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Rule Outs NCMHCE
Rule out diagnoses DSM-5
| Disorder | Rule Outs |
|---|---|
| Antisocial Personality Disorder | Criminal Behavior, Substance Abuse, Narcissistic PD, Paranoid PD, hypomanic episode in bipolar II disorder, cyclothymic disorder |
| Brief Psychotic Disorder | psych. DO due to med. cond., delirium, sub./med. induced psych. DO/delirium/intox., schizophren. DO, Delusional DO, Bipolar DO with psych. feat., other schizo. spec. and other psych. DO, factitious DO, PD, schizophrenia, Dep. w/ psych. feat. |
| Delusional Disorder | delirium, major neuro. DO, psych. DO due to med. cond., subs/med.-induced psych. DO, schizophrenia, schizophren. DO, Dep. DO w/ psych. feat., Bipolar DO w/ psych. feat., OCD or body dismorph. DO w/ absent insight/delusional beliefs, schizoaffective DO |
| major depressive disorder | cancers - present as dep., renal and cardiopulm. dis., infections dis., neuro. illness, nutritional deficiency, endocrinologic anomaly, manic epis. w/ irritable mood or mixed epis., subs/med-induced depressive DO, ADHD, adjust. DO w/ dep. mood, sadness |
| tourette's disorder | Abn. move. med. cond., Effects of subs., Choreiform, dystonic, athetoid, myoclonic, hemiballismic move., Spasms, Hemifacial spasm, Synkinesis, Med-induced move. DO, Stereotyp. move. DO, Autism, compuls., schzphrnia, prov. tic DO, chron. motor DO, pers. mo |
| adjustment disorders | acute stress disorder, Major depressive disorder , PTSD, PD, Psychological factors affecting other medical conditions, Normative stress reactions |
| major or mild neurocognitive disorder due to Alzheimer disease | Normal aging, Major depressive disorder, Delirium, Other neurocognitive disorders, Medical conditions |
| anorexia nervosa | medical condition causing weight loss, major depressive DO resulting in lack of appetite and weight loss, substance abuse DO, bulimia nervosa, social anxiety DO, body dysmorphic DO, OCD, schizophrenia, avoidant/restrictive food intake DO |
| ADHD | Normal temperamental characteristics, Depressive DO, Bipolar DO, Anxiety DO, Intermittent explosive DO, Oppositional defiant DO, Stereotypic movement DO, Tourette's DO, Autism, Specifi |
| exhibitionistic disorder | Neurocognitive disorders, Conduct disorder , Antisocial personality disorder, Schizophrenia , Substance use disorders , Situational difficulties (i.e., lack of suitable partners) |
| borderline personality disorder | Hist. PD, Narcissistic PD, Paranoid PD (do not include self-destructive behavior or feelings of aloneness), Depressive DO, Bipolar DO, Person. change due to another med. cond. , SUD, ID problems, DependentPD, SchizotypalPD, AntisocialPD |
| generalized anxiety disorder | PTSD, adjust. DO, depressive DO, psych. DO, Bipolar DO, anxiety DO med cond., OCD, social anxiety DO, SUD induced anxiety, panic DO |
| factitious Disorder | conversion DO, borderline PD, somatic symptom DO, med. cond. or mental DO not associated w/ intentional symptoms, malingering |
| somatic symptom Disorder | other med. cond., schizophrenia, illness anxiety DO, panic DO, GAD, depressive DO, sexual dysfunction, conversion DO, dissociative DO, OCD, body dismorphic DO, delusional DO |
| body dysmorphic disorder | normal appearance concerns, psych. DO, eating DO, gender dysphoria, MDD, avoidant PD, OCD and related DO, delusional DO somatic type, koro, anxiety DO, illness anxiety DO |
| schizoid personality disorder | "loner" w/o pathology, delusional DO, schizophrenia, autism, bipolar or MDD DO w/ psych. feat., SUD, personality change due to med. cond., schizotypal PD, paranoid PD |
| genito-pelvic pain/penitration disorder | occasional pain associated with sex, medical condition, inadequate sexual stimuli, somatic symptom DO and related DO, specific phobia |
| premature ejaculation | occasional problems with premature ejaculation, substance/medication induced sexual disfunction |
| male hypoactive sexual desire disorder | substance/medication use, interpersonal factors, MDD or other nonsexual mental DO, another medical condition, other sexual dysfunction, occasional problems with sexual desire |
| persistent depressive disorder | bereavement or adjustment DO w/ depressed mood, substace abuse, MDD, psych. DO, PD, substance/medication induced bipolar or depressive DO, bipolar or depressive disorder due to another medical condition |
| depersonalization/derealization disorder | other dissociative DO, schizophrenia and other psychotic DO, MDD, anxiety DO, OCD, histrionic PD, illness anxiety DO, substance/medication induced DO, mental DO due to medical condition |
| paranoid personality disorder | delusional DO persecutory type, schizophrenia, MDD w/ psych. feat., personality change due to med. cond., SUD, borderline PD, narcissistic PD, antisocial PD, schizotypal PD |
| gambling disorder | non disordered gambling, manic episode, PD, adverse effect of meds |
| pyromania | insurance gain, purposeful arson, normal curiosity about fire or experimentation by children, impaired judgement due to medical condition, fire set due to conduct DO or similar DO |
| pedophilic disorder | major neurocogntive DO, schizophrenia, situational difficulties, antisocial PD, alcohol and SUD, OCD |
| major or mild vascular neurocognitive disorder | delirium, other neurocognitive DO, other medical conditions, MDD |
| schizophreniform disorder | brief psych. DO, delirm, maj. neuro. DO, depress./bip. DO w/ psych. or cat. feat., schzphrn, delusnl DO, autism, ADHD, PTSD, TBI, OCD, DO disorg. speech in child, schztyplPD, parndPD, schzdPD, other psych. DO, schzoaffct. DO, sub./med induced psych. DO |
| specific phobia | normal shyness, OCD, illness anx. DO, sep. anx. DO, paranoid PD, panic DO, schizoid PD, MDD, agoraphobia, social anx. DO, eating DO, schizophrenia spectrum & other psych. DO, trauma & stressor-related DO |
| dissociative identity disorder | borderline PD, schizophrenia or other psychotic DO, MDD, bipolar DO, conversion DO, seizure DO, facticious DO, substance/med induced DO, PTSD, malingering in forensic context |
| schizophrenia | temp. lobe epil., neur. dis. or trauma, poison, endoc. DO, brief psych. DO, sczphrnfrm DO, sczfctv DO, manic ph of BiPD, Dlusnl DO, schzd & schztpl PD, SUD, autism, comm. DO, mentl DO w/ psych. episds or cat. feat., OCD, body dysm. DO, PTSD |
| transvestic DO | major nuerocognitive DO, schizophrenia, situational difficulties, fetishistic DO, gender dysphoria |
| narcolepsy | hypersomnolence, sleep deprivation and insufficient nocturnal sleep, sleep apnea leading to daytime sleepiness, abuse of sedative drugs, withdrawal from stimulant drugs, seizures, chorea and movement DO, schizophrenia, conversion DO, MDD |
| narcissistic personality disorder | narcissistic traits w/o DO, histrionic PD, borderline PD, obsessive compulsive PD, BiP DO w/mania or hypomania, SUD, antisocial PD |
| bulimia nervosa | Anorexia - binge-eating/purging type (body weight is much below normal), Kleine-Levin syndrome (episodic eating binges and hypersomnia) , Borderline PD (poor impulse control including impulsive eating) , Binge-eating disorder , MDD w/ atypical features |
| erectile disorder | Presence of erections during REM sleep, morning erections, or erections with masturbation suggest a psychological rather than a physical cause , MDD, Subs/med use , Male hypoactive sexual desire DO, Premature ejaculation, Another medical condition |
| histrionic personality disorder | Borderline PD, Narcissistic PD, Dependent PD, Hypomanic episode in BiPII, Hypomanic symptoms in cyclothymic disorder , Antisocial PD, SUD, Personality change due to another medical condition |
| sexual masochism | major neurocognitive DO, schizophrenia, situational difficulties, dependent PD, alcohol & SUD, other paraphilic DO, sexual masochism in absence of distress |
| obsessive-compulsive disorder | Tourette's & tic DO, Temporal lobe epilepsy, Schizophrenia and other psychotic DO, Obsessive-compulsive PD, Eating disorders , MDD, Body dysmorphic DO, Hoarding DO, Trichotillomania Stereotypic movement DO, GAD, Specific phobia, Social anxiety DO |
| autism spectrum disorder | congenital hearing impairment, psychosocial deprivation, childhood schizophrenia, rett DO (in girls), OCD, schizoid PD, selective mutism, language DO, social communication DO, ADHD ID w/o autism, stereotypic movement DO |
| obsessive-compulsive personality disorder | OCD, SUD, personality change due to another medical condition, hoarding DO, narcissistic PD, schizoid PD, antisocial PD |
| selective mutism | pragmatic communication DO, speech sound DO, language DO, childhood onset fluency DO, lack of knowledge of language, schizophrenia or other psychotic DO, severe ID, social anxiety DO autism |
| voyeuristic disorder | major neurocognitive disorder, schizophrenia, situational difficulties, antisocial PD, conduct DO, SUD |
| posttraumatic stress disorder | TBI caused by the traumatic event, substance abuse, borderline PD, factitious DO, malingering, GAD, adjust. DO, dissociative DO, conversion DO, psychotic DO, MDD, acute stress DO, anxiety DO, OCD |
| trichotillomania | aloprecia or hair pulling due to medical condition, normative hair removal or manipulation, OCD, sterotypic movement DO, psychotic DO |
| obstructive sleep apnea hypopnea | primary snoring, narcolepsy, hypersomnia including related to depression, insomnia DO, central sleep apnea, sleep-related apnea, sleep-related hypoventilation, circadian rhythm sleep DO panic attacks, substance/medication induced sleep DO |
| frotteuristic disorder | major neurocognitive disorder, schizophrenia, conduct disorder, antisocial PD, SUD, situational difficulties |
| conversion disorder | substance/medication induced etiologies, neurological disease, somatic symptom DO, somatization DO, body dysmorphic DO, dissociative DO, factitious DO and malingering, depressive DO, panic DO |
| cyclothymic disorder | Subs/med induced BiP and related DO or depressive DO, MDD, BorderlinePD, BiP w/ rapid cycling, Depressive and BiP and related DO due to another med. cond. |
| dependent personality disorder | dependent traits w/o pathology, depressive DO, agoraphobia, panic DO, SUD, personality change due to med. condition, borderline PD |
| intermittent explosive disorder | Alcohol or drug intox or WD, CD, Dissociative DO, Amok, Disruptive mood dysreg. DO, Antisocial PD, Major neurocog. DO Delirium, ADH, ODD, Autism, Personality change due to another medical condition, Borderline PD |
| avoidant personality disorder | social phobia, dependent PD, schizoid PD, agoraphobia, SUD, personality change due to another medical condition |
| bipolar I disorder | BiPII, schozophrenia, schizoaffective DO, subs. abuse, delirium, cyclothymic DO, MDD, BiP due to another medical condition, PD, DO w/ prominant irritability, ADHD, subs/med induced BiP DO, panic DO, GAD or other anxiety DO, PTSD |
| gender dysphoria | hermaphroditis, severe distress about homosexuality, body dysmorphic disorder, schizophrenia and other psychotic DO |
| kleptomania | stealing for gain, faking to avoid prosecution, conduct disorder in childhood and antisocial PD, manic episode in BiP, major neurocognitive DO, psychotic DO |
| delirium | major neurocognitive DO, psychotic DO, Bipolar DO w/ psychotic features, depressive DO w/ psychotic features, acute stress DO, factitious DO and malingering |
| female orgasmic disorder | nonsexual mental disorder, interpersonal factors, another medical condition, substance/medication use, other sexual dysfunction, incompatible sexual technique or inadequate sexual stimulation |
| delayed ejaculation | incompatible sexual technique, substance/medication use, dysfunction with orgasm, another medical condition |
| schizoaffective disorder | psych. DO due to med. cond., delirium, major neurocog. DO, subs/med. induced psych. DO, subs/med induced delirium, schizophrenia, BiP DO w/ psych. feat., MDD w/ psych. feat., brief psych. DO, schizotypal PD, schizoid PD, delusional DO, schizophreniform DO |
| dissociative amnesia | neurocognitive DO, delirium, normal aging, dissociative identity DO, factitious DO and malingering, PTSD, subst related DO, posttraumatic amnesia due to brain injury, seizure DO, catatonic stupor, depersonalization/derealization DO, acute stress DO |
| schizotypal personality disorder | delusional DO, schizophrenia, mood DO w/ psych. feat., SUD, personality change due to another med. cond., mild form of autism, communication DO, BiP or depressive DO w/ psych. feat, paranoid PD, schizoid PD, borderline PD, transient turmoil of adolescence |
| female sexual interest/arousal disorder | nonsexual mental disorders, interpersonal factors, substance/medication use, another medical condition, other sexual dysfunctions, inadequate or absent sexual stimuli |
| separation anxiety disorder | pervasive developmental DO, schizophrenia or other psych. DO, GAD, panic DO w/ agoraphobia, agoraphobia w/o history of panic DO, psychotic DO, CD, developmentally appropriate levels of separation anxiety |
| panic disorder | myocardial infarcation, social anxiety DO, GAD, depressive DO, specific phobia, illness anxiety DO, factitious DO, susbtance/medication induced anxiety DO, anxiety DO due to another med. condition, other mental DO w/ panic attacks, malingering |
| oppositional defiant disorder | normal oppositional behavior, CD, ADHD, depressive DO, BiP DO, depressive mood dysregulation DO, social anxiety DO, intermittent explosive DO, ID, not understanding instructions due to language disability or poor hearing |
| conduct disorder | depressive DO, Bipolar DO, ADHD, intermittent explosive DO, adjustment DO, ODD, disruptive mood disregulation DO |
| fetishistic disorder | transvestic DO, sexual masochism DO or other paraphilic DO, schizophrenia, major or minor neurocognitive DO, situational difficulties, fetishistic behavior w/o fetishistic DO |
| illness anxiety disorder | other medical cond, somatic sympt in children, somatic sympt DO, OCD, GAD, MDD, sep. anx. DO, body dysmorph. DO, specific phobia, psychotic DO, adjustment DO |
| insomnia | use of stimulants, sedative abuser seeking drugs, normal sleep variations, restless legs syndrome, parasomnias, breathing related sleep DO, narcolepsy, situational/acute insomnia, circadian rhythm sleep wake DO, substance/medication induced sleep DO |
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