Diagnosis Differentials Pt 1 Flashcards
ASD v Social (Pragmatic) Communication Disorder
ASD
- Merged ASD, aspergers, and pervasive development dx, diff severities of symptoms
- Difficulty in social communication and reciprocity and stereotyped, repetitive behaviors (e.g. hand flapping, chewy toys)
- Shows up at young age, screening begins at 3-5 yo, (e.g. baby not making eye contact w/ caregiver, not accepting toy or back and forth play, child not playing w/ peers, limited in play, poor relationships)
- Hard transitions, rely on fixed routine and specialized interests
- Hyper/hypo sensitivity to sensory inputs (e.g. highly aware of loud noises, clock ticking, deep physical pressure, sensitive to t-shirt tags)
Social (Pragmatic) Communication Disorder
- Impaired social communication w/o repetitive behaviors
- Most likely not on test
Specific Learning Disorder vs. ADHD
Specific Learning Dx
- Difficulty learning basic academic skills and need more support than other children, e.g. dyslexia, processing dxs
ADHD
- Need to rule out learning dx prior to dxing ADHD, can be disruptive (e.g. poor vision, unable to read as fast as peers)
- Present before 12 yo and behaviors in 2 diff contexts (e.g. home and school)
- Can be dxed in adulthood b/c ppl compensate w/ high intelligence, but are procrastinators and unable to meet tasks in prompt, linear manner
- Probs w/ attention and have hyperactivity
- More prominent in boys
- Dominant may be inattention - prob w/ sustaining attention, e.g. prob w/ reading for long time, frequently interrupt, annoy/bother others b/c they want the stimulation, trouble w/ organizing and doing tasks requiring a lot of attention
- Hyperactivity - e.g. moves a lot in seat, fidgeting
Pica vs. Rumination Disorder
*Most likely not on exam
Pica
- Rare
- Eating non food substances - e.g. dirt, carpeting
- Could be distraction answer
Rumination
- Repeated regurgitation of food, not related to any other dx
- Reflux dx
Language Disorder vs. Childhood-Onset Fluency Disorder
Language dx
- Usually dx in childhood
- Hard time building vocab - e.g. reduced vocab, child know much fewer words than peers his age, hard time forming 5+ word sentences, drop words out
- Impairs communication
Child-Onset Fluency Dx
- Show up ages 0-5 yo
- Stuttering and broken words (e.g. “I under(pause)stand what you’re saying”)
Tourette’s Disorder vs. Persistent Motor/Vocal Tic Disorder
Tourette’s
- Vocal (shout out word, typically swear word) and motor tic (wince)
Persistent Motor/Vocal Tic Dx
- Have either motor or vocal, not both
Encopresis vs. Enuresis
Encopresis
- Soiling pants
- Older than 4 yo, beyond potty trained expectations
Enuresis
- Urination in clothes 5 yo or older, beyond potty trained, and multiple accidents w/ pattern over time
- Typically common after trauma or sexual abuse
Separation Anxiety Disorder vs. Generalized Anxiety Disorder
Separation Anxiety Dx
- Anxiety specific to separating from attachment figure
- More common w/ children, must be present for 4 wks
- If adult, could be spouse, must present for 6 mos
- Anticipatory anxiety about person leaving and inconsolable or constant worry when attachment figure leaves
GAD
- Across several domains - could be w/ caregiver, school, and sports
- Symptoms must be present for 6 mos in children and adults
- Affects many aspects - e.g. sleep, concentration, socialization
Selective Mutism vs. Social Anxiety Disorder
Selective Mutism
- Impairment in speaking during certain situations, e.g. mute at school, but not at home
Social Anxiety Dx
- Anxiety or fear in social situations, avoid events, keep to ppl they’re comfortable w/
- Different range for adults
Reactive Attachment Disorder vs. Disinhibited Social Engagement Disorder
- Range 9 mo - 5 yo, results from persistent neglect, abuse, or multi caregivers
Reactive Attachment Dx
- AKA “Failure to thrive”
- Very withdrawn, don’t seek comfort or respond to it, limited range of affect, very little positive affect, irritability around self
- e.g. kids sit in corner, do not care for attention, sadness. fear, challenges w/ engagement, low positive affect or emos, “given up” that anyone cares for them
Disinhibited
- No boundaries, attaches easily to ppl, e.g. “will you take me home?” at first meeting
*Oppositional Defiant Disorder vs. Conduct Disorder vs. Disruptive Mood Dysregulation Disorder
*COMMONLY TESTED!
ODD
- Refuses to comply w/ any directions, problem w/ authority
Conduct Disorder
- Violates rights of others, e.g. law breaking activity, stealing, vandalism, initiate fights, destroy property, lack of remorse
- Leads to antisocial personality disorder in adulthood
Mood Dysregulation
- Used to be called bipolar in children, 6-10 yo, but up to 16 yo
- Consistent, reoccuring temper tantrums (happens at least 3x/wk) and negative mood
Brief Psychotic Disorder vs. Schizophreniform Disorder vs. Schizophrenia
Same symptoms, but diff timelins
- Brief Psychotic Dx - presents symptoms up to a month
- Schizphreniform - 1 mo to 6 mo
- Schizophrenia - present for 6+ mo
5 diff categories
- Delusion - belief that’s false, non-bizarre (possible - e.g. movie star is in love with me), bizarre (can’t be true - e.g. movie star is an alien)
- Hallucination - visual or auditory
- Disorganized speech - e.g. rambling, incoherent homeless person
- Disorganized behaviors - movements and gestures that don’t make sense, e.g. moving chairs around in room, result as a reaction to hallucinations
- Negative symptoms - flat affect, lost in own world,
*TEST - hearing things or having hallucinations
Major Depressive Disorder vs. Unspecified Depressive Disorder vs. Persistent Depressive Disorder
- Common things ppl come to tx for
- Depressive dxs related to severity of symptoms
MDD
- Symptoms present for at least 2 weeks
- Dark or black mood, anhedonia (can’t enjoy things), lack motivation to do things
- Changes in bio functioning - e.g. sleeping little, over sleeping, change in appetite
- Suicidal ideation - common symptom, MUST always assess, does not meet full criteria for Major Depression
- Functioning, but feel they have mild disturbances in functioning and no SI
PDD
- Used to be called dysthymia
- Depressed mood for at least 2 yrs in adult and 1 yr in children
- Not as deep as major depressive dx, e.g. On and off w/ depression for 2-3 yrs as adult and lack of enjoyment, w/ down mood, no changes in bio functioning
Unspecified
- Gone on for a really long time
Bipolar I Disorder vs. Bipolar II Disorder vs. Cyclothymic Disorder
Bipolar I
- Manic phase - elevated mood that leads to significant impairment for at least 1 week, e.g. grandiose thoughts, extreme positivity or negativity, excessively spending money, high risk behaviors outside of person’s norm 7+ days, lack sleep, euphoria, high level of energy
- In denial they’re in manic phase, can be hard to address
- Do not need depressive episode following mania, but can have one
Bipolar II
- Need hypomania and major depressive episode
- Hypomania lasts at least 4 days, elevated mood, but not as impaired as manic phase (e.g. less sleep, energized, upbeat but doesn’t cause probs in life)
*May see severity manic phases for Bipolar I and II (Mild, Moderate (sig increase in impaired judgment), Severe (needs supervision or hospitalization)
Cylcothymic
- Milder form of Bipolar Disorder, e.g. not full blown mania or major depression, hypomanic and low level, mild depressive episode, “up and down”
- Present for at least 2 yrs
Unspecified Depressive Disorder vs. Unspecified Mood Disorder vs. Unspecified Bipolar Disorder
Unspecified Depressive
- Depressive symptoms have gone on for a long time
Unspecified Mood
- Causes significant distress or impairment
- Does not meet full criteria for any disorders in bipolar or depressive categories
Unspecified Bipolar
- Significant shift in mood, but not specified as depressed or angry
Schizoaffective Disorder vs. Bipolar I Disorder with Psychotic Features
- All have psychotic features and mood dx aspect
Schizoaffective
- Psychotic features present all the time (Schizo), but mood is not always present
Bipolar Dx w/ Psychotic Features
- Mood dx present all the time with psychotic features coming in and out
