Mood Disorders
A 28-year-old client reports feeling “down” for the past 3 years. She functions at work but describes low energy, poor self-esteem, and hopelessness. She denies any manic symptoms.
Persistent Depressive Disorder
A client experiences obsessions about contamination and repetitive handwashing that consumes several hours daily.
Question: What diagnosis is most likely?
OCD
A client demonstrates flat affect, avolition, and social withdrawal without prominent hallucinations.
Question: What type of schizophrenia symptoms are these?
Negative symptoms in Schizophrenia
A client is emotionally cold, detached, and uninterested in close relationships.
Question: What diagnosis is most likely?
Schizoid Personality Disorder
A child demonstrates severe temper outbursts three times weekly for over a year between ages 6–18.
Question: What diagnosis should be considered?
DMDD
A 24-year-old client presents with unstable relationships, chronic feelings of emptiness, impulsive spending, self-harm behaviors, and intense fear of abandonment. The client also reports periods of increased energy and decreased need for sleep lasting 2–3 days during times of interpersonal stress.
Question: Which two diagnoses must be carefully differentiated?
Borderline Personality Disorder and Bipolar II Disorder
A 22-year-old college student presents with periods of elevated mood, increased productivity, decreased need for sleep, and impulsive spending lasting 5 days. She also reports several episodes of major depression. She has never been hospitalized.
Bipolar II Disorder
A client suddenly experiences heart palpitations, chest pain, sweating, and fear of dying during episodes that peak within minutes. She now avoids stores and crowds.
Question: Which two diagnoses should be considered?
Panic Disorder and Agoraphobia?
A client has depressive episodes and psychotic symptoms, but hallucinations also occur during periods without mood symptoms.
Question: What diagnosis should be considered?
Schizoaffective Disorder
A suspicious client interprets benign comments as threatening and persistently distrusts others.
Question: What diagnosis best fits?
Paranoid Personality Disorder
A child argues with adults, deliberately annoys others, and refuses rules without severe aggression or criminal behavior.
Question: What diagnosis is most appropriate?
Oppositional Defiant Disorder
An 11-year-old child presents with distractibility, irritability, impulsivity, sleep disturbance, and difficulty concentrating in school. The child recently witnessed domestic violence and demonstrates hypervigilance and exaggerated startle response.
Question: Which trauma-related diagnosis must be ruled out before diagnosing ADHD?
Post-Traumatic Stress Disorder
A client presents with severe depression, psychomotor retardation, feelings of worthlessness, and suicidal ideation occurring two months after losing a spouse. Symptoms include pervasive guilt unrelated to the deceased.
What diagnosis should be considered over normal grief?
Major Depressive Disorder
A child repeatedly pulls out hair when stressed, resulting in visible hair loss.
Question: What diagnosis should be considered?
Trichotillomania
A client presents with hallucinations occurring only during methamphetamine intoxication.
Question: What diagnosis is most likely?
Substance-Induced Psychotic Disorder
A perfectionistic client is rigid, preoccupied with rules, and excessively devoted to work.
Question: What diagnosis should be considered?
Obsessive-Compulsive Personality Disorder
A teen engages in theft, aggression toward peers, and destruction of property.
Question: What diagnosis should be considered?
Conduct Disorder
A client experiences chronic mood instability with numerous periods of depressive symptoms and hypomanic symptoms over 2 years, but symptoms never meet full criteria for hypomanic or major depressive episodes.
Question: What diagnosis is most likely?
Cyclothymic Disorder
A 30-year-old arrives in the ER after three days without sleep. He is euphoric, grandiose, hyperverbal, and attempting to invest his life savings into unrealistic business schemes.
Question: Which diagnosis is most appropriate?
Bipolar I Disorder
A client reports panic attacks that occur unexpectedly and repeatedly worries about future attacks for months.
Question: What diagnosis is most likely?
Panic Disorder
A client presents with psychotic symptoms lasting 3 months.
Question: Which diagnosis should be considered between brief psychotic disorder and schizophrenia?
Schizophreniform Disorder
A client rapidly forms intense attachments and becomes dramatic and flirtatious in sessions.
Question: Which diagnosis may be confused with BPD but lacks chronic emptiness and self-harm?
Histrionic Personality Disorder
A child struggles academically despite average intelligence and adequate educational opportunity, particularly in reading.
Question: What diagnosis is most likely?
Specific Learning Disorder
An 8-year-old child is referred for evaluation due to difficulty focusing in class, interrupting others, excessive talking, and trouble completing assignments. Teachers also report the child struggles with social reciprocity, has intense fixated interests in train schedules, becomes distressed by changes in routine, and demonstrates sensory sensitivities to noise and clothing textures.
Question: Which two neurodevelopmental diagnoses must be carefully differentiated and may also co-occur?
Autism Spectrum Disorder and Attention-Deficit/Hyperactivity Disorder
A 19-year-old presents with irritability, pressured speech, risky sexual behavior, and inflated self-esteem after starting prednisone.
Question: What diagnosis should be ruled out before diagnosing Bipolar Disorder?
Substance/Medication-Induced Bipolar Disorder
Requiring exposure to actual or threatened death, serious injury, or sexual violence. This exposure must occur in one of four ways: directly experiencing, witnessing, learning of a close friend/relative's trauma, or extreme indirect exposure to aversive details
Criterion A for PTSD
A client believes strangers are in love with them despite no evidence.
Question: Which subtype of delusional disorder is most likely?
Erotomanic type Delusional Disorder
A client avoids relationships due to fear of rejection but does not display odd beliefs or perceptual distortions.
Question: Which diagnosis is more likely than schizotypal personality disorder?
Avoidant Personality Disorder
A child exposed to chronic neglect demonstrates emotional withdrawal, limited positive affect, and minimal responsiveness to caregivers.
Question: What trauma-related childhood diagnosis should be considered?
Reactive Attachment Disorder
A 13-year-old adolescent is referred for behavioral concerns including defiance toward authority figures, frequent arguments, stealing from peers, physical aggression, and lack of remorse after hurting others. History reveals severe early childhood neglect, multiple foster placements, difficulty forming healthy emotional attachments, and limited emotional responsiveness to caregivers.
Question: Which three diagnoses should be carefully differentiated based on the pattern of aggression, attachment disturbance, and oppositional behavior?
Conduct Disorder, Oppositional Defiant Disorder, and Reactive Attachment Disorder