week 6

Running head: DIFFERENTIAL DIAGNOSIS 1

DIFFERENTIAL DIAGNOSIS 4

Differential Diagnosis

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Differential Diagnosis

The diagnosis that is to be conducted is one for depression. Noting that depression has symptoms that are not straightforward, the determination has to be such that it ends up pinpointing the specific disorder. It is the responsibility of the clinician to look at the general symptoms that the patient comes with to the clinic and use the DSM to account for those symptoms.

The first step when a patient comes to the clinic is to rule out the malingering or factitious disorder. The essence of this step is the dependence of good faith, and collaborative efforts between the patient and the clinician which if absent will make diagnosis impossible. By motivation, factitious disorders do differ from malingering disorders. A malingering disorder is not a mental disorder and is driven by recognizable achievement goals such as avoiding responsibilities. A factitious disorder occurs when there is a conspicuous absence of an external award. During this step, the doctor has to prevent treating the patient like a hostile witness in a court of law. Suspicion of the existence of these disorders will only be raised in specific settings and situations (Duffy, 2013).

The next step involves ruling out of substance etiology. Virtually all the psychiatric disorders can be caused by substance abuse. Therefore it is essential to rule out substance abuse. This can be done by interviewing the patient and his relatives and also looking for signs of active intoxication. Finally, the doctor should order a lab test to consider recent intoxication and even medication side effects. If such symptoms are present, the doctor should take steps to look at the connection with the psychiatric disorder. There are three ways to look at the substance use. One is that the disease might be a direct effect of the substance use or that the disorder may influence the substance use. Also, substance use and the disorder may be two different issues and independent.

The third step involves ruling out disorder due to a general medical condition. The process consists in checking whether the patient has a shape that commonly accounts for psychiatric conditions such as the dysfunction of the thyroid gland. It is either that the medication may be responsible for the state or the disorder may affect the medical condition or the symptoms of the medical disease, and the disorder may be coincidental. The medical condition may end up causing the disorder such as a stroke or such as the depressive symptoms that occur when patients undergo cancer diagnosis. To get an idea of the relationship, the doctor can look at whether the disorder arose after the medical condition, or if they have equal severity with the medical condition or if they do remit immediately after the medical situation is resolved.

The fourth step involves determining the specific disorder. This process involves writing down all the symptoms against all the possible diseases. It is worth noting that most of the depressive disorders will have the same symptoms. Therefore, it is essential to rule out all disorders. The fifth step involves the differentiation of the adjustment disorders from residual other or unspecified categories. This is so when a patient shows other significant diseases that could cause substantial impairment. A clinician is expected to use the adjustment disorder when the responses are of a maladaptive nature.

The final step involves the establishment of a boundary with no mental disorder. The doctor has to check whether the symptoms have an implication on the critical areas of functioning and whether it causes distress. The sign must represent an internal biological or psychological dysfunction in the patient. An example that would not amount to a psychological dysfunction is the grief for the loss of a family member. It would not qualify because it is not internal.