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Protocol - Family History - Psychosis

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Protocol Name from Source:

Family Interview for Genetic Studies (FIGS)-Abbreviated Version

Availability:

Publicly available

Description:

The Family Interview for Genetic Studies (FIGS) is a tool used by a trained interviewer to collect information about biological relatives of the subject who has a mental disorder. The interview is conducted with the relatives themselves and not through the subject. There are three parts to the FIGS. The General Screening Questions gather general information about all known relatives. The Face Sheet is completed for each of the first-degree relatives and any affected relatives. This abbreviated version of the FIGS includes only a Symptom Checklist for psychosis.

Protocol:

GO FIGS Pedigree Drawing Instructions

v. 3.21.12

Begin with the FIGS General Screening Questions (p. 1), Step 1:

Let’s go over your family tree.

Have the pedigree form ready. Place in front of participant, and once constructed, keep it in front of participant throughout interview.

Pedigree Drawing.

1. In the middle of the page, draw a symbol for the participant (circle for female, square for males). This is you. (Write participant’s name under the symbol.)

2. If participant:

    a. Is only child: You told me that you have no brothers and sisters, is that correct? (If yes, above the participant’s symbol, draw a square for dad on the left, a circle for mom on the right, connect with line, and draw another line directly down to participant’s symbol. Proceed with instruction #3 below.)

    b. Has siblings. You told me that you had (insert number) siblings: (insert number) brothers and (insert number) sisters. Is that correct? (If yes, proceed; if not, correct.) Do they all have the same mother and father as you?

        i. YES (same biological parents): Determine where in birth order participant falls (First, second, third and so on). Above the participant’s symbol, draw a square for dad on the left, a circle for mom on the right, connect with line, and draw another line downward. From left to right, add symbols for the other full siblings from oldest (firstborn) to youngest around the proband. Write each sibling’s name underneath his/her symbol.

        ii. NO: "For this family tree, I am going to ask you only about full biological siblings: your brothers/sisters who have the same mom AND dad as you." For FULL sibs only, determine where in birth order participant falls (First, second, third and so on). From left to right, add symbols for the other full siblings from oldest (firstborn) to youngest around the proband. Write each sibling’s name underneath his/her symbol.

3. Do you have any children?

    a. YES: Draw a horizontal line from the participant to a partner, and drop down a line (or set of lines) to depict children. Write each child’s name underneath his/her symbol. Go to FIGS screener.

    b. NO: Go to FIGS screener.

Probandʼs Initials:

_______________________________________

ID:

_______________________________________

FAMID:

_______________________________________

Age:

_______________________________________

Assessor:

_______________________________________

Date:

_______________________________________

Start time:

_______________________________________

End time:

_______________________________________

v. 11/19/09

FIGS: Proband Pedigree

FIGS: GENERAL SCREENING QUESTIONS

Interview date:

- -

Month

Day

Year

Family last name:

Family ID number:

Informant name:

____________________ ____________________ ____________________
First MI Last

Informant ID:

INTERVIEWER: Before you begin, you need to generate or obtain a pedigree on which to record all of the responses to the following General Screening Questions. (See FIGS Manual for details.)

Step 1: Let’s go over your family tree. (Include first-degree relatives only: offspring, parents, siblings.)
Step 2: Now I am asking you to keep in mind all those in your family tree as I go through this list of questions. (Note all positive responses on the pedigree.)
    [ ] Was anyone adopted?
    [ ] Was anyone mentally retarded?
Did anyone:
    [ ] Have problems with their nerves or emotions? Take medicine or see a doctor for it? Take lithium?
    [ ] Feel very low for a couple of weeks or more, or have a diagnosis of depression?
    [ ] Attempt or complete suicide?
    [ ] Seem overexcited (or manic) day and night, or have a diagnosis of mania?
    [ ] **Have visions, hear voices, or have beliefs that seem strange or unreal?
    [ ] **Have unusual or bizarre behavior, or have a diagnosis of schizophrenia?
    [ ] Have trouble with the police, with completing school, or with keeping a job?
    [ ] Have alcohol or drug use that caused problems (with health, family, job, or police)? Go to AA or NA, or have treatment for this?
    [ ] (Was anyone) hospitalized for psychiatric problems, or for drug or alcohol problems?
    [ ] Have inherited medical diseases such as Huntington’s disease or seizure disorder or any other disorders of the brain or nervous system?
    [ ] **(Did anyone) have few friends, or seem to be a loner?
    [ ] **(Did anyone) seem odd or eccentric in behavior or appearance?
    [ ] **(Was anyone) extremely jealous, or suspicious, or believe in magic, or see special meanings in things that no one else saw?
Step 3: Complete a Face Sheet for each of the informant’s first-degree relatives.

FIGS: FACE SHEET

Interview date:

- -

Month

Day

Year

Family last name:

Family ID number:

Informant name:

____________________ ____________________ ____________________
First MI Last

Informant ID:

Person being described name:

____________________ ____________________ ____________________
First MI Last

Person being described ID:

Relationship to informant:

____________________________________________________________

Birthdate of person described, if known:

- -

Month

Day

Year

Is person described living?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

Age and Year when last seen or known about, or died:

in

Age

year

If deceased, cause of death::

____________________________________________________________

Suicide?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

INTERVIEWER: Refer to General Screening Questions if necessary.

1. Write narrative:

If any General Screening Questions endorsed about this relative, code 1 and transcribe details here. Complete psychosis checklist if any *starred* items endorsed.

0

1

9

FIGS: PSYCHOSIS CHECKLIST

Interview date:

- -

Month

Day

Year

Family last name:

Family ID number:

Informant name:

____________________ ____________________ ____________________
First MI Last

Informant ID:

Person being described name:

____________________ ____________________ ____________________
First MI Last

PSYCHOSIS

Code for a single episode (best recalled, worst episode if possible).

1. What were his/her unusual beliefs or experiences?

Specify: ____________________________________________________________________________

Did he/she ever…

No

Yes

Unk

1.a)

…believe people were following him/her, or that someone was trying to hurt or poison him/her?

0

1

9

1.b)

…believe someone was reading his/her mind?

0

1

9

1.c)

…believe he/she was under the control of some outside person or power or force?

0

1

9

1.d)

…believe his/her thoughts were broadcast, or that an outside force took away his/her thoughts or put thoughts into his/her head?

0

1

9

1.e)

…have any other strange or unusual beliefs?

0

1

9

If yes: Describe: _______________________________________________________________________

1.f)

…see things that were not really there?

0

1

9

1.g)

…hear voices or other sounds that were not real?

0

1

9

If yes: Describe: _______________________________________________________________________

If 1.g = 0, then skip to question 1.h

1.g.1)

(Code YES if: voice with content having no relation to depression or elation, or voice keeping up running commentary on subject’s behavior or thoughts, or two or more voices conversing.)

0

1

9

1.h)

…speak in a way that was difficult to make sense of?

0

1

9

If yes: Describe: _______________________________________________________________________

1.i)

…seem to be physically stuck in one position, or move around excitedly without purpose?

0

1

9

1.j)

…appear to have no emotions, or inappropriate emotions?

0

1

9

2. How long did the longest of these experiences last?

Weeks

INTERVIEWER: If less than 1 week (unless successfully treated), STOP HERE. Otherwise continue, if informant is knowledgeable about this person.

Code Response

6.

Code and describe professional treatment (Code and describe all that apply):

0

1

2

3

4

9

[ ] 0 None

[ ] 1 Inpatient: ___________________________________________________

[ ] 2 Outpatient: __________________________________________________

[ ] 3 ECT: _____________________________________________________

[ ] 4 Medication: __________________________________________________

[ ] 9 Unknown

Describe details and/or other treatment:

Age

7.

Age of onset:

Episodes

8.

Number of episodes (Code 001 if chronic symptoms and/or treatment since onset):

Weeks

Years

9.

Total illness duration (all episodes, includes active and prodromal and/or residual symptoms and/or treatment):

OR

Code Response

10. Rate and code impairment or incapacitation:

[ ] 0 None

[ ] 1 Impaired

[ ] 2 Incapacitated

[ ] 9 Unknown

11. Interviewer judgment on reliability of this information:

[ ] 1 Good

[ ] 2 Fair

[ ] 3 Poor

FIGS: PSYCHOSIS CHECKLIST

Interview date:

- -

Month

Day

Year

Family last name:

Family ID number:

Informant name:

____________________ ____________________ ____________________
First MI Last

Informant ID:

Person being described name:

____________________ ____________________ ____________________
First MI Last

Person being described ID:

PSYCHOSIS

Code for a single episode (best recalled, worst episode if possible).

1. What were his/her unusual beliefs or experiences?

Specify: ________________________________________________________________________________________________________________________

Did he/she ever…

1.a) …believe people were following him/her, or that someone was trying to hurt or poison him/her?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.b) …believe someone was reading his/her mind?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.c) …believe he/she was under the control of some outside person or power or force?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.d) …believe his/her thoughts were broadcast, or that an outside force took away his/her thoughts or put thoughts into his/her head?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.e) …have any other strange or unusual beliefs?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

If yes: Describe: ________________________________________________________________________________________________________________

1.f) …see things that were not really there?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.g) …hear voices or other sounds that were not real?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

If yes: Describe: ________________________________________________________________________________________________________________

If no: Skip to Question 1.h.

1.g.1) (Code YES if: Voice with content having no relation to depression or elation, or voice keeping up running commentary on subject’s behavior or thoughts, or two or more voices conversing.)

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.h) …speak in a way that was difficult to make sense of?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

If yes: Describe: ________________________________________________________________________________________________________________

1.i) …seem to be physically stuck in one position, or move around excitedly without any purpose?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

1.j) …appear to have no emotions, or inappropriate emotions?

[ ] 0 No

[ ] 1 Yes

[ ] 9 Unknown

2. How long did the longest of these experiences last?

Weeks

INTERVIEWER: If less than one week, unless successfully treated, STOP HERE. Otherwise continue, if informant is knowledgeable about this person.

3. Code and describe professional treatment (Code and describe all that apply):

[ ] 0 None

[ ] 1 Inpatient: ___________________________________________________

[ ] 2 Outpatient: __________________________________________________

[ ] 3 ECT: _____________________________________________________

[ ] 4 Medication: __________________________________________________

[ ] 9 Unknown

Describe details and/or other treatment: ___________________________________________________________________________________________

4.) Age of onset:

Age

5. Number of episodes (Code 001 if chronic symptoms and/or treatment since onset):

Episodes

6. Total illness duration (all episodes, includes active and prodromal and/or residual symptoms and/or treatment). OR

Weeks

Years

7. Rate and code impairment or incapacitation:

[ ] 0 None

[ ] 1 Impaired

[ ] 2 Incapacitated

[ ] 9 Unknown

8. Interviewer judgement on reliability of this information:

[ ] 1 Good

[ ] 2 Fair

[ ] 3 Poor

Personnel and Training Required

The interviewer must be trained to conduct personal psychiatric interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don’t know" response is provided.

Equipment Needs

The PhenX Working Group acknowledges these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire.

Requirements

Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualYes
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Self-administered

Life Stage:

Adult

Specific Instructions:

For a more detailed interview guide, one that includes symptom checklists for all mental disorders, the Early Psychosis Working Group recommends using the FIGS-Full Version (Family History - Multiple Mental Disorders protocol). A baseline assessment of this measure is an interview of a parent and the ill person. The optimal approach is to directly interview all available biological family members, at least out to second-degree relatives. It is important to gather this information from relatives because it can be difficult to rely on information obtained directly from the ill person. If not all relatives can be directly interviewed, one relative may be interviewed about all others.

Research Domain Information

Release Date:

January 17, 2017

Definition

An interview to collect family psychiatric information of a person with a mental illness.

Purpose

This measure can be used to characterize the diagnoses in first- and second-degree biological relatives of a person with a major mental illness. Family history in close relatives allows an assessment of genetic susceptibility and may be seen as a psychosocial measure of family burden of illness.

Selection Rationale

The use of the Family Interview for Genetic Studies (FIGS) has made it possible to advance in the performance of family studies for research in genetic psychiatry. The questionnaire is reliable and valid for gathering diagnostic information about relatives of a subject.

Language

English

Standards

StandardNameIDSource
Common Data Elements (CDE)Psychosis Family History Assessment Text5627336CDE Browser

Process and Review

The Expert Review Panel has not reviewed this measure yet.

Source

Calkins, M. E., Merikangas, K. R., Moore, T. M., Burstein, M., Behr, M. A., Satterthwaite, T. D., Ruparel, K., Wolf, D. H., Roalf, D. R., Mentch, F. D., Qiu, H., Chiavacci, R., Connolly, J. J., Sleiman, P. M., Gur, R. C., Hakonarson, H., & Gur, R. E. (2015). The Philadelphia Neurodevelopmental Cohort: Constructing a deep phenotyping collaborative. Journal of Child Psychology and Psychiatry, 56(12), 1356-1369.

General References

Maxwell, M. E. (1992). Family Interview for Genetic Studies (FIGS): Manual For FIGS. Bethesda, MD: Clinical Neurogenetics Branch, Intramural Research Program, National Institute of Mental Health.

Protocol ID:

660702

Variables:

Export Variables
Variable NameVariable IDVariable DescriptionVersiondbGaP Mapping