The first part of this page contains the information about the variable from the CPHN Guide for Common Indicators for Canadian Physician Health Programs, version v1.0. CPHN is editing the guide and will eventually produce a new version, v1.1. Concurrently, we are also writing a new version of the guide, for use with CiviCase. We will call this stream v2.0.

Presenting Problem

v1.0 (Refers to CPHN indicator 7 "Presenting Problem")

This is the reason that the individual contacted the PHP and it is recorded based on the assessment of the PHP at the point of first contact. Presenting problems are organized into the seven groups described in the table below, Primary category presenting problem. Within each primary category, additional details about the problem can be provided by making one or more selections.

Psychiatric diagnoses are recorded only if the individual has been diagnosed according to DSMIV criteria, presenting with an existing diagnosis. This grouping should not be selected if the client has self-diagnosed. Further it is not intended to capture an on-the-spot intake diagnosis. A separate list is provided for mental health problems not formally diagnosed accordning to DSMIV criteria.

The CPNH guidlines state: Designate ONE category of problems as the "Primary" presenting problem, and indicate as many problems or sub-categories as apply from the additional details. When a standardized measurement scale is used to measure or diagnose a client's presenting problem, indicate the problem(s) and list the scale(s) used.

Problem Category	Check all that apply (√)	Problem Duration (months)	Definition
1. Addictive Disorders			Includes substance abuse, dependence, gambling, sexually compulsive behaviours, and dual disorders.
1.1 Substance abuse			Problem drug use that meets DSM diagnostic criteria for abuse (see also table for variable 13: Problem Drugs)
1.2 Substance dependence			Dependence on a drug that that meets DSM diagnostic criteria at time of contact.
1.3 Gambling			Difficulties with lack of control over gambling behaviour that is producing problems for the client.
1.4 Sexually compulsive behaviour			Difficulties with lack of control over sexual behaviour that is producing problems for the client.
1.5 Dual disorders			Co-occurrence of at least one addictive problem and at least one psychiatric/psychological problem.
1.6 Other addictive behaviours			Specify
2. Psychiatric Disorders (DSM criteria met)			Past or current psychiatric diagnosis at time of presenting to PHP.
2.1 Mood disorders			Including major depression, dysthymia, bipolar disorder, schizo-affective disorder.
2.2 Anxiety disorders			Anxiety including panic disorder, GAD, acute stress disorder, PTSD, OCD, etc.
2.3 Personality disorders			Pattern of experience and behaviour that is pervasive and inflexible; examples include borderline, narcissistic, antisocial, paranoid personality disorder.
2.4 Eating disorders			Severe disturbances in eating behaviour - e.g. anorexia nervosa and bulimia nervosa.
2.5 Other psychiatric problem(s)			Please specify according to DSM diagnostic criteria.
3. Mental Health (no formal Dx)			Stress, anxiety, depression, and other emotional problems, not formally diagnosed by DSM criteria.
3.1 Anxiety, stress			Disturbed function or reaction of individual as a result of adverse stimuli, or self-identified anxiety.
3.2 Depression			Self-identified low-mood
3.3 Suicide ideation			Troubling thoughts of suicide
3.4 Suicide attempt			Client has attempted suicide
3.5 Other mental health			Specify
4. Occupational Issues			All presenting problems that relate to the workplace including harassment, abuse, complaints, audits, relationships.
4.1 Emotional abuse - subject of			Subject of verbal abuse or harassment causing emotional distress in the workplace involving supervisors, colleagues or patients.
4.2 Sexual abuse - subject of			Subject of sexual suggestion or innuendo and/or physical touching in the workplace
4.3 Physical abuse - subject of			Subject of hitting or other physical violence in the workplace
4.4 Emotional abuse - perpetrator of			Perpetrator of verbal abuse or harassment causing emotional distress in the workplace involving supervisors, colleagues or patients.
4.5 Physical abuse - perpetrator of			Perpetrator of sexual suggestion or innuendo and/or physical touching in the workplace involving patients or colleagues
4.6 Sexual abuse - perpetrator of			Perpetrator of hitting or other physical violence in the workplace involving patients or colleagues
4.7 Disruptive behaviour - perpetrator of			Causing disruption in the workplace by lack of cooperation with colleagues and/or co-workers
4.8 Workplace relationships			Distress related to difficulties in getting along with one or more co-workers
4.9 Occupational stress or burnout			Burnout and problems related to workload, scheduling, shifts, insufficient resources
4.10 Occupation or job change			Requires guidance in change of job or occupation
4.11 Retirement			Help with planning retirement, or difficulties in dealing with life changes accompanying retirement
4.12 Other occupational issues			Specify
Legal and Licensing Issues
4.13 Audit			Random practice audit - generally as arising form Peer Assessment Programs or College Quality Assurance programs
4.14 Regulatory complaint			Patient complaint received by College giving rise to investigation
4.15 Professional boundary issues			Inappropriate boundaries with patients
4.16 Other regulatory issues			Examples include Registration considerations, seeking reinstatement of privileges or changing existing licensing restrictions
4.17 Practice related financial problems			Concerns related to management of practice finances or due to practice audits/repayments (e.g. Medican Review Committee, Revenue Canada)
4.18 Civil suit related to practice			Arising form patient who has pursued civil litigation related to allegations of substandard treatment - patient or other party seeking damages
4.19 Criminal charges related to practice			Arising from charges related to sexual abuse of a patient, fraud, narcotics offenses.
4.20 Other legal & licensing issues			Specify
5. Family - Relationship			Problems in relationships with spouse, partner, children. Caregiver issues and other family problems.
5.1 Marital/partner/relationship			Problems with spouse, partner, or romantic relationship, including separation or divorce.
5.2 Parenting			Problems in dealing with children.
5.3 Caregiver of parents, other			Problems relating to caring for parents or other relatives who need care, including time management, arranging of care, and emotional issues.
5.4 Domestic Violence			Experience of physical abuse in the home, victim or perpetrator.
5.5 Other family problems			Specify
6. Physical / Medical / Cognitive			Physical disabilities, blood borne pathogens, chronic pain, other chronic conditions incl. Cognitive issues
6.1 Physical disability			Chronic physical disability that interferes with work or other aspects of life
6.2 Blood borne pathogen			e.g. HIV, Hep C, Hep B
6.3 Chronic pain			Chronic pain that interferes with work or other aspects of life
6.4 Other medical problem(s)			Specify
6.5 Ageing
6.6 Neuro-degenerative illnesses
6.7 Other cognitive issues			Specify
7. Other personal (Non-occupational)			Problems experienced in personal life including abuse, civil litigation, financial, grief, and support
7.1 Emotional abuse - subject of			Subject of verbal abuse or harassment causing emotional distress outside of the workplace setting.
7.2 Sexual abuse - subject of			Subject of unwanted sexual verbal suggestions or innuendo and/or physical touching in outside of the workplace setting.
7.3 Physical abuse - subject of			Subject of hitting or other physical violence that does not involve spouse/partner outside of the workplace setting.
7.4 Emotional abuse - perpetrator of			Perpetrator of verbal abuse or harassment causing emotional distress outside of the workplace setting.
7.5 Physical abuse - perpetrator of			Perpetrator of sexual suggestion or innuendo and/or physical touching outside of the workplace setting.
7.6 Sexual abuse - perpetrator of			Perpetrator of hitting or other physical violence that does not involve spouse/partner outside of the workplace setting.
7.7 Personal financial troubles
7.8 Civil legal issues			May include lawsuits not related to practice - divorce proceedings, child custody etc.
7.9 Criminal legal issues			Criminal charges not related to practice - divorce proceedings, child custody etc.
7.10 Other personal			Specify

Presenting Problem

Presenting Problem

v1.0 (Refers to CPHN indicator 7 "Presenting Problem")

v2.0 (plans for CiviCRM)