Differential Diagnosis

Question 1

If the patient is not being honest regarding the nature or severity of his or her symptoms, all bets are off regarding the clinician’s ability of arrive at an accurate psychiatric diagnosis.

Answer 1

STEP 1: RULE OUT MALINGERING AND FACTITIOUS DISORDER

Question 2

When the motivation is the achievement of a clearly recognizable goal

Answer 2

Malingering

Question 3

When the deceptive behaviour is present even in the absence of obvious external rewards

Answer 3

Factitious disorder

Question 4

The patient is characteristically manipulative or suggestible

Answer 4

clinician’s index of suspicion should be raised when

Question 5

Whether the presenting symptoms arise from a substance that is exerting a direct effect on the central nervous system.

Answer 5

STEP 2: RULE OUT SUBSTANCE ETIOLOGY (INCLUDING DRUGS OF ABUSE, MEDICATIONS)

Question 6

Step 3

Answer 6

Rule out a disorder due to a general medical condition

Question 7

Determine the specific primary disorders

Answer 7

Step 4

Question 8

Step 5

Answer 8

Different adjustment disorders from the residual other specified or unspecified disorders

Question 9

Step 6

Answer 9

Establish the boundary with no mental disorder