2*cm, rightMargin=2*cm, topMargin=2.5*cm, bottomMargin=2.5*cm, title="Rating Scales in Psychiatry", author="Psychiatry Resident Notes" ) W = A4[0] - 4*cm # usable width # ── Colour palette ─────────────────────────────────────────────────────────── NAVY = colors.HexColor("#1a3557") TEAL = colors.HexColor("#2e7d8c") LTBLUE = colors.HexColor("#e8f4f8") GOLD = colors.HexColor("#c8860a") LGRAY = colors.HexColor("#f5f5f5") DGRAY = colors.HexColor("#444444") WHITE = colors.white BLACK = colors.black # ── Styles ─────────────────────────────────────────────────────────────────── styles = getSampleStyleSheet() title_style = ParagraphStyle( "MainTitle", fontSize=22, leading=28, alignment=TA_CENTER, textColor=WHITE, fontName="Helvetica-Bold", spaceAfter=4 ) subtitle_style = ParagraphStyle( "SubTitle", fontSize=11, leading=14, alignment=TA_CENTER, textColor=colors.HexColor("#cce4ed"), fontName="Helvetica", spaceAfter=0 ) h1 = ParagraphStyle( "H1", fontSize=13, leading=17, textColor=WHITE, fontName="Helvetica-Bold", spaceBefore=14, spaceAfter=4, leftIndent=0, borderPad=6 ) h2 = ParagraphStyle( "H2", fontSize=11, leading=14, textColor=NAVY, fontName="Helvetica-Bold", spaceBefore=10, spaceAfter=3, borderPad=0 ) h3 = ParagraphStyle( "H3", fontSize=10, leading=13, textColor=TEAL, fontName="Helvetica-Bold", spaceBefore=8, spaceAfter=2 ) body = ParagraphStyle( "Body", fontSize=9.5, leading=13.5, textColor=DGRAY, fontName="Helvetica", spaceAfter=4, alignment=TA_JUSTIFY ) bullet = ParagraphStyle( "Bullet", fontSize=9.5, leading=13, textColor=DGRAY, fontName="Helvetica", leftIndent=14, bulletIndent=6, spaceAfter=2 ) note_style = ParagraphStyle( "Note", fontSize=8.5, leading=12, textColor=colors.HexColor("#666666"), fontName="Helvetica-Oblique", spaceAfter=4, alignment=TA_CENTER ) key_style = ParagraphStyle( "Key", fontSize=9, leading=13, textColor=NAVY, fontName="Helvetica-Bold", leftIndent=10, spaceAfter=2 ) # ── Helper functions ───────────────────────────────────────────────────────── def section_header(text): """Dark navy banner with white text for major sections.""" tbl = Table([[Paragraph(text, h1)]], colWidths=[W]) tbl.setStyle(TableStyle([ ("BACKGROUND", (0,0), (-1,-1), NAVY), ("TOPPADDING", (0,0), (-1,-1), 6), ("BOTTOMPADDING", (0,0), (-1,-1), 6), ("LEFTPADDING", (0,0), (-1,-1), 10), ("RIGHTPADDING", (0,0), (-1,-1), 10), ("ROUNDEDCORNERS", [4]), ])) return tbl def sub_header(text): return Paragraph(text, h2) def make_table(headers, rows, col_widths=None): """Nicely formatted table with alternating row colours.""" if col_widths is None: col_widths = [W / len(headers)] * len(headers) header_row = [Paragraph(f"<b>{h}</b>", ParagraphStyle( "TH", fontSize=9, leading=12, textColor=WHITE, fontName="Helvetica-Bold", alignment=TA_CENTER)) for h in headers] data = [header_row] for i, row in enumerate(rows): cell_style = ParagraphStyle( "TD", fontSize=8.5, leading=11.5, textColor=DGRAY, fontName="Helvetica", alignment=TA_LEFT) data.append([Paragraph(str(c), cell_style) for c in row]) tbl = Table(data, colWidths=col_widths, repeatRows=1) style_cmds = [ ("BACKGROUND", (0,0), (-1,0), TEAL), ("TEXTCOLOR", (0,0), (-1,0), WHITE), ("GRID", (0,0), (-1,-1), 0.4, colors.HexColor("#bbbbbb")), ("TOPPADDING", (0,0), (-1,-1), 4), ("BOTTOMPADDING", (0,0), (-1,-1), 4), ("LEFTPADDING", (0,0), (-1,-1), 5), ("RIGHTPADDING", (0,0), (-1,-1), 5), ("VALIGN", (0,0), (-1,-1), "TOP"), ("ROWBACKGROUNDS",(0,1), (-1,-1), [LGRAY, WHITE]), ] tbl.setStyle(TableStyle(style_cmds)) return tbl def bp(text): return Paragraph(f"• &nbsp; {text}", bullet) def sp(n=6): return Spacer(1, n) def hr(): return HRFlowable(width="100%", thickness=0.5, color=colors.HexColor("#cccccc"), spaceAfter=4) # ── Cover block (title table) ──────────────────────────────────────────────── def cover_block(): cover_tbl = Table([ [Paragraph("Rating Scales in Psychiatry", title_style)], [Paragraph("A Comprehensive Review for Psychiatry Residents", subtitle_style)], [Spacer(1, 4)], [Paragraph("Based on Kaplan &amp; Sadock's Comprehensive Textbook of Psychiatry (10th ed.)<br/>" "and Synopsis of Psychiatry (11th ed.)", subtitle_style)], ], colWidths=[W]) cover_tbl.setStyle(TableStyle([ ("BACKGROUND", (0,0), (-1,-1), NAVY), ("TOPPADDING", (0,0), (-1,-1), 18), ("BOTTOMPADDING", (0,0), (-1,-1), 14), ("LEFTPADDING", (0,0), (-1,-1), 14), ("RIGHTPADDING", (0,0), (-1,-1), 14), ("ROUNDEDCORNERS", [6]), ])) return cover_tbl # ════════════════════════════════════════════════════════════════════════════ # BUILD STORY # ════════════════════════════════════════════════════════════════════════════ story = [] # Cover story.append(cover_block()) story.append(sp(14)) # ── 1. DEFINITION ──────────────────────────────────────────────────────────── story.append(section_header("1. Definition")) story.append(sp(6)) story.append(Paragraph( "The term <b>psychiatric rating scales</b> encompasses a variety of questionnaires, interviews, " "checklists, outcome assessments, and other instruments available to inform psychiatric practice, " "research, and administration. They are distinct from free-form clinical notes in that they apply " "a standardized, structured approach to measuring mental states, symptoms, behaviors, and " "functional capacity.", body)) story.append(sp(4)) # ── 2. WHY RATING SCALES MATTER ───────────────────────────────────────────── story.append(section_header("2. Importance of Rating Scales")) story.append(sp(6)) items = [ "<b>Standardization</b> – Ensures consistent, comprehensive evaluation across time and different " "observers; especially valuable in group practices, inpatient wards, and multicenter research.", "<b>Baseline and longitudinal tracking</b> – Objective monitoring of illness progression or " "treatment response.", "<b>Diagnostic aid</b> – Help establish diagnoses, ensure thorough symptom review, and identify " "comorbid conditions.", "<b>Healthcare administration</b> – Payors increasingly require standardized assessments to " "justify clinical services and demonstrate treatment efficacy.", "<b>Research</b> – Backbone of psychiatric clinical trials; familiarity deepens understanding of " "published results.", "<b>Practical efficiency</b> – Self-administered scales can be completed in the waiting room; ease " "inquiry into sensitive areas such as sexual side effects or cognitive decline.", ] for i in items: story.append(bp(i)) story.append(sp(6)) # ── 3. LIMITATIONS ────────────────────────────────────────────────────────── story.append(section_header("3. Limitations")) story.append(sp(6)) lims = [ "Not a replacement for clinical judgment.", "Can produce erroneous measurements due to difficulties in administration or measurement error.", "May give a spurious sense of precision.", "Time-consuming if used indiscriminately.", "Published reliability estimates may not generalize across all clinical settings.", ] for l in lims: story.append(bp(l)) story.append(sp(6)) # ── 4. PSYCHOMETRIC PROPERTIES ─────────────────────────────────────────────── story.append(section_header("4. Psychometric Properties")) story.append(sp(6)) story.append(sub_header("4.1 Reliability")) story.append(Paragraph( "Reliability refers to the consistency and repeatability of ratings across raters, time points, and conditions.", body)) rel_data = [ ["Internal Consistency", "Agreement among individual items measuring the same construct (e.g., Cronbach's alpha)"], ["Interrater Reliability", "Agreement between two or more observers evaluating the same patient with the same information"], ["Test-Retest Reliability", "Reproducibility of ratings when the same patient is assessed at two time points under stable conditions"], ] story.append(make_table(["Type", "Description"], rel_data, [W*0.32, W*0.68])) story.append(sp(8)) story.append(sub_header("4.2 Validity")) story.append(Paragraph( "Validity refers to how accurately the scale measures what it is supposed to measure.", body)) val_data = [ ["Criterion (Concurrent) Validity", "Correlation with an established gold standard"], ["Construct Validity", "Comparison to external validators when no gold standard exists (course of illness, family history, treatment response)"], ["Discriminant Validity", "Ability to separate populations expected to differ on the construct"], ["Sensitivity to Change", "Ability to detect expected changes with treatment or disease progression"], ] story.append(make_table(["Type", "Description"], val_data, [W*0.35, W*0.65])) story.append(sp(6)) story.append(Paragraph( "<i>For continuous measures: correlation coefficients are used. For categorical measures (diagnoses): " "sensitivity, specificity, predictive value positive, and predictive value negative are employed.</i>", note_style)) story.append(sp(8)) # ── 5. CLASSIFICATION ──────────────────────────────────────────────────────── story.append(section_header("5. Classification of Rating Scales")) story.append(sp(6)) story.append(sub_header("A. By Measurement Goals")) goal_data = [ ["Diagnostic", "Assign or rule out a diagnosis", "SCID, MINI"], ["Severity / Symptom Rating", "Quantify current symptom burden", "HAM-D, PANSS, YMRS"], ["Screening", "Detect possible cases in a population", "PHQ-9, GAD-7"], ["Functional / Outcome", "Measure disability or quality of life", "WHODAS 2.0, GAF"], ] story.append(make_table(["Category", "Purpose", "Examples"], goal_data, [W*0.22, W*0.44, W*0.34])) story.append(sp(8)) story.append(sub_header("B. By Type of Construct")) con_data = [ ["Categorical", "Presence or absence of an attribute (e.g., competency, diagnosis)"], ["Continuous", "Quantitative measure along a severity continuum (mild / moderate / severe)"], ["Ordinal", "Ordered categories (e.g., unaffected, mild, moderate, severe)"], ] story.append(make_table(["Construct Type", "Description"], con_data, [W*0.3, W*0.7])) story.append(sp(8)) story.append(sub_header("C. By Rater")) rater_data = [ ["Clinician-Rated (Observer-Rated)", "Completed by trained clinician based on interview and observation"], ["Self-Report", "Completed by the patient; useful for screening and subjective symptom monitoring"], ["Informant-Rated", "Information from caregiver/relative; preferred when insight is limited (e.g., mania, dementia)"], ["Lay-Administered", "Can be administered by non-clinicians with limited training"], ] story.append(make_table(["Type", "Description"], rater_data, [W*0.35, W*0.65])) story.append(sp(8)) story.append(sub_header("D. By Format")) fmt_data = [ ["Checklist", "Simple yes/no observation guide"], ["Structured Interview", "Fully scripted questions with exact wording"], ["Semi-Structured Interview", "Provides some specific wording with room for follow-up probes"], ["Rating Inventory", "Patient/clinician rates items on a numerical scale"], ] story.append(make_table(["Format", "Description"], fmt_data, [W*0.35, W*0.65])) story.append(sp(8)) # ── 6. SCALES BY DIAGNOSTIC DOMAIN ────────────────────────────────────────── story.append(section_header("6. Specific Rating Scales by Diagnostic Domain")) story.append(sp(6)) # 6.1 Global story.append(sub_header("6.1 Global / Functional Assessment")) g_data = [ ["GAF", "Global Assessment of Functioning", "Clinician-rated", "DSM-IV Axis V; 0-100; not retained in DSM-5 but widely used"], ["WHODAS 2.0", "WHO Disability Assessment Schedule", "Self-report / Proxy", "36 items; 6 domains; score 0-100; recommended by DSM-5"], ["BASIS-24", "Behavior & Symptom Identification Scale", "Self-report", "24 items; broad psychiatric symptoms + functional status from patient perspective"], ] story.append(make_table(["Scale", "Full Name", "Type", "Key Features"], g_data, [W*0.12, W*0.28, W*0.18, W*0.42])) story.append(sp(8)) # 6.2 Psychosis story.append(sub_header("6.2 Schizophrenia Spectrum / Psychotic Disorders")) p_data = [ ["BPRS", "Brief Psychiatric Rating Scale", "18-24", "Clinician-rated", "Each item rated 1-7; covers somatic concern, anxiety, emotional withdrawal, conceptual disorganization, hallucinations, delusions, etc."], ["PANSS", "Positive and Negative Syndrome Scale", "30", "Clinician-rated", "Positive (7) + Negative (7) + General Psychopathology (16); each item 1-7; most widely used in antipsychotic trials"], ["SAPS", "Scale for Assessment of Positive Symptoms", "-", "Clinician-rated", "Hallucinations, delusions, bizarre behavior, thought disorder"], ["SANS", "Scale for Assessment of Negative Symptoms", "-", "Clinician-rated", "Affective flattening, poverty of speech, apathy, anhedonia, inattentiveness"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], p_data, [W*0.09, W*0.23, W*0.07, W*0.16, W*0.45])) story.append(sp(4)) story.append(Paragraph( "<i>SAPS and SANS are used in tandem and mainly employed to monitor treatment effects in clinical research.</i>", note_style)) story.append(sp(8)) # 6.3 Depression story.append(sub_header("6.3 Mood Disorders - Depression")) d_data = [ ["HAM-D", "Hamilton Rating Scale for Depression", "17 (std) / 24", "Clinician-rated", "Focus on somatic symptoms; 15-20 min; gold standard in pharmacological trials; less reliable in elderly/medically ill"], ["MADRS", "Montgomery-Asberg Depression Rating Scale", "10", "Clinician-rated", "Designed to be sensitive to change; useful in treatment trials"], ["BDI-II", "Beck Depression Inventory-II", "21", "Self-report", "Behavioral & cognitive dimensions; covers past 2 weeks; 5-10 min"], ["PHQ-9", "Patient Health Questionnaire-9", "9", "Self-report", "DSM-based; score 0-27; score ≥10 = moderate depression; widely used in primary care"], ["IDS", "Inventory of Depressive Symptomatology", "30", "Clinician / Self", "Better coverage of reverse neurovegetative signs than HAM-D"], ["EPDS", "Edinburgh Postnatal Depression Scale", "10", "Self-report", "Validated specifically for perinatal depression"], ["GDS", "Geriatric Depression Scale", "30 / 15", "Self-report", "Designed for elderly; avoids somatic items overlapping with medical illness"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], d_data, [W*0.1, W*0.24, W*0.08, W*0.14, W*0.44])) story.append(sp(8)) # 6.4 Mania story.append(sub_header("6.4 Mood Disorders - Mania / Bipolar")) m_data = [ ["YMRS", "Young Mania Rating Scale", "11", "Clinician-rated", "Gold standard for mania; 4 items double-weighted (irritability, speech, thought content, disruptive-aggressive behavior); widely used in clinical trials"], ["ASRM", "Altman Self-Rating Mania Scale", "5", "Self-report", "Quick screening tool for manic symptoms"], ["MRS", "Mania Rating Scale", "-", "Clinician-rated", "Older instrument; less commonly used now"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], m_data, [W*0.1, W*0.24, W*0.08, W*0.14, W*0.44])) story.append(sp(8)) # 6.5 Anxiety story.append(sub_header("6.5 Anxiety Disorders")) a_data = [ ["HAM-A", "Hamilton Anxiety Rating Scale", "14", "Clinician-rated", "Rates psychic and somatic anxiety; developed 1959"], ["GAD-7", "Generalized Anxiety Disorder 7-item", "7", "Self-report", "DSM-based; score 0-21; ≥10 = moderate anxiety; primary care standard"], ["BAI", "Beck Anxiety Inventory", "21", "Self-report", "Focus on somatic symptoms of anxiety"], ["PDSS", "Panic Disorder Severity Scale", "7", "Clinician-rated", "Multicenter validated; assesses panic frequency and severity"], ["PROMIS Anxiety", "Patient Reported Outcomes Measurement Information System", "-", "Self-report", "Recommended in DSM-5; computer adaptive testing available"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], a_data, [W*0.1, W*0.26, W*0.07, W*0.14, W*0.43])) story.append(sp(8)) # 6.6 OCD story.append(sub_header("6.6 OCD and Related Disorders")) o_data = [ ["Y-BOCS", "Yale-Brown Obsessive Compulsive Scale", "10", "Clinician-rated", "Gold standard for OCD; 5 obsession items + 5 compulsion items; each 0-4; total 0-40; developed 1989"], ["OCI-R", "Obsessive Compulsive Inventory - Revised", "18", "Self-report", "Screens for OCD subtypes"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], o_data, [W*0.1, W*0.24, W*0.08, W*0.14, W*0.44])) story.append(sp(8)) # 6.7 PTSD story.append(sub_header("6.7 PTSD and Trauma-Related Disorders")) pt_data = [ ["CAPS", "Clinician-Administered PTSD Scale", "-", "Clinician-rated", "Gold standard for PTSD diagnosis and severity; rates frequency and intensity of each DSM criterion"], ["PCL-5", "PTSD Checklist for DSM-5", "20", "Self-report", "20 items corresponding to DSM-5 PTSD criteria; score 0-80"], ["IES-R", "Impact of Event Scale - Revised", "22", "Self-report", "Assesses intrusion, avoidance, hyperarousal"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], pt_data, [W*0.1, W*0.24, W*0.08, W*0.14, W*0.44])) story.append(sp(8)) # 6.8 Substance story.append(sub_header("6.8 Substance Use Disorders")) su_data = [ ["AUDIT", "Alcohol Use Disorders Identification Test", "10", "Self-report", "WHO developed; screens for hazardous alcohol use; score ≥8 = risky use"], ["CAGE", "Cut-Annoyed-Guilty-Eye opener", "4", "Self-report", "Quick screening for alcohol dependence"], ["DAST-10", "Drug Abuse Screening Test", "10", "Self-report", "Non-alcohol drug use screening"], ["CIWA-Ar", "Clinical Institute Withdrawal Assessment for Alcohol", "10", "Clinician-rated", "Assesses alcohol withdrawal severity; guides treatment decisions"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], su_data, [W*0.1, W*0.26, W*0.07, W*0.14, W*0.43])) story.append(sp(8)) # 6.9 Cognitive story.append(sub_header("6.9 Cognitive Disorders / Dementia")) c_data = [ ["MMSE", "Mini Mental State Examination", "30", "Clinician-rated", "Screens orientation, registration, attention, recall, language, visuospatial; score ≥24 = normal"], ["MoCA", "Montreal Cognitive Assessment", "30", "Clinician-rated", "More sensitive than MMSE for mild cognitive impairment; assesses 8 domains"], ["CDR", "Clinical Dementia Rating", "-", "Clinician-rated", "Stages dementia 0 (normal) to 3 (severe) across 6 domains"], ["ADAS-Cog", "Alzheimer's Disease Assessment Scale - Cognitive", "11", "Clinician-rated", "Used in Alzheimer's drug trials"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], c_data, [W*0.1, W*0.28, W*0.07, W*0.14, W*0.41])) story.append(sp(8)) # 6.10 Personality story.append(sub_header("6.10 Personality Assessment (Broadband Measures)")) pe_data = [ ["MMPI-2/3", "Minnesota Multiphasic Personality Inventory", "567 (MMPI-2)", "Self-report", "10 clinical scales; widely used in forensic and research settings"], ["PAI", "Personality Assessment Inventory", "344", "Self-report", "22 scales including validity indicators"], ["PCL-R", "Psychopathy Checklist - Revised (Hare)", "20", "Clinician-rated", "Rated from records + interview; gold standard for psychopathy assessment"], ] story.append(make_table(["Scale", "Full Name", "Items", "Type", "Key Features"], pe_data, [W*0.1, W*0.28, W*0.1, W*0.14, W*0.38])) story.append(sp(8)) # 6.11 Side Effects story.append(sub_header("6.11 Side Effects / Medication Monitoring")) se_data = [ ["UKU", "UKU Side Effect Rating Scale", "Clinician-rated", "Comprehensive assessment of psychotropic side effects"], ["AIMS", "Abnormal Involuntary Movement Scale", "Clinician-rated", "Rates tardive dyskinesia; 12 items; mandatory monitoring for long-term antipsychotics"], ["SAS", "Simpson-Angus Scale", "Clinician-rated", "Rates drug-induced parkinsonism / extrapyramidal side effects (EPS)"], ["BARS", "Barnes Akathisia Rating Scale", "Clinician-rated", "Rates drug-induced akathisia; includes objective + subjective + global items"], ] story.append(make_table(["Scale", "Full Name", "Type", "Key Features"], se_data, [W*0.1, W*0.27, W*0.18, W*0.45])) story.append(sp(8)) # 6.12 Suicide story.append(sub_header("6.12 Suicide Risk Assessment")) ssu_data = [ ["C-SSRS", "Columbia Suicide Severity Rating Scale", "Clinician-rated", "Assesses ideation (5 types) and behavior (4 types); FDA-required in drug trials"], ["SBQ-R", "Suicidal Behaviors Questionnaire - Revised", "Self-report", "4 items: lifetime ideation, frequency, communication, likelihood"], ["SAD PERSONS", "-", "Clinician mnemonic", "10-point scale: Sex, Age, Depression, Previous attempt, EtOH, Rational thinking loss, Social support lacking, Organized plan, No spouse, Sickness"], ] story.append(make_table(["Scale", "Full Name", "Type", "Key Features"], ssu_data, [W*0.12, W*0.27, W*0.16, W*0.45])) story.append(sp(8)) # 6.13 ADHD story.append(sub_header("6.13 ADHD")) ad_data = [ ["CAARS", "Conners' Adult ADHD Rating Scale", "Self / Observer", "Rates ADHD symptoms in adults"], ["Conners' Rating Scales", "-", "Parent / Teacher report", "Standard for childhood ADHD assessment"], ["SNAP-IV", "Swanson, Nolan and Pelham Rating Scale", "Self-report", "Based on DSM-IV criteria for ADHD and ODD"], ] story.append(make_table(["Scale", "Full Name", "Type", "Key Features"], ad_data, [W*0.15, W*0.28, W*0.2, W*0.37])) story.append(sp(8)) # 6.14 Eating Disorders story.append(sub_header("6.14 Eating Disorders")) ed_data = [ ["EDE-Q", "Eating Disorder Examination Questionnaire", "Self-report", "Assesses eating disorder psychopathology across 4 subscales"], ["EAT-26", "Eating Attitudes Test", "Self-report", "Screens for eating disorders; 26 items"], ["BITE", "Bulimic Investigatory Test Edinburgh", "Self-report", "Screens specifically for bulimia nervosa"], ] story.append(make_table(["Scale", "Full Name", "Type", "Key Features"], ed_data, [W*0.12, W*0.31, W*0.15, W*0.42])) story.append(sp(8)) # ── 7. SUMMARY TABLE ───────────────────────────────────────────────────────── story.append(PageBreak()) story.append(section_header("7. Quick Reference Summary Table")) story.append(sp(6)) sum_data = [ ["Global Functioning", "GAF, WHODAS 2.0", "WHODAS 2.0"], ["Psychosis", "BPRS, PANSS, SAPS/SANS", "-"], ["Depression", "HAM-D, MADRS", "PHQ-9, BDI-II"], ["Mania", "YMRS", "ASRM"], ["Anxiety (General)", "HAM-A", "GAD-7, BAI"], ["OCD", "Y-BOCS", "OCI-R"], ["PTSD", "CAPS", "PCL-5, IES-R"], ["Alcohol Use", "CIWA-Ar", "AUDIT, CAGE"], ["Drug Use", "-", "DAST-10"], ["Cognition", "MMSE, MoCA, CDR", "-"], ["Side Effects (EPS/TD)", "SAS, AIMS, BARS", "-"], ["Suicide Risk", "C-SSRS", "SBQ-R"], ["Personality", "PCL-R", "MMPI-2/3, PAI"], ] story.append(make_table(["Domain", "Clinician-Rated", "Self-Report"], sum_data, [W*0.3, W*0.38, W*0.32])) story.append(sp(12)) # ── 8. EXAM KEY POINTS ─────────────────────────────────────────────────────── story.append(section_header("8. Key Points to Remember (Exam-Relevant)")) story.append(sp(6)) key_points = [ "<b>HAM-D</b> - Most widely used for depression in pharmacological trials; clinician-rated; 17-item version standard; developed by Max Hamilton (1960).", "<b>PANSS</b> - Most widely used for antipsychotic trials; 30 items; positive (7) + negative (7) + general (16); each item rated 1-7.", "<b>YMRS</b> - Gold standard for mania severity; 11 items; 4 items are double-weighted (irritability, speech, thought content, disruptive-aggressive behavior).", "<b>Y-BOCS</b> - Gold standard for OCD; 10 items (5 obsession + 5 compulsion); total score 0-40; developed 1989.", "<b>CAPS</b> - Gold standard for PTSD; clinician-administered; rates both frequency and intensity of each DSM criterion.", "<b>C-SSRS</b> - FDA-required in most psychotropic drug trials for suicide monitoring; assesses 5 types of ideation and 4 types of behavior.", "<b>MoCA</b> - Superior to MMSE for mild cognitive impairment detection; assesses 8 cognitive domains.", "<b>AIMS</b> - Mandatory monitoring tool for patients on long-term antipsychotics; detects tardive dyskinesia.", "<b>WHODAS 2.0</b> - DSM-5 recommended replacement for GAF; 36 items; 6 domains; score 0-100.", "<b>PHQ-9</b> - 9-item DSM-based depression screener; score ≥10 suggests moderate depression; widely used in primary care.", "<b>GAD-7</b> - 7-item generalized anxiety screener; score ≥10 suggests moderate anxiety.", "<b>CIWA-Ar</b> - Clinician-rated alcohol withdrawal assessment; directly guides management decisions.", ] for k in key_points: story.append(Paragraph(f"&#10003; &nbsp; {k}", key_style)) story.append(sp(3)) story.append(sp(14)) story.append(hr()) story.append(Paragraph( "Sources: Kaplan &amp; Sadock's Comprehensive Textbook of Psychiatry (10th ed.) | " "Kaplan &amp; Sadock's Synopsis of Psychiatry (11th ed.)", note_style)) # ── BUILD ──────────────────────────────────────────────────────────────────── doc.build(story) print(f"PDF saved to: {OUTPUT}") PYEOF echo "Script written."

cd /tmp/workspace/rating-scales-pdf && python generate_pdf.py

ls -lh /tmp/workspace/rating-scales-pdf/Rating_Scales_in_Psychiatry.pdf