Level 2: Mood Change – Initial History: Expert Panel DDX

How does your differential compare with the experts?

What questions will comprise your remaining history and review of systems?

Experts’ DDX:

  1. Major depression – top of list (moderate to moderately severe)
    1. Atypical vs typical (melancholic)
    2. Single episode
    3. Recurrent – (no, this is the first episode)
    4. Seasonal depression
    5. With psychosis
  2. Bipolar depression
  3. Cyclothymia – less likely
  4. Bipolar II – less likely
  5. (Normal) sadness
  6. Anxiety disorder with depressive features
    1. PTSD
    2. GAD
    3. OCD
  7. Personality disorders
    1. Borderline personality disorder
  8. Medical condition
    1. Thyroid (hyper; or hypo)
    2. Autoimmune disease
  9. Post partum depression – move up
  10. Depression (premenstrual dysphoric disorder – PMDD) – move up
  11. Substance related
    1. Legal drugs
      Steroids, cardiac meds, birth control pills, sleep meds (barbs, benzos), anticonvulsants, Antihistamines
    2. Illicit drugs
      Alcohol, marijuana, K2, synthetic marijuana, opiates (heroin), methamphetamine, cocaine