DSM-5 Disorders, Differential Diagnosis, and Treatment

Intellectual Disability (Formerly mental retardation).

Impairment in general mental abilities

Impacts adaptive functioning (conceptual, social, and practical).

Severity is now based on adaptive functioning, no longer on IQ.

70 or below.

Differential Diagnosis:

A. Major and Mild Neurocognitive Disorders

B. Communication Disorders

C. Specific Learning Disorder

D. Autism Spectrum Disorder

Global Developmental Delay

Fails to meet expected developmental milestones in several areas of functioning.

Under the age of 5 when clinical severity cannot be assessed during early childhood.

Language Disorder

Persistent difficulties in acquisition and use of language across modalities due to comprehension or production, with limited vocabulary, limited sentence structure, and impaired discourse.

Differential Diagnosis:

A. Normal Variations in Language

B. Hearing or Other Sensory Impairment

C. Intellectual Development Disorder

D. Neurological Disorders

E. Language Regression

Speech Sound Disorder

Persistent difficulties with speech and sound production.

Interferes with intelligibility and prevents communication.

Differential Diagnosis:

A. Normal Variations in Speech

B. Hearing or Other Sensory Impairment

C. Structural Deficits

D. Dysarthria

E. Selective Mutism

Childhood Onset Fluency Disorder (Previously stuttering)

Disturbances in normal fluency and timing pattern of speech, which causes anxiety about speaking.

Differential Diagnosis:

A. Sensory Deficits

B. Normal Speech Dysfluencies

C. Medication Side Effects

D. Adult-Onset Dysfluencies

E. Tourette's Disorder

Social Pragmatic Communication Disorder

Difficulties in the social use of verbal and non-verbal communication.

Impairment in social use, matching language to social context/needs of the listener, rules of conversation, understanding not explicitly stated.

Differential Diagnosis:

A. Social Anxiety Disorder

B. Intellectual Disability

C. Global Developmental Delay

D. Autism Spectrum Disorder

E. Attention-Deficit/Hyperactivity Disorder

Autism Spectrum

Communication difficulties

Overly dependent on routines

Highly sensitive to changes

Intensely focused on inappropriate items

Must begin in childhood (12-24 months).

Differential Diagnosis:

A. Rett Syndrome

B. Selective Mutism

C. Intellectual Disability without Autism Spectrum Disorder

D. Attention-Deficit/Hyperactivity Disorder

E. Language Disorder

F. Social (Pragmatic) Communication Disorder

G. Stereotypic Movement Disorder

H. Schizophrenia

Treatment:

Best treatment social-cognitive method with speech pathologist.

Behavioral therapy to teach daily living skills, but can also be ineffective for lower-fucntioning.

Meds for aggressive & seizures.

ADHD

Two categories of difficulty:

1. Inattention (Issues with task-accomplishment).

2. Hyperactivity/impuslivity

Pattern of behavior must be present in multiple settings.

Must be present prior to age 12 for 6 months.

Differential Diagnosis:

A. Oppositional Defiant Disorder

B. Autism Spectrum Disorder

C. Reactive Attachment Disorder

D. Personality Disorders

E. Depressive Disorders

F. Bipolar Disorder

G. Substance Use Disorders

H. Disruptive Mood Dysregulation Disorder

I. Specific Learning Disorder

J. Intellectual Disability

K. Autism Spectrum Disorder

L. Anxiety Disorders

M. Psychotic Disorders

N. Medication-Induced Symptoms of ADHD

O. Neurocognitive Disorders

Treatment Approaches:

Client education

Group counseling

Individual counseling

Parent counseling/education

Medication

School Intervention

Social skills training

Best treatment is behavioral, with goal of increasing child's ability to learn.

Training teachers.

Time-management & scheduling techniques.

Stress-management and relaxation techniques.

Specific Learning Disorder

Persistent difficulties in reading, writing, arithmetic/math reasoning.

Must not be better accounted for by developmental delay.

Differential Diagnosis:

A. Normal Variations in Academic Attainment

B. Intellectual Disability

C. Learning Difficulties Due to Neurological or Sensory Disorders

D. Neurocognitive Disorders

E. Attention-Deficit/Hyperactivity Disorder

F. Psychotic Disorders

Motor Disorders

Developmental Coordination Disorder:

Onset: Early Developmental Period

Symptoms: Difficulty engaging coordinated motor activity appropriate to the stated age and cultural exposure

Inability to use culturally appropriate eating utensils (e.g. fork, chopsticks, finger set), handwriting difficulties, unsteady gate,

Bumping into others, tripping over own feet, and struggling to hold objects

Differential Diagnosis:

A. Motor Impairments Due to Another Medical Condition

B. Intellectual Development Disorder

C. Attention-Deficit/Hyperactivity Disorder

D. Autism Spectrum Disorder

E. Joint Hypermobility Syndrome

Stereotypic Movement Disorder:

Onset: Early Developmental Period/by age 3

Symptoms: Repeated, obsessive, almost rhythmic movements that do not appear to serve a purpose or be adaptive to the individual's context.

Movements may or may not cause self-injury.

Rocking, head banging, hitting self, skin picking, nail biting, biting self, arm waving, face slapping

Differential Diagnosis:

A. Normal Development

B. Autism Spectrum Disorder

C. Tic Disorders

D. Obsessive-Compulsive and Related Disorders

E. Other Neurological and Medical Conditions

Tic Disorders (Tourettes and Persistent)

Tourette's Disorder:

Has both motor and vocal tics

Differential Diagnosis:

A. Abnormal Movements that May Accompany Other Medical Conditions and Stereotypic Movement Disorder

B. Substance-Induced Paroxysmal Dyskinesias

C. Myoclonus

D.Obsessive-Compulsive and Related Disorders

Persistent Tic Disorder:

(chronic) Has only one or more of only vocal or only motor

Differential Diagnosis:

A. Abnormal Movements that May Accompany Other Medical Conditions and Stereotypic Movement Disorder

B. Substance-Induced Paroxysmal Dyskinesias

C. Myoclonus

D. Obsessive-Compulsive and Related Disorders

Delusional Disorder

At least one month, delusions but no hallucinations and no marked impairment in functioning.

Brief Psychotic Disorder

1 day-1 month.

Abrupt onset of: delusions, hallucinations, bizarre behavior/posture, and disorganized speech.

Differential Diagnosis:

A. Other Medical Conditions

B. Substance-Related Disorders

C. Other Psychotic Disorders

D. Depressive and Bipolar Disorders

E. Malingering

F. Factitious Disorder

G. Personality Disorders

Schizophreniform Disorder

Treatment:

Antipsychotics

Family Therapy

Group Therapy

Hospitalization

Psychoeducation

Psychotherapy

Schizophrenia

6 months +.

Delusions, hallucinations, disorganized speech and behavior.

Present for 6 months with one month of active symptoms.

Exclude schizoaffective, mood disorder, medical, autism, and developmental.

Differential Diagnosis:

A. Delusional Disorder

B. Schizoaffective Disorder

C. Brief Psychotic Disorder

D. Schizophreniform Disorder

E. Schizotypal Personality Disorder

F. Autism Spectrum Disorder or Communication Disorders

G. Major Depressive Disorder with Psychotic Features or with Catatonia

H. Bipolar Disorder with Psychotic Features or with Catatonia

I. Substance Intoxication (i.e. Hallucinogens, Stimulants)

J. Post-Tramatic Stress Disorder

Treatment:

CBT

Family Therapy

Group Therapy

Individual Therapy

Medication

Psychodynamic Therapy

Psychoeducation

Behavior therapy, social learning programs, family education, social skills training, and vocational rehab.

Schizoaffective Disorder

Uninterrupted period of illness.

Major mood episode (manic and/or major depressive).

+ Criteria A for schizophrenia (hallucinations/delusions).

Mood episode must be present for the majority.

Differential Diagnosis:

A. Schizophrenia

B. Bipolar I Disorder with Psychotic Features

C. Major Depressive Disorder with Psychotic Features

D. Post-Tramatic Stress Disorder

E. Psychotic Disorder Due to Another Medical Condition

F. Substance Intoxication

G. Substance/Medication-Induced Psychotic Disorder

Treatment:

SSRI

Anti-manic/anti-psychotic meds

CBT

ECT

Family Therapy

Hospitalization

Psychoeducation

Catatonia

Stupor, catalepsy (held against gravity), wavy flexibility, mutism, negativism, posturing, mannerism, stereotyped movement, agitation, grimacing, echolalia, echopraxia (mimicking movements).

Not a separate diagnosis (Must be with another disorder (as specifier), due to medical condition, or unspecified.

Bipolar I

At least one manic episode, onset at 18 years of age, for 7 days.

May be followed by hypomanic and/or majordepressive.

Differential Diagnosis:

A. Major Depressive Disorder

B. Other Bipolar Disorders

C. Attention-Deficit/Hyperactivity Disorder

D. Generalized Anxiety Disorder

E. Psychotic Disorders

F. Panic Disorder

G. Post-Tramatic Stress Disorder

H. Disorders with Prominent Irritability

I. Personality Disorders

Treatment:

CBT

Interpersonal

Psychodynamic

Rational-emotive

CBT

Family Therapy

Medication

Psychoeducation

Bipolar I Disorder

See above.

Bipolar II Disorder

Hypomanic (4 days) and Major Depressive (2 weeks).

If manic episode occurs, move to BPI.

Differential Diagnosis:

A. Other Bipolar Disorders

B. Cyclothymic Disorder

C. Major Depressive Disorder

D. Schizophrenia Spectrum and Other Related Psychotic Disorders

E. Panic Disorder or Other Anxiety Disorders

F. Substance Use Disorders

G. Attention-Deficit/Hyperactivity Disorder

H. Borderline Personality Disorder

Cyclothymic Disorder

Hypomanic symptoms plus major depressive symptoms that do not meet criteria for a full major depressive episode.

2 Years in adults, and 1 year in children.

Differential Diagnosis:

A. Borderline Personality Disorder

B. Bipolar and Related Disorder Due to Another Medical Condition

C. Depressive Disorder Due to Another Medical Condition

D. Substance/Medication-Induced Bipolar and Related Disorder

E. Substance/Medication-Induced Depressive Disorder

F. Bipolar I and II Disorders with Rapid Cycling

Treatment:

CBT

Psychoeducation

Persistent Depressive Disorder (formerly known as dysthymia)

Depressed mood occurs most of the day for at least 2 years (1 for child/adolescent).

A major depressive episode may occur during this disorder.

Differential Diagnosis:

A. Major Depressive Disorder

B. Psychotic Disorders

C. Depressive or Bipolar and Related Disorder Due to Another Medical Condition

D. Substance/Medication-Induced Depressive or Bipolar Disorder

E. Personality Disorders

Treatment:

SSRI

CBT

Interpersonal

Psychodynamic

Supportive therapy

Motivational Interviewing

Disruptive Mood Dysregulation Disorder

7-18 years (onset usually before 10).

Chronic, severe, and non-episodic irritability.

Frequent temper outbursts (at least 1 year in 2 settings) that are developmentally inappropriate.

Differentiated from ODD- greater severity and ODD does not have to include irritability, could only be opposition.

Differentiated from intermittent explosive-non-episodic.

Differential Diagnosis:

A. Oppositional Defiant Disorder

B. Attention-Deficit/Hyperactivity Disorder

C. Bipolar Disorders

D. Intermittent Explosive Disorder

E. Autism Spectrum Disorder

F. Major Depressive Disorder

G. Anxiety Disorders

Major Depressive Disorder

2 weeks of either depressed mood or loss of interest or pleasure in nearly all activities. Must have 5 of the following criteria:

Weight loss, in/hypersomnia, psychomotor agitation/retardation, fatigue, worthlessness, difficulty thinking/concentrating, suicidality.

Distinguish from grief by feelings of emptiness/loss.

Differential Diagnosis:

A. Manic Episodes with Irritable Mood or Mixed Episodes

B. Mood Disorder Due to Another Medical Condition

C. Attention-Deficit/Hyperactivity Disorder

D. Substance/Medication-Induced Depressive or Bipolar Disorder

E. Adjustment Disorder with Depressed Mood

F. Sadness

Treatment:

In the elderly:

Medication

Supportive Psychotherapy

Other:

CBT

Interpersonal

Medication

Psychodynamic

Premenstrual Dysphoric Disorder

Mood irritability, dysphoria, anxiety, repeatedly during the premenstrual phase.

Remits at the onset of menses.

Has adverse effect on work and social functioning.

Differential Diagnosis:

A. Premenstrual Syndrome

B. Dysmenorrhea

C. Bipolar Disorder

D. Major Depressive Disorder

E. Persistent Depressive Disorder

F. Use of Hormonal Treatments

Separation Anxiety Disorder

Excessive fear or anxiety over the separation from home/attachment figures (4 weeks kids, 6 months adults).

1. Distress anticipating separation.

2. Worry about losing attachment figure.

3. Worry about event causing separation.

4. Refusal to love.

5. Fear of being alone.

6. Refusal to sleep away.

7. Nightmares

8. Somatic symptoms.

Differential Diagnosis:

A. Generalized Anxiety Disorder

B. Panic Disorder

C. Agoraphobia

D. Conduct Disorder

E. Social Anxiety Disorder

F. Post-Tramatic Stress Disorder

G. Illness Anxiety Disorder

H. Bereavement

I. Depressive and Bipolar Disorders

J. Oppositional Defiant Disorder

K. Psychotic Disorders

L. Personality Disorders

Treatment:

SSRI & Benzo

Insisitent, firm, and empathetic.

Furnish positive behaviors.

Family should be referred to support group.

Selective Mutism

Failure to speak in social situations where there is an expectation for speaking, despite speaking in other situations.

Differential Diagnosis:

A. Communication Disorders

B. Neurodevelopmental Disorders

C. Schizophrenia

D. Social Anxiety Disorder (Social Phobia)

Specific Phobia

Marked fear/anxiety about a specific object/situation that is out of proportion with actual danger.

Object is actively avoided.

6 months with distress/impairment.

Differential Diagnosis:

A. Agoraphobia

B. Panic Disorder

C. Social Anxiety Disorder

D. Obsessive-Compulsive Disorder

E. Trauma- and Stressor-Related Disorders

F. Eating Disorders

G. Schizophrenia Spectrum and Other Psychotic Disorders

Treatment:

Behavioral

Psychodynamic

Medication

Psychotherapy

Systematic desentization

Social skills training & relaxation strategies.

Social Anxiety Disorder

Fear/anxiety in social situations in which one may be scrutinized. Fears he/she will act in a way that will demonstrate their fear (blushing).

6 months+.

Differential Diagnosis:

A. Normative Shyness

B. Agoraphobia

C. Panic Disorder

D. Generalized Anxiety Disorder

E. Separation Anxiety Disorder

F. Specific Phobias

G. Selective Mutism

H. Major Depressive Disorder

I. Body Dysmorphic Disorder

J. Delusional Disorder

K. Autism Spectrum Disorder

L. Personality Disorders

M. Other Mental Disorders

N. Other Medical Conditions

O. Oppositional Defiant Disorder

Panic Disorder

Recurrent unexpected panic attacks, with at least 4 symptoms.

Abrupt surge of fear/discomfort that reaches peak within minutes.

Followed by 1 month of worry about additional attack and or behavior change to avoid attacks.

Differential Diagnosis:

A. Anxiety Disorder Due to Another Medical Condition

B. Substance/Medication-Induced Anxiety Disorder

Treatment:

Behavioral Therapy

CBT

Medication

Psychodynamic

Psychoed

Agoraphobia

Fear or anxiety of 2 or more:

Public transit, open/closed spaces, lines/crowds, outside the home.

Fear due to thought of escape being difficult.

6 months or more.

Differential Diagnosis:

A. Specific Phobia, Situational Type

B. Separation Anxiety Disorder

C. Social Anxiety Disorder

D. Acute Stress Disorder

E. Post-Tramatic Stress Disorder

F. Panic Disorder

G. Major Depressive Disorder

H. Other Medical Conditions

Treatment:

CBT

Medication

Generalized Anxiety Disorder

Excessive anxiety/worry occurring more days than not for 6 months about a number of events/activities.

Difficulty controlling the worry.

Keyed up, easily fatigued, difficulty concentrating/ blank mind, irritability, muscle tension, sleep disturbance.

Differential Diagnosis:

A. Social Anxiety Disorder

B. Substance/Medication-Induced Anxiety Disorder

C. Post-Tramatic Stress Disorder

D. Obsessive-Compulsive Disorder

E. Depressive, Bipolar, and Psychotic Disorders.

Treatment:

Behavioral Therapy

CBT

Anti-anxiety medication

OCD

Presence of obsessions/complusions.

Time consuming/causes significant distress.

Not pleasurable or experienced as voluntary.

Onset after age 18.

Differential Diagnosis:

A. Anxiety Disorders

B. Major Depressive Disorder

C. Other Obsessive-Compulsive and Related Disorders

D. Eating Disorders

E. Tics and Stereotyped Movements

F. Psychotic Disorders

G. Other Compulsive-like Behaviors

H. Obsessive-Compulsive Personality Disorder

Treatment:

Behavioral Therapy

Cognitive Therapy

Exposure Therapy

Medication

Psychodynamic Therapy

Rational Emotive Response Prevention

Body Dysmorphic Disorder

Preoccupied with one or more perceived deficits/flaws in physical appearance, which are not seen by others.

Includes repetitive behavior (mirroring, checking, grooming).

Onset 12-13 years old, w/ 2/3 of population having onset before age 18.

Differential Diagnosis:

A. Eating Disorders

B. Illness Anxiety Disorder

C. Other Obsessive-Compulsive and Related Disorders

D. Major Depressive Disorder

E. Anxiety Disorders

F. Normal Appearance Concerns and Clearly Noticeable Physical Defects

G. Psychotic Disorders

H. Other Disorders and Symptoms

Treatment:

CBT

Hoarding Disorder

Difficulty discarding/departing with possessions regardless of values. Feel they need to save items.

Results in accumulations/congestion/cluttering of active living areas that comprises their intended use.

Different from Prader-Willi Syndrome.

Differential Diagnosis:

A. Other Medical Conditions

B. Neurodevelopmental Disorders

C. Schizophrenia Spectrum and Other Psychotic Disorders

D. Major Depressive Disorder

E. Obsessive-Compulsive Disorder

F. Neurocognitive Disorders

Trichotilomania

Recurrent pulling out of one's hair, resulting in hair loss.

Repeated attempts to decrease/stop.

Differential Diagnosis:

A.Other Obsessive-Compulsive and Related Disorders

B. Neurodevelopmental Disorders

C. Normative Hair Removal/Manipulation

D. Psychotic Disorders

E. Another Medical Condition

F. Substance-Related Disorders

Treatment:

Behavioral

Psychodynamic

Supportive

Excoriation

Skin picking. Recurrent resulting in skin lesions.

Repeated attempts to stop.

Differential:

Excoriation (Skin-Picking) Disorder

Term

A. Psychotic Disorder

B. Other Obsessive-Compulsive and Related Disorders

C. Neurodevelopmental Disorders

D. Somatic Symptom and Related Disorders

E. Other Medical Conditions

F. Substance/Medication-Induced Disorders

Reactive Attachment Disorder

Inhibited/emotionally withdrawn toward adult caregivers:

Rare/minimal seeking of response and/or comfort.

Social/emotional disturbance with limited responsiveness, affect, unexplained irritability, sad/fearful in non-threatning situations.

Has experienced insufficient care/neglect/change in caregiver.

Onset before age 5, age has reached at least 9 months.

Differential Diagnosis:

A. Autism Spectrum Disorder

B. Depressive Disorders

C. Intellectual Disability

Disinhibited Social Engagement Disorder

Actively approaches/interacts with unfamiliar adults:

Reduced stranger reticence, overly familiar verbal/physical, reduced checking back with caregiver, willingness to go off with stranger.

Has experienced insufficient care/neglect/change in caregiver.

Differential Diagnosis:

A. Attention-Deficit/Hyperactivity Disorder

B. Child Maltreatment and Neglect

PTSD

Ages 6+.

Exposure to actual/threatened death, serious injury, and sexual violence.

Intrusive memories, distressing dreams, prolonged psychological distress, arousal, avoidance, negative alterations in cognition for more than 1 month.

Differential Diagnosis:

A. Acute Stress Disorder

B. Adjustment Disorders

C. Personality Disorders

D. Dissociative Disorders

E. Other Post-Tramatic Disorders and Conditions

F. Psychotic Disorders

G. Major Depressive Disorder

H. Conversion Disorder

I. Traumatic Brain Injury

Treatment:

Abreative Therapy

Art Therapy

CBT

EMDR

Flooding

Group Therapy

Hypnosis

NLP

Medication

Psychoed

Psychotherapy

Restructuring

Acute Stress Disorder

Exposure to actual/threatened death, serious injury, or sexual violence.

3 days-1 month.

Differential Diagnosis:

A. Post-Tramatic Stress Disorder

B. Adjustment Disorders

C. Panic Disorder

D. Psychotic Disorders

E. Dissociative Disorders

F. Obsessive-Compulsive Disorder

G. Traumatic Brain Injury

Treatment:

CBT

Hypnosis

Psychodynamic

Adjustment Disorder

Presence of emotional/behavioral symptoms in response to an identifiable stressor, which occurs within 3 months of the stressor.

Marked distress out of proportion to severity/intensity of the stressor.

Differential Diagnosis:

A. Post-Tramatic Stress Disorder

B. Acute Stress Disorder

C. Normative Stress Reactions

D. Major Depressive Disorder

E. Personality Disorders

F. Psychological Factors Affecting Other Medical Conditions

Treatment:

CBT

Family Therapy

Group Therapy

Multi-systemic Therapy

Parent Management

Agent for insomnia

Psychodynamic

Psychoed

Supportive psychotherapy

Dissociative Identity Disorder

Disruption of identity characterized by 2+ distint personality states, which some cultures may describe as being possessed.

This is accompanied by alternations in affect, behavior, memory, perception, cognition, and/or sensory-motor functioning.

Marked discontinuity of self.

Recurrent gaps in recall of events.

Not due to normal cultural/religious practices.

Differential Diagnosis:

A. Other Specified Dissociative Disorder

B. Major Depressive Disorder

C. PTSD

D. Psychotic Disorders

E. Substance/Medication-Induced Disorders

F. Factitious Disorder and Malingering

G. Bipolar Disorders

H. Personality Disorders

I. Conversion Disorder

J. Seizure Disorders

Treatment:

CBT

Family therapy

Hypnosis

SSRI

Psychodynamic

E. Dissociative Amnesia

F. Factitious Disorder

Dissociative Amnesia

Inability to recall important autobiographical information, (usually of a traumatic or stressful nature), which should be stored in memory ordinarily.

Localized or selective amnesia for a specific event. or generalized amnesia for identity and life history.

If with fugue, apparent purposeful travel or bewildered wandering that is associated with identity or for other important autobiographical info.

Differential Diagnosis:

A. Dissociative Identity Disorder

B. Post-Tramatic Stress Disorder

C. Substance-Related Disorders

D. Factitious Disorder or Malingering

E. Neurocognitive Disorders

F. Post-Tramatic Amnesia Due to Brain Injury

G. Seizure Disorders

H. Catatonic Stupor

I. Normal and Age-Related Changes in Memory

Treatment:

CBT

Group therapy

Hypnosis

Medication

Supportive psychotherapy

Depersonalization/Derealization Disorder

Experiences of depersonalization/derealization.

Depersonalization: Unreality, detachment, being outside of one's own body, time numbing.

Derealization: Detachment from surroundings, dreamlike, people/objects feel unreal, foggy, along with visual distortions.

Reality testing is in tact.

Differential Diagnosis:

A. Other Dissociative Disorders

B. Illness Anxiety Disorder

C. Obsessive-Compulsive Disorder

D. Psychotic Disorders

E. Major Depressive Disorder

F. Substance/Medication-Induced Disorders

G. Anxiety Disorders

H. Mental Disorders Due to Another Medical Condition

Treatment:

Anti-anxiety meds

CBT

Psychodynamic psychotherapy

Family therapy

Creative therapy

Hypnosis

Somatic Symptoms Disorder

Multiple, current, somatic symptoms.

Excessive thoughts, feelings, and behaviors related to somatic symptoms and health concerns. (Disproportionate, high anxiety, excessive time/energy.)

With: Predominate pain, persistent for 6+ months, mild/mod/severe.

Differential Diagnosis:

A. Panic Disorder

B. Generalized Anxiety Disorder

C. Illness Anxiety Disorder

D. Conversion Disorder

E. Delusional Disorder

F. Body Dysmorphic Disorder

G. Depressive Disorders

H. Obsessive-Compulsive Disorder

I. Other Medical Conditions

Treatment:

Behavioral Therapy

CBT

Psychoed

Illness Anxiety Disorder

Preoccupation with acquiring or having a serious illness.

Somatic symptoms are not present (or only mild in intensity).

Increased anxiety about health, excessive health- related behaviors, for at least 6 months.

(Care seeking type/care avoidant type).

Differential Diagnosis:

A. Somatic Symptom Disorder

B. Anxiety Disorders

C. Obsessive-Compulsive and Related Disorders

D. Psychotic Disorders

E. Other Medical Conditions

F. Major Depressive Disorder

G. Adjustment Disorders

Conversion Disorder (Functional Neurological Symptom Disorder)

One or more symptoms of altered voluntary motor oe sensory function.

Not due to neurological or medical condition.

Weakness/paralysis, abnormal movement, swallowing, speech, attacks/seizures, anasthesia/sense loss, visual, olfactory, hearing, mixed.

Differential Diagnosis:

A. Somatic Symptom Disorder

B. Factitious Disorder and Malingering

C. Dissociative Disorders

D. Body Dysmorphic Disorder

E. Neurological Disease

F. Depressive Disorders

G. Panic Disorder

Treatment:

Behavioral therapy

Biofeedback (mind-body technique that helps teach pt's how to influence their autonomic nervous system.

Environmental Intervention

Physical Therapy

Speech Therapy

Supportive Psychotherapy

Psychological Factors Affecting Other Medical Conditions

Presence of one or more psych/behv factors that adversely affects a medical condition and interferes with treatment (anxiety exacerbates asthma, denial of need for tx of chest pain, manipulation of insulin for weight loss).

Differential Diagnosis:

A. Mental Disorder Due to Another Medical Condition

B. Adjustment Disorders

C. Somatic Symptom Disorder

D. Illness Anxiety Disorder

Factitious Disorder

Falsification of symptoms or induction of injury/disease.

Presents self to others as ill/impaired/injured, with behavior being evident in absence of external rewards.

By Proxy: (Now imposed on another).

Differential Diagnosis Imposed on Another:

A. Somatic Symptom Disorder

B. Conversion Disorder

C. Borderline Personality Disorder

D. Malingering

E. Medical Condition or Mental Disorder Not Associated with Intentional Symptom Falsification

Treatment:

CBT

Psychodynamic

Reality therapy

Malingering

Similar to factitious but symptoms for external rewards.

Pica

Persistent eating of non-nutritive non-food substances for 1 month.

Inappropriate developmentally, and non-socially normative practice.

Children 2+.

Differential Diagnosis:

A. Factitious Disorder

B. Anorexia Nervosa

C. Nonsuicidal Self-Injury and Nonsuicidal Self-Injury Behaviors in Personality Disorders

Treatment:

Behavioral Therapy

Rumination Disorder

Regurgitation of food, which may be re-chewed, re-swallowed, and/or spit out.

Not medical/anorexia/bulimia.

Differential Diagnosis:

A. Anorexia Nervosa

B. Bulimia Nervosa

C. Gastointestinal Conditions

Avoidant/Restrictive Food Intake Disorder

An eating or feeding disturbance (lack of interest in eating food, avoidance based on sensory characteristics of food, concern about aversive consequences of eating), as manifested by persistent failure to meet nutritional and/or energy needs associated with 1 or more:

Weight loss.

Nutritional deficiency.

Dependence on eternal feeding or supplements.

Interference w/psychosocial functioning.

Does not occur during course of anorexia or bulimia.

Differential Diagnosis:

A. Autism Spectrum Disorder

B. Specific Phobia

C. Anorexia Nervosa

D. Social Anxiety Disorder

E. Anxiety Disorders

F. Other Medical Conditions

G. Specific Neurological/Neuromuscular, Structural, or Congenital Disorders and Conditions Associated with Feeding Difficulties

H. Obsessive-Compulsive Disorder

I. Major Depressive Disorder

J. Schizophrenia Spectrum Disorders

K. Factitious Disorder or Factitious Disorder Imposed on Another

Anorexia

Restriction of energy intake that leads to low body weight.

Intense fear of weight gain.

Disturbance in body image.

Restrictive Type- During last 3 months, individual has not engaged in binge or purge behavior. Rather, accomplished through dieting, fasting and/or excessive exercise.

Binge-Purge Type- During last 3 months, recurrent episodes of binge eating or purging behavior (self-induced vomiting or laxatives).

Mild BMI: >17kg

Severe BMI: 15-15.99

Extreme BMI: <15

Differential Diagnosis:

A. Bulimia Nervosa

B. Body Dysmorphic Disorder

C. Avoidant/Restrictive Food Intake Disorder

D. Substance Use Disorder

E. Obsessive-Compulsive Disorder

Treatment:

Behavioral therapy

Cognitive therapy

Psychotherapy

Family therapy

Group therapy

Psychodynamic

Psychiatric meds can also be used in eating disorders.

Use Millon*

Challenge body-image distortions, improve self-esteem, general social-skills training, assertiveness training, group therapy.

Meds have no direct use with anorexia.

Bulimia

Recurrent episodes of binge eating (within 2 hours), loss of control, more than what most people would eat.

Recurrent inappropriate compensatory behavior to prevent weight gain.

3 months.

Self-evaluation influenced by body.

Mild 1-3 times per week

Moderate: 4-7 times per week

Severe: 8-13 times per week

Extreme: 14+ times a week

Differential Diagnosis:

A. Anorexia Nervosa, Binge Eating/Purging Type

B. Binge-Eating Disorder

C. Major Depressive Disorder with Atypical Features

D. Kleine-Levin Syndrome

E. Borderline Personality Disorder

Treatment:

CBT- also addresses protectionist behavior.

Family therapy

Interpersonal psychotherapy

Psychodynamic psychotherapy

Psychoeducation

Nutritional counseling.

Group

Can include meds.

Binge-Eating Disorder

Recurrent episodes of binge eating.

Need 3 or more:

Eating rapidly, eating until uncomfortably full, large amounts when not hungry, binging alone due to embarrassment, and being disgusted with oneself.

Differential Diagnosis:

A. Bulimia Nervosa

B. Bipolar Disorders

C. Depressive Disorders

D. Borderline Personality Disorder

E. Obesity

Enuresis

Repeated voiding of urine into bed/clothes either voluntarily or involuntarily.

2x a week for 3 months or with distress.

Must be at least 5.

Noctural/Dicurnal/Both.

Differential Diagnosis:

A. Medication Side Effects

B. Bladder Condition Due to a Medical Condition

Treatment:

Behavioral w/ star-charts.

Alarm & pad monitor.

Antidepressants also used.

Encopresis

Repeated passage of feces into inappropriate places either voluntarily or involuntarily.

1x a month for 3 months.

Must be at least 4 years old.

Differential Diagnosis:

A. Fecal Incontinence Due to Another Medical Condition

B. Fecal Incontinence Due to a Medication Side Effect

Treatment:

Behavioral

Insomnia Disorder

Dissatisfaction with sleep quality or quantity, associated with one or more:

Difficulty initiating sleep, difficulty maintaining sleep, and early morning waking with an inability to return to sleep.

3 nights/week for 3 months.

Differential Diagnosis:

A. Parasomnias

B. Narcolepsy

C. Breathing-Related Sleep Disorders

D. Delayed Sleep Phase and Shift Work Types of Circadian Rhythm Sleep-Wake Disorder

E. Restless Legs Syndrome

F. Normal Sleep Variations

G. Situational/Acute Insomnia

H. Substance/Medication-Induced Sleep Disorder, Insomnia Type

Hypersomnolence

Self-reported excessive sleepiness despite main sleeping period lasting 7 hours, with at least one of the following:

1. Recurrent periods of sleep or lapses into sleep within the same day.

2. A prolonged main sleep episode of more than 9 hours per day that is non-restorative

3. Difficulty being fully awake after abrupt wakening.

Occurs at least 3x per week, for at least 3 months.

Differential Diagnosis:

A. Parasomnias

B. Circadian Rhythm Sleep-Wake Disorders

C. Normative Variation in Sleep

D. Poor Quality and Fatigue

E. Breathing-Related Sleep Disorders

F. Other Mental Disorders (ex. during a Major Depressive Episode or depressed phase of Bipolar Disorder)

Treatment:

No specific approach

Narcolepsy

Recurrent episodes of irrepressible need to sleep, lapsing into sleep, or napping within the same day.

3x/week for 3 months.

Differential Diagnosis:

A. Attention-Deficit/Hyperactivity Disorder

B. Schizophrenia

C. Other Hypersomnias

D. Sleep Deprivation and Insufficient Nocturnal Sleep

E. Sleep Apnea Syndromes

F. Major Depressive Disorder

G. Conversion Disorder

H. Seizures

I. Chorea and Movement Disorders

Treatment:

Group Therapy

REM Sleep Behavior Disorder

Repeated episodes of arousal during sleep with vocalizations/movement during REM.

Dream enacting behavior.

Differential Diagnosis:

A. Other Parasomnias

B. Nocturnal Seizures

C. Obstructive Sleep Apnea

D. Other Specified Dissociative Disorder

E. Malingering

Obstructive Sleep Apnea/Hypopnea

Upper airway obstruction during sleep.

Nocturnal breathing: snoring, snorting, breathing pauses, with sleepiness the following day.

Differential Diagnosis:

A. Primary Snoring

B. Central Sleep Apnea

C. Narcolepsy

D. Sleep-Related Hypoventilation

E. Attention-Deficit/Hyperactivity Disorder

F. Substance/Medication-Induced Insomnia or Hypersomnia

G. Panic Attacks

H. Insomnia Disorder

I. Circadian Rhythm Sleep Disorders

Central Sleep Apnea

Breathing pauses during sleep due to central nervous system but nor psychological basis.

Differential Diagnosis:

A. Other Breathing-Related Sleep Disorders

B. Insomnia Disorder

Sleep-Related Hypoventilation

Episodes of decreased respiration. Differential Diagnosis:

A. Obesity Hypoventilation Syndrome (Picwickian Syndrome)

B. Obstructive Sleep Apnea Hypopnea

C. Lung Disease

D. Skeletal Malformations

E. Neuromuscular Disorders

F. Central Sleep Apnea

Circadian Rhythym Sleep-Wake Disorder

Sleep disruption due to alteration of circadian system.

Leads to excessive sleepiness or insomnia, or both.

2 hour delay in timing of sleep/wake cycle.

Differential Diagnosis:

A. Normative Variations in Sleep with Shift Work

B. Depressive Disorder

C. Bipolar Disorder

D. Other medical conditions and mental disorders.

Treatment:

Behavioral

Non-REM Arousal Disorder

Sleep walking/terrors

Episodes of incomplete awakening from sleep, usually during the first third of the major sleep episode.

Little to no dreamy imagery is recalled and amnesia is present.

Differential Diagnosis:

A. Nightmare Disorder

B. Breathing-Related Sleep Disorders

C. REM Sleep Behavior Disorder

D. Parasomnia Overlap Syndrome

E. Sleep-Related Seizures

F. Alcohol-Induced Blackouts

G. Dissociative Amnesia with Dissociative Fugue

H. Malingering

I. Panic Disorder

J. Medication-Induced Complex Behaviors

K. Night Eating Syndrome

Treatment:

Hypnosis

Psychodynamic psychotherapy

Nightmare Disorder

Extended, extremely dysphoric, well remembered dreams of threats to survival, security, physical integrity, 2nd half of sleep episode.

Rapidly becoming oriented upon waking.

Differential Diagnosis:

A. Sleep Terror Disorder

B. REM Sleep Behavior Disorder

C. Bereavement

D. Narcolepsy

E. Nocturnal Seizures

F. Breathing-Related Sleep Disorders

G. Panic Disorder

H. Sleep-Related Dissociative Disorders

I. Medication or Substance Use

Treatment:

Behavioral Therapy

<1 month= acute

+6 months= persistent

Restless Leg Disorder

Urge to move legs with unpleasant sensations in legs:

During rest, relieved by movement, and worse at night.

Differential Diagnosis:

A. Another Medical or Behavioral Conditions

Delayed Ejaculation

75-100% of the time

Marked delay in ejaculation

Marked infrequence/absence of ejaculation for 6 months

Differential Diagnosis:

A. Another Medical Condition

B. Substance/Medication Use

C. Dysfunction with Orgasm

Treatment:

Analytically-oriented psychotherapy

Behavioral therapy

Erectile Disorder

75-100% of the time.

Difficulty obtaining/maintaining an erection.

Decreased rigidity for 6 months.

Differential Diagnosis:

A. Nonsexual Mental Disorders

B. Normal Erectile Function

C. Substance/Medication Use

D. Another Medical Condition

E. Other Sexual Dysfunctions

Treatment:

Behavioral therapy targeting performance anxiety.

CBT

Interpersonal

Psychodynamic

Psychoed

Systemic

Enhance sexual arousal, lower anxiety regarding sexual performance, and address issues that limit sexual satisfaction.

Systematic desentizisation, relaxation, reframing, modifying maldaptive sexual attitudes, and working through unconscious conflicts.

Sensate focus.

Female Orgasmic Disorder

75-100% of the time

Delay/in/frequency/absence of orgasm

Reduced intensity.

Differential Diagnosis:

Female Orgasmic Disorder

Term

A. Major Depressive Disorder

B. Substance/Medication-Induced Sexual Dysfunction

C. Female Sexual Interest/Arousal Disorder

D. Another Medical Condition

E. Interpersonal Factors

Treatment:

CBT

Masturbation

Psychodynamic

Psychoed

Relax

Sensate-focus (sexual exercises for couples)

Systems

Female Sexual Intercourse/Arousal Disorder

Lack of/significantly reduced sexual interest/arousal.

Absence/reduction in: activity, thoughts, initiations, excitement, and genital sensations.

Differential Diagnosis:

A. Major Depressive Disorder

B. Substance/Medication-Use

C. Other Sexual Dysfunctions

D. Another Medical Condition

E. Interpersonal Factors

F. Inadequate or Absent Sexual Stimuli

Treatment:

CBT

Psychodynamic

Psychoed

Genito-Pelvic Pain/Penetration Disorder

Persistent/recurrent difficulties with: vaginal penetration.

Vulvo/pelvic pain during intercourse.

Fear/anxiety about penetration.

Marked tensing/tightening of the pelvic floor muscles.

Differential Diagnosis:

A. Somatic Symptom Disorder

B. Another Medical Condition

C. Medication Side Effect

D. Inadequate Sexual Stimulation/Preparation

Treatment:

Behavioral therapy

Cognitive therapy

Psychodynamic therapy

Male Hypoactive Sexual Desire Disorder

Deficient/absent sexual/erotic thoughts/fantasies. "Desire discrepancy."

Differential Diagnosis:

A. Major Depressive Disorder

B. Substance/Medication Use

C. Another Medical Condition

D. Interpersonal Factors

E. Other Sexual Dysfunctions

Treatment:

Marital therapy

Psychotherapy

Premature (Early) Ejaculation

Ejaculation within 1 minute of vaginal penetration and before the individual wishes.

Mild-30 sec-1 min

Mod-15-30

Severe-15 seconds before activity.

Differential:

A. Substance/Medication-Induced Sexual Dysfunction

B. Sub-clinical Ejaculation Concerns

Treatment:

Behavioral therapy

Cognitive therapy

Educational

Psychodynamic

Squeeze approach

Treatment:

Behavioral training in stop-start hand stimulation by partner.

A homework assignment to read your brochure about premature ejaculation.

Exploration of emotions relevant to the presenting problem.

Behavioral training in stop, contract PC muscle, break, start.

Behavioral training in Kegel exercises for the wife.

Practicing relaxation exercises during sexual activity.

Gender Dysphoria

Incongruence between experience/expressed gender and assigned gender.

Desires to be different.

Cross dressing/role play/toys.

Prefers playmates of other gender.

Rejection of typical toys.

Dislike of sexual anatomy.

Desire for other genitals.

Differential Diagnosis:

A. Body Dysmorphic Disorder

B. Transvestic Disorder

C. Nonconformity to Gender Roles

D. Schizophrenia and Other Psychotic Disorders

E. Other Clinical Presentations

Treatment:

Behavioral therapy

Psychodynamic

Psychoed

Psychotherapy

Oppositional Defiant Disorder

Pattern of angry/irritable mood (temper, annoyed, angry/resentful.)

Argumentative/defiant behavior (argues with authority, refuses to comply with rules, deliberately annoys/blames others.)

Vindictiveness (spiteful/vindictive 2x in 6 months).

Differential Diagnosis:

A. Conduct Disorder

B. Attention-Deficit/Hyperactivity Disorder

C. Disruptive Mood Dysregulation Disorder

D. Intermittent Explosive Disorder

E. Depressive and Bipolar Disorders

G. Intellectual Disability

H. Language Disorder

I. Social Anxiety Disorder

Intermittent Explosive Disorder

Reccurent behavior outbursts, representing failure to control aggressive impulses.

Verbal aggression/physical aggression that does not result in damage/injury.

2xweek/3months or 3 behavior outbursts involving damage/injury within 12 months.

Out of proportion and not premeditated. At least 6 months.

Differential Diagnosis:

A. Disruptive Mood Dysregulation Disorder

B. Antisocial Personality Disorder

C. Borderline Personality Disorder

D. Delirium

E. Major Neurocognitive Disorder

F. Personality Change Due to Another Medical Condition, Aggressive Type

G. Substance Intoxication or Substance Withdrawal

H. Attention-Deficit/Hyperactivity Disorder

H. Conduct Disorder

I. Oppositional Defiant Disorder

J. Autism Spectrum Disorder

Conduct Disorder

Basic rights of others/major societal norms are violated.

Aggression towards people/animals.

Destruction of property.

Deceitfulness or theft.

Serious violation of rules.

3 of 15 criteria in 12 months, with at least one present for 6 months.

Differential Diagnosis:

A. Oppositional Defiant Disorder

B. Intermittent Explosive Disorder

C. Adjustment Disorder, with Disturbance of Emotions and Conduct or Disturbance of Conduct

D. Attention-Deficit/Hyperactivity Disorder

E. Depressive and Bipolar Disorders

Treat by emphasizing future consequences, create list of people deserving apology, confront thoughts, and open REBT confrontation (interrupt previously held thoughts).

USE: TAT Test

Journaling, role-play, sand-tray therapy, play therapy,and token economy.

Differentiation of DMDD, ODD, IED and CD

DMDD:

Chronic, non-episodic irritability.

ODD:

Oppositional, angry, vindictive, no to authority.

IED:

Outburts with failure to control angry impulses--not planned out.

CD:

Basic rights of others violated through aggression, destruction of property, deceitfulness/theft, serious violation of rules.

Pyromania

Deliberate/purposeful fire setting

Tension/affect arousal before setting.

Fascination/curiosity/attraction to fire.

Pleasure/gratification/relief when setting fires.

Not done for gain.

A. Other Causes of Intentional Fire Setting

B. Conduct Disorder

C. Part of a Manic Episode

D. Antisocial Personality Disorder

E. Response to a Delusion or Hallucination

F. Attributable to the Physiological Effects of Another Medical Condition

G. Impaired Judgment Associated with Major Neurocognitive Disorder, Intellectual Disability, or Substance Intoxication

Treatment:

Behavioral

CBT

Family Therapy

Psychodynamic

Kleptomania

Failure to resist impulses to steal objects not needed.

Increasing tension before.

Please/relief/gratification after stealing.

Not an expression of anger or a delusion.

A. Antisocial Personality Disorder

B. Conduct Disorder

C. Manic or Hypomanic Episode

D. Ordinary Theft

E. Malingering

F. Major Neurocognitive Disorder

G. Psychotic Episodes

Treatment:

Aversive conditioning

Behavioral therapy

Family therapy

Psychodynamic

Supportive therapy

Substance Use Disorder

Individual continues using a substance despite significant related problems:

Desire to cut down unsuccessful.

Large time obtaining/using/recovering.

Daily activities revolve around use.

Intense desire.

Continued use/problems.

Activities given up.

Withdraw from people.

Used in hazerdous situations.

Failure to abstain despite resulting difficulties.

Not caffiene.

Treatment:

For short-term, psychodynamic is qleast-effective.

High-levels of motivational support should be included.

Treatment:

Behavioral

Cognitive

Family

Group

Psychodynamic

Psychoed

Substance-Induced Disorder

Includes:

Substances intoxication/withdrawl and/or substancemedication induced mental disorders.

Substance Intoxification/Withdrawl

Problematic behavior/psychological changes associated with intoxication.

Not attributable to medical condition.

Affects important areas of functioning.

Alcohol Intoxication

Recent ingestion of alcohol; one or more:

Slurred speech, incoordination, unsteady gait, impairment in attention, etc.

Differential Diagnosis:

A. Other Medical Conditions

B. Sedative, Hypnotic, or Anxiolytic Intoxication

Caffiene Withdrawl

Prolonged daily use of caffiene.

Abrupt cessation/reduction, followed within 24 hours by 3 or more: headache, fatigue/drowsiness, depressed mood, difficulty concentrating, and flu-like symptoms.

Differential Diagnosis:

A. Other medical disorders

B. Medical side effecrs

Alcohol Use Disorder

Problematic pattern of use, leads to impairment, w/at least 2 present in 12 months:

Large amounts consumed, desire or unable to cut down, lots of time spent tying to obtain alcohol, craving/strong desire, reccurent use and/or tolerance.

Differential Diagnosis:

A. Non-pathological Use of Alcohol

B. Alcohol Intoxication

C. Sedative, Hypnotic, or Anxiolytic Use Disorder

D. Conduct Disorder in Childhood

E. Antisocial Personality Disorder

Alcohol Withdrawal

Cessation in alcohol.

2 or more within several hours to last few days:

Autonomic hyperactivity, increased hand tremor, insomnia, hallucinations, psychomotor agitation, anxiety, and/or seizures.

Differential Diagnosis:

A. Sedative, Hypnotic, or Anxiolytic Withdrawal

B. Other Medical Conditions

Caffeine Intoxication

Recent consumption of caffeine (usually high amounts).

5 or more: Restlessness, nervousness, excitement, insomnia, flushed face, peeing, gi distress, muscle twitches, rambling thoughts, heart palps, inexhaustibly, and/or psycho-motor agitation.

Differential Diagnosis:

A. Panic Disorder

B. Generalized Anxiety Disorder

C. Amphetamine Intoxication

D. Sedative, Hypnotic, or Anxiolytic Withdrawal

E. Tobacco Withdrawal

F. Medication Side Effects

G. Manic Episode

H. Sleep Disorders

I. Other Caffeine-Induced Disorders

Substance/Medication-Induced Mental Disorder

Symptomatic presentation of a relevant mental disorder.

One month of substance intox/with medicine.

Gambling Disorder

Problematic gambling:

More $ to achieve desire excitement

Restless/irritable when cutting down

Unsuccessful control

Preoccupied with

Gambles when distressed

After losing, returns to "get even."

Lies to conceal.

Jeopardized jobs/relationships.

Relies on others for financial help.

Differential Diagnosis:

A. Nondisordered Gambling

B. Manic Episode

C. Personality Disorders

D. Other Medical Conditions

Treatment:

Behavioral

CBT

Gamblers anonymous

Psychodynamic

Rational-emotive

Reality therapy

Delirium

Disturbance in attention/awareness.

Develops over a short period of time (hrs/days) from baseline and fluctuates throughout the day.

Additional disturbance in cognition (memory, disorientation, language, perceptions.)

Differential Diagnosis:

A. Psychotic Disorders and Bipolar and Depressive Disorders with Psychotic Features

B. Acute Stress Disorder

C. Malingering

D. Factitious Disorder

E. Other Neurocognitive Disorders

Treatment:

Cognitive therapy

Psychoed

Haldol often used.

Major Neurocognitive Disorder

Significant cognitive decline from previous performance: 1 or more:

complex attention, executive function, learning and memory, language, perceptual-motor, and social cognition.

Cognitive deficits interfere with independence in everyday living, whereas mild neurocognitive disorder does.

Differential Diagnosis:

A. Normal Cognition

B. Delirium

C. Major Depressive Disorder

D. Specific Learning Disorder

E. Other Neurodevelopmental Disorders

Treatment:

CBT

Psychodynamic

Psychoed.

Huntington's Disease

Progressive cognitive impairment, rather than memory. Fatal genetic brain disorder, includes:

Involuntary movements/twitches and spasms.

Problems with balance/coordination.

Personality changes like irritability, depression, and mood swings.

Trouble with memory, concentrating, and making decisions.

Begin during late 30s/early 40s.

Alzheimer's Disease

Generally affects elderly, but early onset can affect people from late 30s to 40s.

Causes problems with memory, thinking and behavior.

Trouble remembering newly learned info.

Disorientation, mood/behavior changes, confusion, suspicious about fam/friends, difficulty speaking, swallowing, and walking.

Parkinson's Disease

Changes in memory, concentration and judgment

Trouble interpreting visual information

Muffled speech

Visual hallucinations

Delusions, especially paranoid ideas

Depression

Irritability and anxiety

Sleep disturbances, including excessive daytime drowsiness and rapid eye movement (REM) sleep disorder.

Dimentia With Lewy Bodies

Changes in thinking and reasoning

Confusion and alertness that varies significantly from one time of day to another or from one day to the next

Parkinson's symptoms, such as a hunched posture, balance problems and rigid muscles

Visual hallucinations

Delusions

Trouble interpreting visual information

Acting out dreams, sometimes violently, a problem known as rapid eye movement (REM) sleep disorder

Malfunctions of the "automatic" (autonomic) nervous system

Memory loss that may be significant but less prominent than in Alzheimer's

Mild Neurocognitive Disorder

Mild, and does not interfere with daily living capacities, whereas major does.

Differential Diagnosis:

A. Normal Cognition

B. Delirium

C. Major Depressive Disorder

D. Specific Learning Disorder

E. Other Neurodevelopmental Disorders