Differential diagnosis is described as distinguishing a particular condition or disease from others that have similar or identical clinical features. Physicians use different procedures to diagnose a specific disease in a patient or at least eliminate any possible life-threatening conditions. For each individual with possible options of diseases, a differential diagnosis is made. Generally, procedures for differential diagnosis are systematic and identify the presence of any disease entity that has multiple alternatives. The use of differential diagnosis is common in the field of psychiatry or psychology. Patients that are diagnosed with psychological conditions may be given a differential diagnosis because of the similarity in symptoms for the conditions. Strategies used in creating a differential diagnosis depending on the experience of the health providers. Assessments provide all explanations for the patient’s worries and concerns, a more experienced physician will draw a conclusion based on pattern recognition and experience to protect the question from risk delays or cost-inefficient tests. In this paper, we will speculate the possible diagnosis for a young male patient who has been experiencing learning problems, exhibiting odd mannerism, and is socially isolated.
The process for differential diagnosis for this patient will include following a standard six-step procedure that requires the physician or psychiatrist to gather all information and create a list of symptoms about the patient. The physician will prioritize the listing by placing the most dangerous causes on top of the list. Thirdly, the doctor will list all the possible causes of the patient’s symptoms. Lastly, will treat or rule out the possible causes attending to the most urgent conditions, then he or she will work down the list (Tracy,2013).
The first step, in this case, is to rule out the factitious or malingering disorder. The young adult male has exhibited possible mentally ill behavior that has not been manifested fully to need significant intervention. The elimination of malingering disorder will avoid the responsibilities or insurance compensation of the condition as a mental disorder. Secondly, assessing the situation concludes that the patient may suffer from a factitious disorder. This diagnosis is made because there’s no apparent external award (First, 2013).
In the second step, the clinician will consider whether the young adult male symptoms may be caused by substance abuse. This stage is also called the rule out substance etiology stage. The information provided about the patient is that he does not abuse any substances. The patient explains that his actions are sanctioned by the Torah, a religious book for Jews. A laboratory test can be carried out to verify whether the claims are true or false. If substance abuse is evident, psychiatric and substance symptoms must be put into consideration.
Thirdly, the medical practitioner will carry out a direct medical exam for conditions that account for psychiatric symptoms such as Asperger syndrome or obsessive compulsive disorder. If the young adult exhibits a medical condition that may be responsible for the symptoms, the clinician will link the problem to probable etiological relationships. Certain medications are responsible for psychiatric symptoms and cause adverse conditions and cause adverse general medical conditions (First, 2013). Additionally, a general medical condition can cause mental health signs and symptoms. This condition may be a result of a direct physiological impact on the brain, such as strokes. In this case, the patient may be depressed due to a general medical condition, which may result in an adjustment disorder. This condition could also be the reason why he is isolating himself from everyone and is in a constant bad mood.
To make a conclusive decision on whether the general medical condition is affecting the patient, the clinician will examine the temporary relationship between the symptoms and the beginning of the medical condition. An atypical symptom trend may warrant medical work-up. The clinician will establish the age of onset for the condition and if there has been any severe weight or memory loss (First, 2013).
The fourth stage will determine the particular primary disorder. At this point, the clinician will be able to identify a specific disorder. For the patient in question, it is evident that he may be suffering from an obsessive compulsive disorder or a related mental illness (First, 2013).
Another stage will differentiate adjustment disorders from and specific categories or residual disorders. At this point, the clinician may use other specified conditions to give a reason that meets or does not meet the criteria or even use general categories.
Finally, the clinicians will evaluate whether or not the patient has significant distress or impairment in occupational, social, or other essential functioning areas. The young adult male exhibits social isolation as well as difficulty in learning. However, his behaviors do not show an overtly developmentally delayed or mentally ill person.
Areas of Assessment for the Patient
Clinicians will examine any significant stress or impairment, causing the inability to perform the usual functions for the young adult male patient. Medical examinations will be carried out to determine whether or not substance abuse may have resulted in the symptoms. the patient will also be tested for any existing general medical conditions. The patient will be assessed for any possible psychological or internal biological dysfunction
Religion in Diagnosis
The religious and cultural context will be included in the assessment as additional information for prognosis. Mental health providers will use medical evidence to determine whether to treat mental illness can alleviate suffering from the patient as opposed to passing judgment on the patient’s religious beliefs. However, if the patient exhibits the distressful conditions that hinder them from performing their regular duty, then the religious beliefs may be included as a possible causal factor for a mental disorder (Menezes, 2010).
Other Actors in Diagnosis
Other actors that make may be incorporated in the assessment of the patient would be the previous diagnosis of general medical conditions or mental disorders. The results may be used to determine whether the symptoms are recurrent or developing from a different condition (Raines, 2019).
Incorporating a Multidimensional and Biopsychosocial Assessment
By examining the case of the patient, it is essential to include multidimensional and biopsychosocial assessment. As one goes through environmental and life changes, the brain and its functions change too. According to the biopsychosocial model, the most appropriate way to analyze the causal factors for mental illness is by examining their biopsychosocial perspective. In this case, the patient’s religious beliefs may affect their psyche and biology. The social, psychological, and biological determinants affect mental health. The patient who exists in a distinct, Jewish Orthodox environment may have been affected by religious practices. The patient may be socially isolated due to religion as opposed to a mental disorder (Cardoso, 2019).
Cultural and social factors are considered as stressful events; they can differentially affect the mental health of an individual. The biopsychosocial assessment assumes that cultural or social factors may or may not contribute to mental or health illness. But, the interaction between these situations determines the path of one’s psychological or physical development (Menezes,2010).
This perspective is useful to medical practitioners as they utilize other factors in treating mental illnesses. The clinicians will apply all aspects of a patient’s life to their diseases. The biopsychosocial perspective has enabled people with mental illness to understand their health entirely and has broadened the way people view mental illness (Cardoso, 2019).
The differential diagnosis of the patient described in this paper has pointed out multiple mental illnesses. Typically, tests and examinations have been carried out to determine the cause of factors of the symptoms exhibited by the patient. The patient suffers from Asperger syndrome and obsessive compulsive disorder. Eventually, the physician will rule out specific symptoms based on the right diagnosis and begin treatment.
Beidel, D. C., & Frueh, B. C. (Eds.). (2018). Adult psychopathology and diagnosis. John Wiley & Sons.
First, M. B. (2013). DSM-5 handbook of differential diagnosis. American Psychiatric Pub.
Menezes, A., & Moreira-Almeida, A. (2010). Religion, spirituality, and psychosis. Current psychiatry reports, 12(3), 174-179.
Raines, J. C. (Ed.). (2019). Evidence-Based Practice in School Mental Health: Addressing DSM-5 Disorders in Schools. Oxford University Press.
Tracy, N. (2014, December 3). Depression and Slow Thinking (Reduced Processing Speed), HealthyPlace. Retrieved on 2019, October 31 from www.healthyplace.com/depression/symptoms/depression-and-slow-thinking-reduced-processing-speed