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Dr. Rossi
Dr. Rossi, Psychotherapist
Category: Mental Health
Satisfied Customers: 4627
Experience:  PsyD, LPC, CHt
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when a diagnosis is schizoaffective disorder bipolar type,

Resolved Question:

when a diagnosis is schizoaffective disorder bipolar type, rule out malingering. what does it mean.
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Rossi replied 2 years ago.

Dr. Rossi :

Hi,

Dr. Rossi :

Is this a written diagnosis you're looking at?

Dr. Rossi :

Generally disorders are conded based on their class. Bipolar disorder is a depressive spectrum condition.

Dr. Rossi :

Schizoaffective is a different spectrum condition

Dr. Rossi :

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.

JACUSTOMER-rlnhvp4x- :

so if they say rule out malingering they are definitely accusing you of malingering?

Dr. Rossi :

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)

Dr. Rossi :

Ensure that the behavior is genuinely due to the condition rather than malingering.

Dr. Rossi :

R/O (rule out) is not a definite

Dr. Rossi :

A person can have more than one disorder. For example bipolar disorder and schizoaffective disorder.

Dr. Rossi :

Or, a clinician may change a diagnosis later on if it becomes more clear what is behind the person's symptoms/behaviors.

JACUSTOMER-rlnhvp4x- :

you can have both. i thought schizoaffective disorder had a depressive and bipolar subtypes

Dr. Rossi :

A person w/ schizoaffective disorder may experience symptoms as those found in bipolar disorder ex: mania/psychosis or depressed mood.

JACUSTOMER-rlnhvp4x- :

i see

Dr. Rossi :

And a person can have a subtype as well

Dr. Rossi :

I just need to know how it was charted to know for sure

Dr. Rossi :

Do you see this diagnosis listed on one line generally it would say something like Axis I or Axis II etc

JACUSTOMER-rlnhvp4x- :

if i recall it said axis 1

Dr. Rossi :

A schizoaffective diagnosis w/ bipolar subtype is possible and it is possible for a person to have multiple diagnosis

JACUSTOMER-rlnhvp4x- :

axis one is where they also put rule out malingering


 

Dr. Rossi :

In that respect, the clinician is most likely suspecting that manic behaviors may be as a result of the schizoaffective underlined condition

Dr. Rossi :

Yes, R/O would mean that they're suspecting that the behavior is more genuine than fake

Dr. Rossi :

Hence R/O rule it out (cancel it)

Dr. Rossi :

It is something used when a person may have doubt but is more inclined to rule it out

Dr. Rossi :

Does it make sense?

JACUSTOMER-rlnhvp4x- :

let me see if i get this

Dr. Rossi :

It is in case another clinician looks at their summary and keeps in mind to rule it out

JACUSTOMER-rlnhvp4x- :

so they were ruling out malingering

Dr. Rossi :

Yes

Dr. Rossi :

Think of R/O as FYI

JACUSTOMER-rlnhvp4x- :

for your information

Dr. Rossi :

Yes, in those guidelines to whoever may read the diagnostic summary

Dr. Rossi :

To consider ruling that out as a cause and focus on the diagnosis/conditions sited

JACUSTOMER-rlnhvp4x- :

oh. so thay is not an accusation

Dr. Rossi :

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

Dr. Rossi :

It's not an accusation. If it was, they would have documented it as such

JACUSTOMER-rlnhvp4x- :

okay. i think i get it.


rule out as axis 1 means elimination of that

Dr. Rossi :

Malingering is volitional.

Dr. Rossi :

Yes, rule it out as not being evident

JACUSTOMER-rlnhvp4x- :

so the opposite would be to rule in

Dr. Rossi :

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)

Dr. Rossi :

They could of used Factitious Disorder instead

Dr. Rossi :

These could be both physical/psychological in nature. Think of malingering leading to some sort of a gain.

JACUSTOMER-rlnhvp4x- :

it is just that when i saw rule out malingering next to schizoaffective i freaked

JACUSTOMER-rlnhvp4x- :

i understood what malingering meant

JACUSTOMER-rlnhvp4x- :

but the rule out i did not understand


 

Dr. Rossi :

No; don't freak out.

Dr. Rossi :

Is it more clear now?

Dr. Rossi :

The clinician is saying basically "don't attribute the symptoms of this individual as malingering; they're most likely genuine symptoms/behaviors"

JACUSTOMER-rlnhvp4x- :

got it. i just have alot riding on their opinions right now. thats why i am touchy

Dr. Rossi :

Sure

Dr. Rossi :

It could help to get a second oppinion if you're worried that this was a misdiagnosis in some way

Dr. Rossi :

Unless it matches what is going on

Dr. Rossi :

I'm surprised that the clinician did not go over with you in regard to explaining their findings/diagnosis

JACUSTOMER-rlnhvp4x- :

nope


 

Dr. Rossi :

I mean- if they're helping you with something, you should know what it is right?

JACUSTOMER-rlnhvp4x- :

that is my theory

JACUSTOMER-rlnhvp4x- :

i am not sure whether i am bipolar or schizoaffective


 

Dr. Rossi :

At least they let you have a copy of the assessment I guess

Dr. Rossi :

Did you get medication prescribed?

JACUSTOMER-rlnhvp4x- :

i am receiving an injectable anti psychotic, lithium

JACUSTOMER-rlnhvp4x- :

and celexa


 

Dr. Rossi :

It seems that the current diagnosis for now is schizoaffective/bipolar type

Dr. Rossi :

And the medication lithium is a mood stabilizer and the celexa an antidepressant

Dr. Rossi :

Is the medication working for you?

JACUSTOMER-rlnhvp4x- :

it seems to be. my thinking is not bizarre, usually, i am not suffering from mania and hypersexuality


 

Dr. Rossi :

In order for a specific diagnosis to be given, most of the required symptoms must be evident.

Dr. Rossi :

So, if they gave this specific diagnosis versus another one, it means there was justification in assigning it rather than another one

JACUSTOMER-rlnhvp4x- :

got ya


 

Dr. Rossi :

Great

Dr. Rossi :

Anything else?

JACUSTOMER-rlnhvp4x- :

no thank you

Dr. Rossi :

Take care; you welcome!

Dr. Rossi, Psychotherapist
Category: Mental Health
Satisfied Customers: 4627
Experience: PsyD, LPC, CHt
Dr. Rossi and other Mental Health Specialists are ready to help you
Expert:  Dr. Rossi replied 2 years ago.
Our chat has ended, but you can still continue to ask me questions here until you are satisfied with your answer. Come back to this page to view our conversation and any other new information.

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Expert:  Dr. Rossi replied 2 years ago.

Hi Gerald,

 

Did you need any further info? I noticed that you've not yet rated the thread. Let me know. Thanks!

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