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Is this a written diagnosis you're looking at?
Generally disorders are conded based on their class. Bipolar disorder is a depressive spectrum condition.
Schizoaffective is a different spectrum condition
Malingering would relate to a suspicion that the client is fabricating some of their symptoms. It generally relates to a secondary gain ex: obtaining Social Security Disability, using the diagnosis in court, etc.
so if they say rule out malingering they are definitely accusing you of malingering?
No, rule out means- ensure that it is not malingering. It does not mean they're accusing the person of it (only suspecting it untill proven otherwise)
Ensure that the behavior is genuinely due to the condition rather than malingering.
R/O (rule out) is not a definite
A person can have more than one disorder. For example bipolar disorder and schizoaffective disorder.
Or, a clinician may change a diagnosis later on if it becomes more clear what is behind the person's symptoms/behaviors.
you can have both. i thought schizoaffective disorder had a depressive and bipolar subtypes
A person w/ schizoaffective disorder may experience symptoms as those found in bipolar disorder ex: mania/psychosis or depressed mood.
And a person can have a subtype as well
I just need to know how it was charted to know for sure
Do you see this diagnosis listed on one line generally it would say something like Axis I or Axis II etc
if i recall it said axis 1
A schizoaffective diagnosis w/ bipolar subtype is possible and it is possible for a person to have multiple diagnosis
axis one is where they also put rule out malingering
In that respect, the clinician is most likely suspecting that manic behaviors may be as a result of the schizoaffective underlined condition
Yes, R/O would mean that they're suspecting that the behavior is more genuine than fake
Hence R/O rule it out (cancel it)
It is something used when a person may have doubt but is more inclined to rule it out
Does it make sense?
let me see if i get this
It is in case another clinician looks at their summary and keeps in mind to rule it out
so they were ruling out malingering
Think of R/O as FYI
for your information
Yes, in those guidelines to whoever may read the diagnostic summary
To consider ruling that out as a cause and focus on the diagnosis/conditions sited
oh. so thay is not an accusation
Let's say you bring your chart to another clinician, when they see R/O they'd think about ignoring the malingering and focusing on the condition
It's not an accusation. If it was, they would have documented it as such
okay. i think i get it.
rule out as axis 1 means elimination of that
Malingering is volitional.
Yes, rule it out as not being evident
so the opposite would be to rule in
They would not use the wording rule in. Rather, they'd jus list the diagnosis they suspect if any. And, if they suspect malingering, they'd indicated it (or simply not give a certain diagnosis at all)
They could of used Factitious Disorder instead
These could be both physical/psychological in nature. Think of malingering leading to some sort of a gain.
it is just that when i saw rule out malingering next to schizoaffective i freaked
i understood what malingering meant
but the rule out i did not understand
No; don't freak out.
Is it more clear now?
The clinician is saying basically "don't attribute the symptoms of this individual as malingering; they're most likely genuine symptoms/behaviors"
got it. i just have alot riding on their opinions right now. thats why i am touchy
It could help to get a second oppinion if you're worried that this was a misdiagnosis in some way
Unless it matches what is going on
I'm surprised that the clinician did not go over with you in regard to explaining their findings/diagnosis
I mean- if they're helping you with something, you should know what it is right?
that is my theory
i am not sure whether i am bipolar or schizoaffective
At least they let you have a copy of the assessment I guess
Did you get medication prescribed?
i am receiving an injectable anti psychotic, lithium
It seems that the current diagnosis for now is schizoaffective/bipolar type
And the medication lithium is a mood stabilizer and the celexa an antidepressant
Is the medication working for you?
it seems to be. my thinking is not bizarre, usually, i am not suffering from mania and hypersexuality
In order for a specific diagnosis to be given, most of the required symptoms must be evident.
So, if they gave this specific diagnosis versus another one, it means there was justification in assigning it rather than another one
no thank you
Take care; you welcome!
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