Template - diagnosis, aetiology, risks, prognosis

Question 1

Spiel for intro to diagnosis (3)

Answer 1

My preferred diagnosis is
On a background of
Complicated by

Question 2

Spiel for in favour of this diagnosis (4)

Answer 2

In favour of this, the patients presents with the main symptoms of … for a period/duration of … which is line with the diagnostic criteria.
Symptoms cause distress, impair work, social or personal functioning.
Additionally in favour of this, the patient has certain risk factors for….
Given the number and severity of symptoms, and according to ICD-10 criteria this would fit a diagnosis of ….

Question 3

Spiel for against this diagnosis

Answer 3

The patient lacks [symptoms] which are also typically found in …
And given the patient’s age/sex/background history, he/she doenst present with the typical aetiological/risk factors for ……

Question 4

Spiel for differentials

Answer 4

Other diagnoses I would like to consider and that would be important to rule out

Question 5

Spiel for aetiology

Answer 5

We have relatively little evidence from the assessment so far by which to consider probable aetiological factors.
However, in general we need to think about possible predisposing, precipitating and perpetuating factors, and within these biological, psychological and social causes.

Question 6

Prognosis subheadings

Answer 6

In general
Mortality
Favourable prognostic factors
Less favourable prognostic factors

Question 7

Risk subheadings (7)

Answer 7

To self 
To others 
From others 
Driving
Safeguarding 
Protective 
Iatrogenic

Question 8

Risk to self (10)

Answer 8

DSH and suicide
Co-morbid conditions
Self-neglect
Social damage
Disengagement from therapy 
Misuse of medication 
STDs, blood-borne viruses
Physical health
Accidental/misadventure
Absconding/wandering

Question 9

Risk to others (3)

Answer 9

Aggression and violence
Infanticide, persecutory or jealous delusions
Increased if psychotic, emotionally labile, substance use, previous violence

Question 10

Risk from others (2)

Answer 10

Exploitation

Abuse

Question 11

Iatrogenic risks (3)

Answer 11

Side effects of medication
Presenting with mixed picture = risk of misdiagnosing
Medicalising something normal

Question 12

Protective factors (3)

Answer 12

Family support
Having children/pets at home
Religious belief