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Table 1 Study questionnaire

From: Prevalence of elevated serum anti-N-methyl-D-aspartate receptor antibody titers in patients presenting exclusively with psychiatric symptoms: a comparative follow-up study

ID: Initial: Sex: Age:
Blood pressure, Pulse rate, Body temperature
Japan coma scale
(1) DSM-IV diagnosis:
(2) Precedent infectious symptoms (fever/headache/throat pain/diarrhea)
(3) The first episode or the exacerbation
 3–1) How much time had passed from the onset of symptoms until receiving a medical examination?
 3–2) How long have you been under psychiatric care in the hospital?
  less than 1 month/less than 3 months/less than 1 year
  less than 5 years/less than 10 years/more than 10 years
 3–3) How many times did your symptoms exacerbate?
two/three/four/five/more than five
(4) Psychiatric symptom(s) (possible plural answers)
 a) anxiety/depression symptom
  irritation/anxiety/depressive mood/depersonalization
  sleep disorder/will drop/concentration drop/suicidal feeling
 b) mania symptom
  hyperthymia/hyperlogia/hyperactivity/flight of idea
 c) schizophrenia-like symptom
  auditory hallucination/visual hallucination/delusion/obfuscation
  excitement/echolalia/echopraxia/stereotypic language
  stereotypic movement/catalepsy/idle–autosynnoia/flattened feeling
(5) Neurological symptom(s)
 convulsions/orolingual dyskinesia/systemic dyskinesia/eyeball dyskinesia
 instability of blood pressure and pulse/sweat and drooling abnormality
 respiratory depression/disorientation/amnesia