#!/usr/bin/env python
"""
camcops_server/tasks/icd10specpd.py
===============================================================================
Copyright (C) 2012, University of Cambridge, Department of Psychiatry.
Created by Rudolf Cardinal (rnc1001@cam.ac.uk).
This file is part of CamCOPS.
CamCOPS is free software: you can redistribute it and/or modify
it under the terms of the GNU General Public License as published by
the Free Software Foundation, either version 3 of the License, or
(at your option) any later version.
CamCOPS is distributed in the hope that it will be useful,
but WITHOUT ANY WARRANTY; without even the implied warranty of
MERCHANTABILITY or FITNESS FOR A PARTICULAR PURPOSE. See the
GNU General Public License for more details.
You should have received a copy of the GNU General Public License
along with CamCOPS. If not, see <https://www.gnu.org/licenses/>.
===============================================================================
"""
from typing import Any, Dict, List, Optional, Tuple, Type
from cardinal_pythonlib.datetimefunc import format_datetime
import cardinal_pythonlib.rnc_web as ws
from cardinal_pythonlib.stringfunc import strseq
from cardinal_pythonlib.typetests import is_false
from sqlalchemy.ext.declarative import DeclarativeMeta
from sqlalchemy.sql.schema import Column
from sqlalchemy.sql.sqltypes import Boolean, Date, UnicodeText
from camcops_server.cc_modules.cc_constants import (
CssClass,
DateFormat,
ICD10_COPYRIGHT_DIV,
PV,
)
from camcops_server.cc_modules.cc_ctvinfo import CTV_INCOMPLETE, CtvInfo
from camcops_server.cc_modules.cc_db import add_multiple_columns
from camcops_server.cc_modules.cc_html import (
answer,
get_yes_no_none,
get_yes_no_unknown,
subheading_spanning_two_columns,
tr_qa,
)
from camcops_server.cc_modules.cc_request import CamcopsRequest
from camcops_server.cc_modules.cc_sqla_coltypes import (
BIT_CHECKER,
CamcopsColumn,
)
from camcops_server.cc_modules.cc_string import AS
from camcops_server.cc_modules.cc_summaryelement import SummaryElement
from camcops_server.cc_modules.cc_task import (
Task,
TaskHasClinicianMixin,
TaskHasPatientMixin,
)
# =============================================================================
# Icd10SpecPD
# =============================================================================
def ctv_info_pd(
req: CamcopsRequest, condition: str, has_it: Optional[bool]
) -> CtvInfo:
return CtvInfo(content=condition + ": " + get_yes_no_unknown(req, has_it))
class Icd10SpecPDMetaclass(DeclarativeMeta):
# noinspection PyInitNewSignature
def __init__(
cls: Type["Icd10SpecPD"],
name: str,
bases: Tuple[Type, ...],
classdict: Dict[str, Any],
) -> None:
add_multiple_columns(
cls,
"g",
1,
cls.N_GENERAL,
Boolean,
pv=PV.BIT,
comment_fmt="G{n}: {s}",
comment_strings=[
"pathological 1",
"pervasive",
"pathological 2",
"persistent",
"primary 1",
"primary 2",
],
)
add_multiple_columns(
cls,
"g1_",
1,
cls.N_GENERAL_1,
Boolean,
pv=PV.BIT,
comment_fmt="G1{n}: {s}",
comment_strings=[
"cognition",
"affectivity",
"impulse control",
"interpersonal",
],
)
add_multiple_columns(
cls,
"paranoid",
1,
cls.N_PARANOID,
Boolean,
pv=PV.BIT,
comment_fmt="Paranoid ({n}): {s}",
comment_strings=[
"sensitive",
"grudges",
"suspicious",
"personal rights",
"sexual jealousy",
"self-referential",
"conspiratorial",
],
)
add_multiple_columns(
cls,
"schizoid",
1,
cls.N_SCHIZOID,
Boolean,
pv=PV.BIT,
comment_fmt="Schizoid ({n}): {s}",
comment_strings=[
"little pleasure",
"cold/detached",
"limited capacity for warmth",
"indifferent to praise/criticism",
"little interest in sex",
"solitary",
"fantasy/introspection",
"0/1 close friends/confidants",
"insensitive to social norms",
],
)
add_multiple_columns(
cls,
"dissocial",
1,
cls.N_DISSOCIAL,
Boolean,
pv=PV.BIT,
comment_fmt="Dissocial ({n}): {s}",
comment_strings=[
"unconcern",
"irresponsibility",
"incapacity to maintain relationships",
"low tolerance to frustration",
"incapacity for guilt",
"prone to blame others",
],
)
add_multiple_columns(
cls,
"eu",
1,
cls.N_EU,
Boolean,
pv=PV.BIT,
comment_fmt="Emotionally unstable ({n}): {s}",
comment_strings=[
"act without considering consequences",
"quarrelsome",
"outbursts of anger",
"can't maintain actions with immediate reward",
"unstable/capricious mood",
"uncertain self-image",
"intense/unstable relationships",
"avoids abandonment",
"threats/acts of self-harm",
"feelings of emptiness",
],
)
add_multiple_columns(
cls,
"histrionic",
1,
cls.N_HISTRIONIC,
Boolean,
pv=PV.BIT,
comment_fmt="Histrionic ({n}): {s}",
comment_strings=[
"theatricality",
"suggestibility",
"shallow/labile affect",
"centre of attention",
"inappropriately seductive",
"concerned with attractiveness",
],
)
add_multiple_columns(
cls,
"anankastic",
1,
cls.N_ANANKASTIC,
Boolean,
pv=PV.BIT,
comment_fmt="Anankastic ({n}): {s}",
comment_strings=[
"doubt/caution",
"preoccupation with details",
"perfectionism",
"excessively conscientious",
"preoccupied with productivity",
"excessive pedantry",
"rigid/stubborn",
"require others do things specific way",
],
)
add_multiple_columns(
cls,
"anxious",
1,
cls.N_ANXIOUS,
Boolean,
pv=PV.BIT,
comment_fmt="Anxious ({n}), {s}",
comment_strings=[
"tension/apprehension",
"preoccupied with criticism/rejection",
"won't get involved unless certain liked",
"need for security restricts lifestyle",
"avoidance of interpersonal contact",
],
)
add_multiple_columns(
cls,
"dependent",
1,
cls.N_DEPENDENT,
Boolean,
pv=PV.BIT,
comment_fmt="Dependent ({n}): {s}",
comment_strings=[
"others decide",
"subordinate needs to those of others",
"unwilling to make reasonable demands",
"uncomfortable/helpless when alone",
"fears of being left to oneself",
"everyday decisions require advice/reassurance",
],
)
super().__init__(name, bases, classdict)
[docs]class Icd10SpecPD(
TaskHasClinicianMixin,
TaskHasPatientMixin,
Task,
metaclass=Icd10SpecPDMetaclass,
):
"""
Server implementation of the ICD10-PD task.
"""
__tablename__ = "icd10specpd"
shortname = "ICD10-PD"
info_filename_stem = "icd"
date_pertains_to = Column(
"date_pertains_to", Date, comment="Date the assessment pertains to"
)
comments = Column("comments", UnicodeText, comment="Clinician's comments")
skip_paranoid = CamcopsColumn(
"skip_paranoid",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for paranoid PD?",
)
skip_schizoid = CamcopsColumn(
"skip_schizoid",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for schizoid PD?",
)
skip_dissocial = CamcopsColumn(
"skip_dissocial",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for dissocial PD?",
)
skip_eu = CamcopsColumn(
"skip_eu",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for emotionally unstable PD?",
)
skip_histrionic = CamcopsColumn(
"skip_histrionic",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for histrionic PD?",
)
skip_anankastic = CamcopsColumn(
"skip_anankastic",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for anankastic PD?",
)
skip_anxious = CamcopsColumn(
"skip_anxious",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for anxious PD?",
)
skip_dependent = CamcopsColumn(
"skip_dependent",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Skip questions for dependent PD?",
)
other_pd_present = CamcopsColumn(
"other_pd_present",
Boolean,
permitted_value_checker=BIT_CHECKER,
comment="Is another personality disorder present?",
)
vignette = Column("vignette", UnicodeText, comment="Vignette")
N_GENERAL = 6
N_GENERAL_1 = 4
N_PARANOID = 7
N_SCHIZOID = 9
N_DISSOCIAL = 6
N_EU = 10
N_EUPD_I = 5
N_HISTRIONIC = 6
N_ANANKASTIC = 8
N_ANXIOUS = 5
N_DEPENDENT = 6
GENERAL_FIELDS = strseq("g", 1, N_GENERAL)
GENERAL_1_FIELDS = strseq("g1_", 1, N_GENERAL_1)
PARANOID_FIELDS = strseq("paranoid", 1, N_PARANOID)
SCHIZOID_FIELDS = strseq("schizoid", 1, N_SCHIZOID)
DISSOCIAL_FIELDS = strseq("dissocial", 1, N_DISSOCIAL)
EU_FIELDS = strseq("eu", 1, N_EU)
EUPD_I_FIELDS = strseq("eu", 1, N_EUPD_I) # impulsive
EUPD_B_FIELDS = strseq("eu", N_EUPD_I + 1, N_EU) # borderline
HISTRIONIC_FIELDS = strseq("histrionic", 1, N_HISTRIONIC)
ANANKASTIC_FIELDS = strseq("anankastic", 1, N_ANANKASTIC)
ANXIOUS_FIELDS = strseq("anxious", 1, N_ANXIOUS)
DEPENDENT_FIELDS = strseq("dependent", 1, N_DEPENDENT)
[docs] @staticmethod
def longname(req: "CamcopsRequest") -> str:
_ = req.gettext
return _("ICD-10 criteria for specific personality disorders (F60)")
[docs] def get_clinical_text(self, req: CamcopsRequest) -> List[CtvInfo]:
if not self.is_complete():
return CTV_INCOMPLETE
infolist = [
ctv_info_pd(
req,
self.wxstring(req, "meets_general_criteria"),
self.has_pd(),
),
ctv_info_pd(
req,
self.wxstring(req, "paranoid_pd_title"),
self.has_paranoid_pd(),
),
ctv_info_pd(
req,
self.wxstring(req, "schizoid_pd_title"),
self.has_schizoid_pd(),
),
ctv_info_pd(
req,
self.wxstring(req, "dissocial_pd_title"),
self.has_dissocial_pd(),
),
ctv_info_pd(
req, self.wxstring(req, "eu_pd_i_title"), self.has_eupd_i()
),
ctv_info_pd(
req, self.wxstring(req, "eu_pd_b_title"), self.has_eupd_b()
),
ctv_info_pd(
req,
self.wxstring(req, "histrionic_pd_title"),
self.has_histrionic_pd(),
),
ctv_info_pd(
req,
self.wxstring(req, "anankastic_pd_title"),
self.has_anankastic_pd(),
),
ctv_info_pd(
req,
self.wxstring(req, "anxious_pd_title"),
self.has_anxious_pd(),
),
ctv_info_pd(
req,
self.wxstring(req, "dependent_pd_title"),
self.has_dependent_pd(),
),
]
return infolist
[docs] def get_summaries(self, req: CamcopsRequest) -> List[SummaryElement]:
return self.standard_task_summary_fields() + [
SummaryElement(
name="meets_general_criteria",
coltype=Boolean(),
value=self.has_pd(),
comment="Meets general criteria for personality disorder?",
),
SummaryElement(
name="paranoid_pd",
coltype=Boolean(),
value=self.has_paranoid_pd(),
comment="Meets criteria for paranoid PD?",
),
SummaryElement(
name="schizoid_pd",
coltype=Boolean(),
value=self.has_schizoid_pd(),
comment="Meets criteria for schizoid PD?",
),
SummaryElement(
name="dissocial_pd",
coltype=Boolean(),
value=self.has_dissocial_pd(),
comment="Meets criteria for dissocial PD?",
),
SummaryElement(
name="eupd_i",
coltype=Boolean(),
value=self.has_eupd_i(),
comment="Meets criteria for EUPD (impulsive type)?",
),
SummaryElement(
name="eupd_b",
coltype=Boolean(),
value=self.has_eupd_b(),
comment="Meets criteria for EUPD (borderline type)?",
),
SummaryElement(
name="histrionic_pd",
coltype=Boolean(),
value=self.has_histrionic_pd(),
comment="Meets criteria for histrionic PD?",
),
SummaryElement(
name="anankastic_pd",
coltype=Boolean(),
value=self.has_anankastic_pd(),
comment="Meets criteria for anankastic PD?",
),
SummaryElement(
name="anxious_pd",
coltype=Boolean(),
value=self.has_anxious_pd(),
comment="Meets criteria for anxious PD?",
),
SummaryElement(
name="dependent_pd",
coltype=Boolean(),
value=self.has_dependent_pd(),
comment="Meets criteria for dependent PD?",
),
]
# noinspection PyUnresolvedReferences
def is_pd_excluded(self) -> bool:
return (
is_false(self.g1)
or is_false(self.g2)
or is_false(self.g3)
or is_false(self.g4)
or is_false(self.g5)
or is_false(self.g6)
or (
self.all_fields_not_none(self.GENERAL_1_FIELDS)
and self.count_booleans(self.GENERAL_1_FIELDS) <= 1
)
)
def is_complete_general(self) -> bool:
return self.all_fields_not_none(
self.GENERAL_FIELDS
) and self.all_fields_not_none(self.GENERAL_1_FIELDS)
def is_complete_paranoid(self) -> bool:
return self.all_fields_not_none(self.PARANOID_FIELDS)
def is_complete_schizoid(self) -> bool:
return self.all_fields_not_none(self.SCHIZOID_FIELDS)
def is_complete_dissocial(self) -> bool:
return self.all_fields_not_none(self.DISSOCIAL_FIELDS)
def is_complete_eu(self) -> bool:
return self.all_fields_not_none(self.EU_FIELDS)
def is_complete_histrionic(self) -> bool:
return self.all_fields_not_none(self.HISTRIONIC_FIELDS)
def is_complete_anankastic(self) -> bool:
return self.all_fields_not_none(self.ANANKASTIC_FIELDS)
def is_complete_anxious(self) -> bool:
return self.all_fields_not_none(self.ANXIOUS_FIELDS)
def is_complete_dependent(self) -> bool:
return self.all_fields_not_none(self.DEPENDENT_FIELDS)
# Meets criteria? These also return null for unknown.
def has_pd(self) -> Optional[bool]:
if self.is_pd_excluded():
return False
if not self.is_complete_general():
return None
return (
self.all_truthy(self.GENERAL_FIELDS)
and self.count_booleans(self.GENERAL_1_FIELDS) > 1
)
def has_paranoid_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_paranoid():
return None
return self.count_booleans(self.PARANOID_FIELDS) >= 4
def has_schizoid_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_schizoid():
return None
return self.count_booleans(self.SCHIZOID_FIELDS) >= 4
def has_dissocial_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_dissocial():
return None
return self.count_booleans(self.DISSOCIAL_FIELDS) >= 3
# noinspection PyUnresolvedReferences
def has_eupd_i(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_eu():
return None
return self.count_booleans(self.EUPD_I_FIELDS) >= 3 and self.eu2
def has_eupd_b(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_eu():
return None
return (
self.count_booleans(self.EUPD_I_FIELDS) >= 3
and self.count_booleans(self.EUPD_B_FIELDS) >= 2
)
def has_histrionic_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_histrionic():
return None
return self.count_booleans(self.HISTRIONIC_FIELDS) >= 4
def has_anankastic_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_anankastic():
return None
return self.count_booleans(self.ANANKASTIC_FIELDS) >= 4
def has_anxious_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_anxious():
return None
return self.count_booleans(self.ANXIOUS_FIELDS) >= 4
def has_dependent_pd(self) -> Optional[bool]:
hpd = self.has_pd()
if not hpd:
return hpd
if not self.is_complete_dependent():
return None
return self.count_booleans(self.DEPENDENT_FIELDS) >= 4
[docs] def is_complete(self) -> bool:
return (
self.date_pertains_to is not None
and (
self.is_pd_excluded()
or (
self.is_complete_general()
and (self.skip_paranoid or self.is_complete_paranoid())
and (self.skip_schizoid or self.is_complete_schizoid())
and (self.skip_dissocial or self.is_complete_dissocial())
and (self.skip_eu or self.is_complete_eu())
and (self.skip_histrionic or self.is_complete_histrionic())
and (self.skip_anankastic or self.is_complete_anankastic())
and (self.skip_anxious or self.is_complete_anxious())
and (self.skip_dependent or self.is_complete_dependent())
)
)
and self.field_contents_valid()
)
def pd_heading(self, req: CamcopsRequest, wstringname: str) -> str:
return f"""
<tr class="{CssClass.HEADING}">
<td colspan="2">{self.wxstring(req, wstringname)}</td>
</tr>
"""
def pd_skiprow(self, req: CamcopsRequest, stem: str) -> str:
return self.get_twocol_bool_row(
req, "skip_" + stem, label=self.wxstring(req, "skip_this_pd")
)
def pd_subheading(self, req: CamcopsRequest, wstringname: str) -> str:
return f"""
<tr class="{CssClass.SUBHEADING}">
<td colspan="2">{self.wxstring(req, wstringname)}</td>
</tr>
"""
def pd_general_criteria_bits(self, req: CamcopsRequest) -> str:
return f"""
<tr>
<td>{self.wxstring(req, "general_criteria_must_be_met")}</td>
<td><i><b>{get_yes_no_unknown(req, self.has_pd())}</b></i></td>
</tr>
"""
def pd_b_text(self, req: CamcopsRequest, wstringname: str) -> str:
return f"""
<tr>
<td>{self.wxstring(req, wstringname)}</td>
<td class="{CssClass.SUBHEADING}"></td>
</tr>
"""
def pd_basic_row(self, req: CamcopsRequest, stem: str, i: int) -> str:
return self.get_twocol_bool_row_true_false(
req, stem + str(i), self.wxstring(req, stem + str(i))
)
def standard_pd_html(self, req: CamcopsRequest, stem: str, n: int) -> str:
html = self.pd_heading(req, stem + "_pd_title")
html += self.pd_skiprow(req, stem)
html += self.pd_general_criteria_bits(req)
html += self.pd_b_text(req, stem + "_pd_B")
for i in range(1, n + 1):
html += self.pd_basic_row(req, stem, i)
return html
[docs] def get_task_html(self, req: CamcopsRequest) -> str:
h = self.get_standard_clinician_comments_block(req, self.comments)
h += f"""
<div class="{CssClass.SUMMARY}">
<table class="{CssClass.SUMMARY}">
"""
h += self.get_is_complete_tr(req)
h += tr_qa(
req.wappstring(AS.DATE_PERTAINS_TO),
format_datetime(
self.date_pertains_to, DateFormat.LONG_DATE, default=None
),
)
h += tr_qa(
self.wxstring(req, "meets_general_criteria"),
get_yes_no_none(req, self.has_pd()),
)
h += tr_qa(
self.wxstring(req, "paranoid_pd_title"),
get_yes_no_none(req, self.has_paranoid_pd()),
)
h += tr_qa(
self.wxstring(req, "schizoid_pd_title"),
get_yes_no_none(req, self.has_schizoid_pd()),
)
h += tr_qa(
self.wxstring(req, "dissocial_pd_title"),
get_yes_no_none(req, self.has_dissocial_pd()),
)
h += tr_qa(
self.wxstring(req, "eu_pd_i_title"),
get_yes_no_none(req, self.has_eupd_i()),
)
h += tr_qa(
self.wxstring(req, "eu_pd_b_title"),
get_yes_no_none(req, self.has_eupd_b()),
)
h += tr_qa(
self.wxstring(req, "histrionic_pd_title"),
get_yes_no_none(req, self.has_histrionic_pd()),
)
h += tr_qa(
self.wxstring(req, "anankastic_pd_title"),
get_yes_no_none(req, self.has_anankastic_pd()),
)
h += tr_qa(
self.wxstring(req, "anxious_pd_title"),
get_yes_no_none(req, self.has_anxious_pd()),
)
h += tr_qa(
self.wxstring(req, "dependent_pd_title"),
get_yes_no_none(req, self.has_dependent_pd()),
)
h += f"""
</table>
</div>
<div>
<p><i>Vignette:</i></p>
<p>{answer(ws.webify(self.vignette),
default_for_blank_strings=True)}</p>
</div>
<table class="{CssClass.TASKDETAIL}">
<tr>
<th width="80%">Question</th>
<th width="20%">Answer</th>
</tr>
"""
# General
h += subheading_spanning_two_columns(self.wxstring(req, "general"))
h += self.get_twocol_bool_row_true_false(
req, "g1", self.wxstring(req, "G1")
)
h += self.pd_b_text(req, "G1b")
for i in range(1, Icd10SpecPD.N_GENERAL_1 + 1):
h += self.get_twocol_bool_row_true_false(
req, "g1_" + str(i), self.wxstring(req, "G1_" + str(i))
)
for i in range(2, Icd10SpecPD.N_GENERAL + 1):
h += self.get_twocol_bool_row_true_false(
req, "g" + str(i), self.wxstring(req, "G" + str(i))
)
# Paranoid, etc.
h += self.standard_pd_html(req, "paranoid", Icd10SpecPD.N_PARANOID)
h += self.standard_pd_html(req, "schizoid", Icd10SpecPD.N_SCHIZOID)
h += self.standard_pd_html(req, "dissocial", Icd10SpecPD.N_DISSOCIAL)
# EUPD is special
h += self.pd_heading(req, "eu_pd_title")
h += self.pd_skiprow(req, "eu")
h += self.pd_general_criteria_bits(req)
h += self.pd_subheading(req, "eu_pd_i_title")
h += self.pd_b_text(req, "eu_pd_i_B")
for i in range(1, Icd10SpecPD.N_EUPD_I + 1):
h += self.pd_basic_row(req, "eu", i)
h += self.pd_subheading(req, "eu_pd_b_title")
h += self.pd_b_text(req, "eu_pd_b_B")
for i in range(Icd10SpecPD.N_EUPD_I + 1, Icd10SpecPD.N_EU + 1):
h += self.pd_basic_row(req, "eu", i)
# Back to plain ones
h += self.standard_pd_html(req, "histrionic", Icd10SpecPD.N_HISTRIONIC)
h += self.standard_pd_html(req, "anankastic", Icd10SpecPD.N_ANANKASTIC)
h += self.standard_pd_html(req, "anxious", Icd10SpecPD.N_ANXIOUS)
h += self.standard_pd_html(req, "dependent", Icd10SpecPD.N_DEPENDENT)
# Done
h += (
"""
</table>
"""
+ ICD10_COPYRIGHT_DIV
)
return h