- 9 Questions Someone With Mental Illness Wishes You Would Ask
- 5 Questions Doctors Ask When Screening for Depression
- How to start the conversation
- Next Avenue Editors Also Recommend:
- 10 Introductory Questions Therapists Commonly Ask
- The Simple Questions That Really Help Depressed People
- About the author
- Screening questions
- Screening for specific psychiatric disorders
9 Questions Someone With Mental Illness Wishes You Would Ask
If you have family, friends or colleagues who live with mental illnesses, you may be unsure of how to speak to them in a respectful way. You want to show you care, but don’t know how to express your concern and not hurt the person at the same time.
- Can you help me understand what it’s like living with your condition?
- Is there anything you need from me or something I can do to help you?
- Can we do something together – get coffee, go for a walk or see a movie?
Just because the person has mental illness doesn’t mean he/she won’t want to do regular activities
- What is your diagnosis and how do you feel about it?
- Do you need to talk?
Sometimes talking can help make things feel a little better.
- What can I do to be there for you, and help you feel supported?
- How can I support you – can I listen to you, leave you alone, give you a hug?
- How has living with this condition shaped who you are today?
- How are you? You don’t seem like yourself, and I want to know how you’re really feeling because I care about you.
Help is available. For additional information, visit MagellanHealth.com/MYMH.
5 Questions Doctors Ask When Screening for Depression
Not everyone experiences the same warning signs of depression. Some people may endure sadness, hopelessness, feelings of guilt; others may lose interest in their favorite activities, have trouble thinking clearly, or face fatigue and changes in their sleeping or eating patterns. That’s why diagnosing depression isn’t always easy — and why doctors have developed a number of screening tools to help determine if you are at risk.
“Diagnosing depression requires a complete history and physical exam,” says Richard Shadick, PhD, associate adjunct professor of psychology and director of the counseling center at Pace University in New York City. Doctors must also rule out medical problems such as thyroid disease and consider coexisting emotional health issues like anxiety disorder, post traumatic stress, and substance abuse.
What goes into a depression screening? “There are many types of depression scales and depression screens,” explains Shadick. “The questions asked look for common symptoms as well as how much these symptoms might be affecting a person’s ability to function and maintain relationships.”
Which Depression Screening Will Your Doctor Use?
Two of the most commonly used standardized screening tools for depression are the Hamilton Depression Rating Scale (HAMD) and the Montgomery-Asberg Depression Rating Scale (MADRS). These depression screenings may also include questions that are specifically designed to screen the elderly or children.
Some doctors also rely on the Beck Depression Inventory and the nine-item Patient Health Questionnaire (PHQ-9). “These various screens may include questions about motivation, fatigue, sleep patterns, suicidality, or hopelessness. They may also ask about frequency and duration,” adds Shadick. “In most cases, a depression symptom must be present most days of the week for at least two weeks to be significant.”
The Type of Questions Your Doctor Will Ask
Here are some typical questions from a few of the more common depression screening scales:
- From PHQ-9: “In the past two weeks, how often have you felt down, depressed, or hopeless?” Your possible answers include: Not at all, several days, more than half the days, or nearly every day. Feeling down for more than half the days or nearly every day over the past two weeks suggests depression.
- From the HAMD: “Have you had any thoughts of suicide?” Answers to this question allow mental health professionals to rate the severity of depression. The person being screened can answer as follows: Never, some thoughts of death, some thoughts of suicide, or some attempt at suicide.
- From the MADRS: “How is your sleep?” Answers include: Sleeping as usual, slight difficulty, sleep reduced by at least two hours, or getting less than three hours of sleep at night. Greater sleep disturbance signals a greater risk for depression.
- From the Beck Depression Inventory: “How is your energy?” Declines in energy level are a common sign of depression — the more significant your lack of energy, the higher your depression risk rating. Possible answers to this question include: As much energy as ever, less energy than before, not enough to do much, or not enough to do anything.
- From the Geriatric Depression Scale: “Do you prefer to stay at home rather than going out and doing new things?” This question asks for a yes or no answer and recognizes that isolation and withdrawal are common signs of depression — especially in the elderly.
True depression isn’t the same as occasional periods of feeling down. The questions mental health professionals ask when screening for depression try to determine how many symptoms of depression you have, how long you have had them, and how much they interfere with your ability to live life normally.
If you answer yes to some of these warning signs of depression, and your symptoms have been present for more than two weeks, you could be depressed. But don’t forget: Screening for depression is just the first step to helping you get better. Depression treatments work — so answer the questions as honestly as you can, and don’t be afraid to ask for help.
How to start the conversation
Some people are not ready, do not know how or may not want to speak to someone about how they are feeling.
The longer someone delays getting the help they need, the more distressed they are likely to become, making it a much harder place to recover from. 6
While this is very worrying for people close to them it doesn’t help to pressure them to talk if they are not ready, it’s up to them whether they want to talk or not.
So what can you do?
- Focus on spending time with them so that they don’t feel alone. It can take time for someone to feel comfortable enough to talk about how they are feeling.
- Let them know that you are concerned about them and are there if they want to talk. Reassure them with phrases such as “call me if you ever want to talk” or “I am here for you if you decide you want to talk”.
- Ask them if there are any specific reasons for why they don’t want to seek help. Once you have an idea on what is worrying them, you may be able to work together to find a solution.
- Suggest, when they are ready, that they can speak to someone else they trust if they want to, a GP or contact a support line if they would feel more comfortable speaking to someone they don’t know.
- Offer to go with them to the GP or support service, if they would like you to.
- Some people may find it hard to see a GP or other support services because they feel anxious, frightened that others are against them or fear they will be criticised. Explain to them how a GP or a professional support service is there to help and will not judge them.
- Some people are reluctant to seek help from a GP or support service because they have difficulty putting their thoughts together to explain what is going on, find it hard to talk about how they feel or don’t realise that they need help. In this instance you can support them by speaking to a GP or a support service beforehand or writing notes about your concerns in advance that you can take to the appointment.7
You don’t need have all the answers or to deal with the situation on your own, there are that can provide advice and support 8
Remember that is it best for the person involved to voluntarily seek help. However, if you are concerned that they need urgent help (i.e. are at risk to others or themselves call 000 or call the Mental Health Emergency response Line (MHERL) 1300 555 788 (Perth Metro Residents); 1800 676 822 (Peel Residents).
Everybody knows about the emotional symptoms of depression. But depression doesn’t just affect your mood. Not only can it make you feel alone or hopeless, it can also affect sleep, appetite, and weight. It can also cause physical pain.
Even people who know they are depressed might not connect some of these symptoms with their condition. Since it’s so easy to miss some symptoms of depression, here are questions you can ask your doctor. Print them out and take them to your next appointment. Go in prepared — it’s very easy to forget the questions you wanted to ask when you’re actually sitting in the doctor’s office.
- What kind of depression do I have? Depression can take many forms. Different types respond better to different sorts of treatment.
- Should my depression be treated with medicines, psychotherapy, or both? Depending on the type and severity of symptoms you may have, your doctor can advise you on the best type of treatment. Psychotherapy is often helpful for better coping with feelings related to depression, and finding more effective ways to manage daily stresses that can affect your mood.
- How might depression affect my appetite and weight? Many people notice physical changes because of their depression. Some lose weight because they’ve lost their appetite or feel sick. Others gain weight because they might stop exercising or turn to food for comfort.
- How could depression affect my sleep? People often associate depression with oversleeping. But depression can also cause insomnia.
- Could my depression be causing me physical pain? Studies have shown that depression can increase the feelings of physical pain, including headaches, back pain, and abdominal pain.
- Could other health conditions be contributing to my symptoms of depression? Conditions like heart disease, cancer, and thyroid problems can trigger or worsen the symptoms of depression. Some can affect how well your antidepressants work.
- Do I need medicine to treat my depression? Medication — often along with therapy — can be a highly effective way to treat depression. This can especially be true when symptoms are severe or certain symptoms are present — such as suicidal thoughts, hopelessness, or a marked inability to feel pleasure.
- What are the side effects of this drug? Talk over the pros and cons of taking the each of the different medication options to treat depression. Ask how any side effects might be managed.
- Do the symptoms of depression need special treatment? In addition to treating depression, you may need to treat specific symptoms as well. For instance, if your depression is making it impossible to sleep, you may need to treat that separately until the full measure of the depression is better controlled.
- What kind of lifestyle changes will help with my symptoms of depression? Ask your doctor about what you can do to ease symptoms. Getting exercise, eating well, avoiding alcohol and illicit drugs, and following a regular routine might help.
- What about alternative treatments? So far, research has not shown that any alternative treatments or dietary supplements can cure depression. However, some may be helpful. So always talk to your doctor before using these treatments.
- What should I do in an emergency? You and your doctor should have a plan for a crisis. If you are ever in danger of hurting yourself, you — and your family — need to know what steps to take.
The following is a list of questions for discussion with your doctor about depression from Second Opinion. But it is not a comprehensive list.
- What exactly is depression? Is there a widely accepted definition?
- What are the differences between bipolar and unipolar depression? Are there other types of depression?
- Is there a difference between depression and a “mood disorder”?
- How do I know if I suffer from depression or am simply going through a “rough patch”?
- What causes depression?
- What are the most common symptoms?
- Does depression affect appetite or diet? Sleep patterns? Energy level? How I view and relate to other people?
- What are the most common treatments?
- What is cognitive behavioral therapy (CBT) or cognitive psychotherapy (CT)?
- What about the concerns I’ve heard about anti-depressant medicines?
- What about the concerns I’ve heard about electroconvulsive therapy (ECT)?
- Are there reasons a doctor might disagree with prescribing a certain treatment, say, specific anti-depressants or ECT?
If you believe you suffer from depression:
- Can I be depressed and still work and function more or less normally?
- Is there a relationship between emotional suffering and depression?
- What sort of “environmental” or circumstantial changes affect mental health?
- What’s the connection, if any, between depression and physical pain?
- What’s the role, if any, of genetics or biological factors in depression?
- What goes into a doctor’s development of a diagnosis?
- Why do some people become depressed while others don’t?
- My child seems to be always depressed. What can I as a parent do?
If you have received a diagnosis of depression:
- How did you reach your diagnosis? What specifically leads you to believe that I suffer from depression?
- Is there anything I should stop or start doing to help my situation?
- Which treatments do you prefer, and why?
- Do medications lose their effectiveness the longer a patient takes them?
- How do I deal with the stigma of my diagnosis?
- What’s wrong with me that I should suffer from depression? Why can’t I “cope”?
- How can I be sure you’re providing me with the appropriate care and treatment?
- I’ve heard of the patient forming a “therapeutic alliance” with the doctor? What is that?
This article reprinted with permission from Second Opinion, a public television health program hosted by Dr. Peter Salgo and produced by WXXI (Rochester, N.Y.), West 175 and the University of Rochester Medical Center.
Next Avenue Editors Also Recommend:
- Know the Symptoms of Depression and Find a Treatment
- Cancer Patients Dealing With Depression
- It’s Possible to Overcome Depression
- Caregiver Depression: Unspoken but Traumatic
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10 Introductory Questions Therapists Commonly Ask
Therapy is about the fine art of asking directive questions. So what should you expect from your first appointment with a counselor, social worker or psychologist?
The answer is simple: You should expect easy, brain-expanding questions, questions and more questions. A “change map” (often called “treatment goals”) is then created to guide you in solving the problems that are currently plaguing you.
Here are 10 of the more typical questions a psychotherapist will ask to prime your mental pump for positive change during the counseling process. Following the question is an example of what it might sound like.
- What brings you here? “It seems like you know yourself pretty well and have thought a bunch about what you would like to talk about here. People who show up here have courage galore, perhaps even a tad bit of exasperation. If you don’t mind, I’m going to ask you some questions, and take notes about what you say so I can keep it fresh in my memory. Oh, and feel free to interrupt me at any time or steer the conversation to where you need it to go. In your mind, what brings you here today?”
- Have you ever seen a counselor before? “You seem pretty comfortable and confident coming in here and talking about the challenges in your life. Have you ever seen a counselor before? If so, how many meetings did you attend and for what issues? Did you achieve the results you sought, and did your results ‘stick?’ What one thing do you remember most that your previous counselor/psychologist/social worker told you? What went right, or what didn’t turn out the way you would have liked it to?”
- What is the problem from your viewpoint? “Everyone has a different perspective on what the problem is, and who or what the solution is. The point of counseling is to create positive changes as rapidly as possible without feeling hurried. How do you see the problem or how do you define it? Which difficult people in your life are causing problems for you? How do you get along with people at work? How would you describe your personality? What are three of your biggest life accomplishments? Who or what is most important to you in your life? What is the problem from your viewpoint?”
- How does this problem typically make you feel? “We all have problems or challenges that we must face. Are you an optimist or a pessimist? How do you feel when a problem pops up unexpectedly? Although feelings aren’t right or wrong, good or bad, every problem has a way of making us feel one way or another. So, how does this problem typically make you feel? Do you feel sad, mad, hopeless, stuck or what?”
- What makes the problem better? “How often do you experience the problem? What do you think causes the problem to worsen? Have you ever not had the problem or noticed that the problem went away altogether? Have you tried certain tools, read books or pursued avenues in the past that have worked well to solve the problem? How does the problem affect your self-esteem or your sense of guilt?”
- If you could wave a magic wand, what positive changes would you make happen in your life? “Setting goals creates focus. Do you regularly set positive goals for your work life, love life and fun life? What is your attitude about change? What are your positive change goals? How would you like to improve your life to be more satisfied and happy? If we can find ways to make the problem better, perhaps we can find ways to greatly reduce or even eliminate the problem.”
- Overall, how would you describe your mood? “Moods come and go like the weather. Some of us are moodier than others or pick up someone else’s mood like a cold. Still others are pretty thick-skinned about emotional events. In your case, what makes you feel anxious? Is your mood like a roller coaster, or is it pretty steady? What brings you down or makes you feel blue? What’s guaranteed to make you feel up? How do you get yourself out of a bad mood? Do you use drugs, alcohol, sex, money, or other ‘mood soothers’ to make you feel better? What have people close to you told you about your moods?”
- What do you expect from the counseling process? “Everyone who comes here expects something different. I believe you are paying me to help you achieve your positive goals as quickly as possible. Some people like to receive homework, some clients like to vent and have me listen, and others want a high level of interaction. How do you think you learn best? Do you think of me as your communications and relationships coach? What do you expect from the counseling process? How many meetings do you think it will take to achieve your goals? How might you undermine achieving your own goals? Do you blame anyone for your problem? Do you use good advice to grow on? How will you know when we are done?”
- What would it take to make you feel more content, happier and more satisfied? “On a scale of 0-10, how content are you with your life? What keeps happening repeatedly that frustrates you? What do people keep doing that you dislike, and what do you wish they would change? How do you typically handle irritations, aggravations and frustrations? Do you get mad easily? How does your anger come out? What baggage or resentments do you carry from the past? What wrongs have been done to you that you haven’t forgiven? What changes could someone make that would really make you happy? What has been a major life disappointment? Do you feel mad when you don’t get your way or lose control? Who is pulling your strings, and why?”
- Do you consider yourself to have a low, average or high interpersonal IQ? “Would you rate your communication skills as negative, neutral or positive? How well do you get along with your life partner? Do you love your life partner? What positive relationship rules do you follow? How would you describe your relationship with your kids or grandkids? Do you get along with your siblings? How would you best describe your relationship with your parents? What family conflicts have you been embroiled in recently? What relationship have you been in that you judged to be a failure? Who do you call upon when your heart is hurting to mentor you? Have you put time and money into improving your communication skills lately? What is your biggest vulnerability or Achilles heel in relationships?”
Emotional intimacy is created when you know the honest answers to the questions above.
10 Introductory Questions Therapists Commonly Ask
The Simple Questions That Really Help Depressed People
A technique called ‘Socratic questioning’ can help depressed people recover, a new study finds.
Socratic questioning is used by many therapists to help patients explore new perspectives on themselves and the world.
Mr Justin Braun, one of the study’s authors, said:
“People with depression can get stuck in a negative way of thinking.
Socratic questioning helps patients examine the validity of their negative thoughts and gain a broader, more realistic perspective.”
Socratic questioning differs from ‘normal’ questioning by focusing on fundamental issues and concerns.
For example, if a patient feels their life is a failure because of a divorce, the therapist might ask:
- Is everyone who experienced divorce a failure?
- Can you think of anyone for whom that is not true?
- How does being divorced seem to translate into being a failure as a person for you?
- What evidence is there that you have succeeded, and thus not been a “total failure?”
Dr Daniel Strunk, another of the study’s authors, said:
“We found that Socratic questioning was predictive of symptom improvements above and beyond the therapeutic relationship — the variable that has been most examined in previous studies.”
The study involved 55 patients who were followed over a 16-week course of cognitive therapy.
The sessions were taped and the researchers examined how much Socratic questioning each therapist used.
They found that more Socratic questioning led to more improvements in depressive symptoms.
Mr Braun explained how Socratic questioning can help:
“Patients are learning this process of asking themselves questions and being skeptical of their own negative thoughts.
When they do, they tend to see a substantial reduction in their depressive symptoms.”
Dr Strunk continued:
“We think that one of the reasons that cognitive therapy has such enduring positive effects is that patients learn to question their negative thoughts, and continue doing so even after the treatment ends.
They find out that they may be overlooking information that is contrary to their negative thoughts.
They often aren’t looking at the whole situation, positive and negative.”
The study was published in the journal Behaviour Research and Therapy (Braun et al., 2015).
Psychologist, Jeremy Dean, PhD is the founder and author of PsyBlog. He holds a doctorate in psychology from University College London and two other advanced degrees in psychology.
He has been writing about scientific research on PsyBlog since 2004. He is also the author of the book “Making Habits, Breaking Habits” (Da Capo, 2003) and several ebooks:
- Accept Yourself: How to feel a profound sense of warmth and self-compassion
- The Anxiety Plan: 42 Strategies For Worry, Phobias, OCD and Panic
- Spark: 17 Steps That Will Boost Your Motivation For Anything
- Activate: How To Find Joy Again By Changing What You Do
→ Dr Dean’s bio, Twitter, Facebook and how to contact him.
Therapy image from
One of the most important things primary care providers can do to elicit emotional information, which may be somewhat hidden, is simply to “open the door” by asking screening questions. And don’t ask with your hand on the doorknob at the end of the assessment!
Two simple questions, for example, can help to detect depression:
- “Over the past month, have you felt down, depressed or helpless?”
- “Over the past month, have you felt little interest or pleasure in doing things?”
If the patient replies “yes” to either question, the clinician can ask further questions.
Screening for specific psychiatric disorders
Primary care providers should ask specific screening questions for specific psychiatric disorders. Due to time constraints, the screening questions should be:
- related to the specific problem(s) that the patient presents with on that day
- fairly stark, so that a positive answer would be quite significant, and should be explored.
The following section provides examples of screening questions for different psychiatric disorders.
- Have you ever had a period where you felt down? Not just for a week or two but for many weeks or, perhaps, months?
- Did you find you had no energy, had no interest in things, and overall had great difficulty functioning?
- Has this ever happened to you before?
- In the past, have you ever had a period where you felt not just good, but better than good?
- Did this feeling of unusually high energy and a decreased need for sleep go on not for hours or an evening, but for days and days at a time?
- Have you felt down or low but able to function over the last number of years?
Generalized anxiety disorder
- Would you describe yourself as a chronic worrier? Would others say you are someone who is always worrying about things?
- Do you worry about anything and everything as opposed to just one or two things?
- If so, how long has this been going on?
- Some people tell me that they are worriers but they can usually handle it. Other people tell me that they are such severe worriers that they find that worrying gets in the way of their life or paralyzes them. Is this the case for you?
- Do you have any unusual or repetitive thoughts that you know are silly but you simply cannot stop thinking about (for example, being contaminated by germs)?
- Do you feel there are certain rituals you have to do, such as tap your hand a certain way or do things in sets of threes, which takes up a lot of time in the day?
Delusions and hallucinations
- Do you have unusual experiences, such as hearing voices that other people cannot hear? What about seeing things that other people cannot see?
- Do you have unusual ideas, such as feeling that the TV or radio has special messages for you?
- Do you have unusual ideas that people you do not even know are plotting to harm or kill you?
- Do you have unusual ideas, such as feeling that you have special powers that no one else has?
- Do you have panic attacks or anxiety attacks? By that I mean an attack of anxiety that comes fairly suddenly and is rather uncomfortable and involves feeling a certain number of physical sensations such as heart palpitations, shortness of breath or dizziness.
- Do you avoid going certain places because you are fearful of having a panic attack? Has this feeling restricted your activities?
Posttraumatic stress disorder
- Do you find it hard to stop thinking about a very difficult event that has happened to you?
- Do you find that you have nightmares related to the event?
- Do you find that you have flashbacks? By that I mean very vivid daydreams or what we may call a “daymare” about the event?
- When something happens that reminds you of the event, does that trigger a very large response in you?
- Do you find that you avoid things that remind you of the event?
- Generally, do you feel anxious since the event and have trouble sleeping or startle easily?
- Do you feel that this event, and the way it has left you feeling, still gets in the way of your life?
- Are you able to go to social situations where you may have to interact with people you don’t know well, or is that very daunting for you?
- Can you eat in restaurants in front of others?
- Were you able to give presentations in front of others when you were in school, or can you do it now?
- Do your social fears get in the way of your life?
Borderline personality disorder
- Do you feel you are still searching for your sense of who you are (self-identity)?
- By “sense of who you are,” I mean do you have a set of values (what is important to you) that stays constant over time?
- Do you have long-term feelings of sadness?
- Do you have long-term feelings of anger?
- Do you find that your relationships usually get very difficult and end abruptly?
- Have you had thoughts of killing yourself on and off over the years?
- Have you tried to kill yourself in the past?
- Have you had episodes in the past where you tried to hurt yourself, not to kill yourself but simply to cause yourself pain or distract you from something?
- How do you feel after these episodes? (Patients often respond that they feel a sense of release or relief.)
- Do you often feel empty inside?
- Do you find that you can be feeling okay then suddenly feel angry, or you can be feeling okay and suddenly feel sad? Does this happen a lot during the course of a day?
- Do you find that you do things on impulse and then regret it afterwards?
Adapted from: Jon Davine, The art of the brief psychiatric interview in primary care, Psychiatry in Primary Care (CAMH, 2011)
Take Care of Yourself to Take Care of Your Patient
Any healthcare professional knows that dealing with issues of mental illness or patient trauma can be emotionally difficult for the provider him- or herself. It is, in fact, easy, for physicians to be emotionally affected when patients confide in them about, for instance, a history of sexual abuse. Physicians, especially those at the beginning of their professional career, should be aware of this danger and learn to take care of themselves in order to better take care of their patients. That is why organizations like the World Health Organization encourage healthcare professionals working with mentally ill patients to:
● Set limits and not try to do everything; realize that you can only do so much when it comes to helping your patients.
● Make time when you are not working to relax and get away from the pressures of your professional duties.
● Don’t let the stress build up but find some sort of healthy outlet for it, such as exercise or particular hobby or pursuit.
● Continue to educate yourself about new breakthroughs or knowledge in the field of mental health through continuing training/education so that you will be aware of new advances–such as a new treatment or medication–and be able to communicate these to your patients.
● Work closely with other members of your health care team and find a co-worker whom you trust and whom you can confide in when it comes to the emotional difficulties you are facing in your professional life.
Following these suggestions for self-care can make it easier to deal with the emotional rigors of working with mentally ill patients and can leave you feeling able to give your patients what they need.
To conclude, beginning a conversation with your patients about their mental health status can feel like a daunting task because of the very personal nature of the questions and because of the stigma which unfortunately remains around issues of mental illness. However, a doctor who presents himself as open and caring and appears comfortable discussing matters of mental health can set a patient at ease and open up that preliminary conversation which must take place before a problem can be identified and a course of action set.
Blaszcyyk, J. et. al. General Principles of Effective Communication Between Physicians and
Patients with Selected Mental Health Disorders. Polish Medical Journal. 2015. 38(226)
Harris, B. et. al. Patients’ Experiences of Psychiatric Care in Emergency Departments: A
Secondary Analysis. International Emergency Nursing. 2015.
Talking to Mental Health Patients/Clients. BJC Healthcare. 2015
Talking to Your Patients About Alcohol, Drug and Mental Health Problems. United States
Department of Health and Human Services. 2014.
What Workers Need to Know About Mental Health and HIV/AIDS. World Health Organization.
B Brian Wu graduated from the University of Maryland with a Bachelor’s of Science in Physiology and Neurobiology, and graduated from the Keck School of Medicine (University of Southern California) with an MD with a focus on holistic care and treatment. He currently holds a PhD in integrative biolog… Brian Wu graduated from the University of Maryland with a Bachelor’s of Science in Physiology and Neurobiology, and graduated from the Keck School o…
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