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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,

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when a diagnosis is schizoaffective disorder bipolar type, rule out malingering. what does it mean.
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 and other Mental Health Specialists are ready to help you

Hi Gerald,

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