solving the puzzle of diagnosis: the diagnosis formula (sx + time - sa = dx)
TRANSCRIPT
Solving The Puzzle of Diagnosis
Diagnosis Drives Effective Treatment
Misdiagnosis significantly impairs treatment success
The Diagnosis Formula
Sx + Time – SA = Dx
The Diagnosis Formula
Sx + Time – SA = Dx
Symptoms
Time of Presentation
SubstanceAbuse
AccurateDiagnosis
The Diagnosis Formula
Sx + Time – SA = Dx
Symptoms
Sx = Symptoms
These include behavioral and cognitive manifestations
Sx = Symptoms
Let’s use bipolar disorder symptoms as an example
Sx = Symptoms
Mania:-excessive energy-irritability-racing thoughts-grandiosity and others
Sx = Symptoms
MajorDepression:-anhedonia-insomnia or hypersomnia-worthlessness-hopelessness-helplessnessand others
Remember: a disorder must causeSocioeconomic Dysfunction
The Diagnosis Formula
Sx + Time – SA = Dx
Symptoms
Time of Presentation
Time of Presentation
For every disorder it is critical to know the length of time symptoms were/are presented.
Let’s use roadrage as an example…
Time of Presentation
Driving home she becomes irate because she was cut off, screamed at, something hit her car, etc. She rolls down the window and screams out obscenities, waves her fist, etc.
Time of Presentation
Is this indicative of bipolar disorder? For many clinicians this is all they need to know and they would give this individual a bipolar Dx…
Time of Presentation
The reality is that this can be a multitude of things that are causing this and it may be situationally specific, not representative of long-term mental status.
Time of Presentation
Genuine symptom presentation is typically not hours, but days or years!
The Diagnosis Formula
Sx + Time – SA = Dx
Symptoms
Time of Presentation
SubstanceAbuse
AccurateDiagnosis
Substance Abuse BlursReliable Diagnoses
Substance Abuse BlursReliable Diagnoses
Bipolar and Sub-
stance Abuse60%
BipolarOnly40%
Cited in Singh, T. & Rajput, M. (2006). Misdiagnosis of Bipolar Disorder. Psychiatry, 57-63
Substance Abuse BlursReliable Diagnoses
You must separate out the drug induced behavior from the genuine cognitive and behavioral symptoms that are the result of mental illness.
The Diagnosis Formula
Sx + Time – SA = Dx
Following the formula will significantly increase yourability to accurately diagnosis your clients
Where do we go from here?
Critical Questions for Reliable Diagnosis
Critical Questions for Reliable Diagnosis
Can you describe your symptoms for me?
Critical Questions for Reliable Diagnosis
How long have these Sx (list each separately)
being going on?
Critical Questions for Reliable Diagnosis
What drugs have you done in the pastand when did you use them?
Follow the path of the diagnosis formulaand you will hit the bullseye every time
Follow the path of the diagnosis formulaand you will hit the bullseye every time
Sx + Time – SA = Dx
Learn more about Dr. Fox at www.drdfox.comor [email protected] or 832-482-8531