What we’ve said about Differential diagnosis

“using the major DSM chapters, being aware of their names, use that as your major differential diagnosis. Don't drill down to a specific diagnosis within each chapter just yet. Simply think of the major category first”

“It's like psychosis, bipolar, depression, anxiety, OCD, trauma, dissociative disorders, somatic disorders, eating disorders, sleep problems, sexual problems, impulse control, addiction”

“personality is the one thing that every single patient that walks through your door is going to have, as opposed to all the other diagnostic and pathological categories”

“just like in a forensic psychiatry analysis of a moment of any person's behavior, we need to consider all the different possibilities, not just the possibilities that are medical diagnoses like autism or neurodiversity, right? We want to consider rational behaviors”

“you need to make connection between your conclusion and what you're seeing. And again, the best way to do that is to actually consider the context”

“the ability to think in terms of a hierarchy and then also think in terms of a differential diagnosis where I don't think of my job as knowing for certain what the diagnosis is. But knowing, having a prediction and a percentage that I think it fits and then an order”

“please consider what kind of substances, herbs, supplements, natural remedies, energy drinks, caffeine, medical conditions, other psychiatric conditions. Like I mentioned, the eating disorders, if you're not eating correctly, you're not going to be able to function correctly”

“When we talk about medication management, assess entirely for other physiological and medical causes, especially substances of anxiety”

“you really need to consider the possibility of both medication and substance-induced bipolar-type disorders. You should also consider medically-induced bipolar-type disorders, for example, from strokes, head injuries, and seizure disorders”

“just because everyone has told you that it's meth, the patient has told you, you have told yourself that it's meth, and the parents have told you that it's meth, doesn't mean that you should automatically assume that's that”

“you can't take the approach of going straight for the ADHD. Instead, you have to essentially rule in and rule out the other comorbidities that you have evidence for”

“the biggest one I see is depression slash adjustment disorder. Mood symptoms that are making it difficult to concentrate. I'll throw anxiety in there and that people are really anxious and that makes it so that they're using a lot of avoidance for tasks”

“my prepared list in terms of my own experiences about what is probably the most common explainers is depressive disorders, anxiety disorders, trauma disorders. That's a big one. I put OCD here not because it's frequent, but I think it's important”

“the biggest things that are ignored are trauma disorders, proper trauma disorders, not just people of history, trauma, um, What else is ignored is mood disorders, and the most harmful one to ignore is, of course, bipolar disorder”

“Borderline conditions, I think, are the great mimicker of psychiatry, right? It can look like so many other known and named conditions. It makes it particularly difficult to accurately understand”

“You need to find a temporal relationship and a sequence between this syndrome and those traumas. Why? Because as you can expect, after having gone through all of these criteria, these are all symptoms and impairments that are commonly seen in other conditions as well”

“It's important to note that having these issues does not mean that you have autism. This is only one arm of the ASD definition and there's a lot more to it. And like almost every other disorder in the DSM, there are multiple possible things that can explain the same deficits, right? The differential diagnosis process is key in diagnosis”

“I don't think they are aggressive enough about the not better acceptable aspect. Yeah, the differential diagnosis. And I think it's probably because autism researchers and the framers of the definition of this diagnosis probably mostly work with children”

“Does this patient have a personality disorder that might be causing them to become depressed in the face of rejection or abandonment? They might be anxious in interpersonal situations. They might be having trouble sleeping because their relationships are up and down”

“Patient comes into primary care doctor. And they go, I have a cough. They don't get told they have a cough disorder. We have to figure out what's going on underneath”

“So top of the differential usually is substances, personality, and mood disorders. OK, so now you're going to assess for those and you're going to you can't just assess responsibly when there is high dangerousness based on the output statements and behaviors on one look of a patient”

“Imagine if you said that about any other diagnosable psychiatric condition. Oh, I don't like to jump to bipolar. Oh, I don't like to jump to an eating disorder. I don't like to jump to an anxiety disorder”

“A doctor can't talk to you for 45 minutes and know with 100% confidence what your diagnoses are. And you essentially can't rule out conditions by meeting and talking to someone with 45 minutes”

“a good clinician, their motto should be never say never, right? It's not, you absolutely don't have this. It's that my working theory is currently this, but we're going to continue to screen, monitor, and watch out for XYZ”