Level 2: Mood Change – MHROS: Expert Panel DDX

How does your differential compare with the experts?

What physical exam maneuvers would you like to perform?

Experts’ DDX:

  1. 1. Major depression – top of list (moderate to moderately severe)
    1. 1.1. Single episode
    2. 1.2. Melancholic
  2. 2. Medical condition
    1. 2.1. Thyroid (hyper; or hypo) – needs to be checked
    2. 2.2. Autoimmune disease – fairly low
    3. 2.3. DM
  3. 3. Substance related
    1. 3.1 Legal drugs
      Steroids, cardiac meds, birth control pills, sleep meds (barbs, benzos), anticonvulsants, Antihistamines
    2. 3.2. Illicit drugs – lower until a drug screen is done
      Alcohol, marijuana, K2, synthetic marijuana, opiates (heroin), methamphetamine, cocaine
  4. 4. Anxiety disorder with depressive features – very less likely
  5. 5. Personality disorders – much less likely
  6. 5.1. Borderline personality disorder
  7. 6. Depression (premenstrual dysphoric disorder – PMDD) –– put lower
  8. 7. Pregnancy