Differential diagnosis using the MMPI-2: Goldberg’s index revisited

2003 ◽  
Vol 18 (8) ◽  
pp. 409-411 ◽  
Author(s):  
Jos I.M. Egger ◽  
Peter A.M. Delsing ◽  
Hubert R.A. De Mey
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Clinical Decision Making ◽  
Minnesota Multiphasic Personality Inventory ◽  
Psychiatric Patients ◽  
Clinical Decision ◽  
Clinical Scales ◽  
Diagnostic Categories ◽  
Personality Psychopathology Five ◽  
Personality Psychopathology

AbstractBackgroundThe Minnesota Multiphasic Personality Inventory (MMPI-2) often supports clinical decision-making in complex diagnostic problems like differentiating neurosis from psychosis and psychosis from bipolar disorder. The MMPI Goldberg index, an arithmetical combination of five clinical scales, has been considered to provide a good estimate for discriminating between neurotic and psychotic profiles. Similarly, the MMPI-2 Personality Psychopathology Five (PSY-5) scales have been found to be useful in differentiating diagnostic categories.MethodThis study evaluates these findings in a sample of psychiatric patients diagnosed with depressive, psychotic, or bipolar disorder using ANOVA and discriminant analysis.ResultsResults corroborate the validity of Goldberg’s index and find MMPI-2 PSY-5 scale Disconstraint to significantly differentiate between psychotic and bipolar-I disorder.ConclusionThe MMPI-2 Goldberg index and PSY-5 scales can offer a useful contribution to the differential diagnosis of depressive, psychotic and bipolar disorder.

scholarly journals Vici syndrome in an Egyptian infant: case report and differential diagnosis of inherited hypopigmented disorders

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Marwa Abd Elmaksoud ◽  
Aya Attya Abeesh ◽  
Catarina Pereira ◽  
Marwa El-Saeed El-Deeb
Keyword(s):  
Differential Diagnosis ◽  
Corpus Callosum ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Phenotype Correlation ◽  
Multisystem Disease ◽  
Case Presentation ◽  
Correlation Studies ◽  
Clinical Description ◽  
Infant Case

Abstract Background Vici syndrome is a severe inherited multisystem disease caused by mutations in the EPG5 gene. The diagnosis depends on the constellation of cardinal features of agenesis of the corpus callosum, cataracts, oculocutaneous hypopigmentation, cardiomyopathy, and a combined immunodeficiency followed by confirmation by genetic testing. We report an Egyptian infant with Vici syndrome carrying a homozygous splice site variant (c.1252+1G>T; NM_020964.2) in the EPG5 gene, detailed clinical description, outcome, and differential diagnosis of inherited hypopigmentation disorders associated with neurological manifestations. Case presentation The infant initially presented with oculocutaneous hypopigmentation, agenesis of the corpus callosum, and immunodeficiency. A few months later, a diagnosis of dilated cardiomyopathy was made. Family history revealed 2 deceased siblings phenotypically matching our index infant. He died at the age of 15 months with acute respiratory failure. Conclusion The accurate diagnosis of such rare diseases with genetic confirmation is vital for proper clinical decision-making, genetic counseling of the affected families, and future genotype-phenotype correlation studies.

Narcolepsy: Differential Diagnosis or Etiology in Some Cases of Bipolar Disorder and Schizophrenia?

CNS Spectrums ◽  
2003 ◽  
Vol 8 (2) ◽  
pp. 120-126 ◽  
Author(s):  
Alan B. Douglass
Keyword(s):  
Bipolar Disorder ◽  
Differential Diagnosis ◽  
Psychiatric Patients ◽  
Human Leukocyte ◽  
Sleep Paralysis ◽  
Leukocyte Antigen ◽  
Psychotic Features ◽  
Hypnagogic Hallucinations ◽  
Rule Out

AbstractDoes narcolepsy, a neurological disease, need to be considered when diagnosing major mental illness? Clinicians have reported cases of narcolepsy with prominent hypnagogic hallucinations that were mistakenly diagnosed as schizophrenia. In some bipolar disorder patients with narcolepsy, the HH resulted in their receiving a more severe diagnosis (ie, bipolar disorder with psychotic features or schizoaffective disorder). The role of narcolepsy in psychiatric patients has remained obscure and problematic, and it may be more prevalent than commonly believed. Classical narcolepsy patients display the clinical “tetrad”—cataplexy, hypnagogic hallucinations, daytime sleep attacks, and sleep paralysis. Over 85% also display the human leukocyte antigen marker DQB10602 (subset of DQ6). Since 1998, discoveries in neuroanatomy and neurophysiology have greatly advanced the understanding of narcolepsy, which involves a nearly total loss of the recently discovered orexin/hypocretin (hypocretin) neurons of the hypothalamus, likely by an autoimmune mechanism. Hypocretin neurons normally supply excitatory signals to brainstem nuclei producing norepinephrine, serotonin, histamine, and dopamine, with resultant suppression of sleep. They also project to basal forebrain areas and cortex. A literature review regarding the differential diagnosis of narcolepsy, affective disorder, and schizophrenia is presented. Furthermore, it is now possible to rule out classical narcolepsy in difficult psychiatric cases. Surprisingly, psychotic patients with narcolepsy will likely require stimulants to fully recover. Many conventional antipsychotic drugs would worsen their symptoms and make them appear to become a “chronic psychotic,” while in fact they can now be properly diagnosed and treated.

Clinical Problem Solving: Decreased Level of Consciousness and Unexplained Hydrocephalus

2022 ◽  
pp. 194187442110567
Author(s):  
Naomi Niznick ◽  
Ronda Lun ◽  
Daniel A. Lelli ◽  
Tadeu A. Fantaneanu
Keyword(s):  
Decision Making ◽  
Differential Diagnosis ◽  
Clinical Decision Making ◽  
Clinical Problem ◽  
Clinical Decision ◽  
Decision Making Process ◽  
Clinical Problem Solving ◽  
Level Of Consciousness ◽  
History Of

We present a clinical reasoning case of 42-year-old male with a history of type 1 diabetes who presented to hospital with decreased level of consciousness. We review the approach to coma including initial approach to differential diagnosis and investigations. After refining the diagnostic options based on initial investigations, we review the clinical decision-making process with a focus on narrowing the differential diagnosis, further investigations, and treatment.

Pain Emergencies and Complications of Pain Treatments

2019 ◽  
pp. 221-240
Author(s):  
Isaac Tong ◽  
R. Jason Yong ◽  
Beth B. Hogans
Keyword(s):  
Decision Making ◽  
Differential Diagnosis ◽  
Chest Pain ◽  
Clinical Assessment ◽  
Associated Factors ◽  
Clinical Decision Making ◽  
Acute Chest Pain ◽  
Clinical Decision ◽  
Common Occurrence ◽  
Pain Characteristics

Chapter 13 reviews some common pain-associated emergencies and also discusses some complications of pain treatments that require immediate attention. Pain is a common occurrence in emergent illness, and some complications of pain treatments require emergent management. Chest pain is an excellent example of clinical decision-making following a process of organized, rapid pain assessment and then diagnostic and treatment reasoning based on the findings and observations of the clinical assessment. Providers assessing patients for acute chest pain elicit basic pain characteristics of region, quality, severity, and timing as well as usually associated factors and then pursue testing and treatment for elements in the differential diagnosis accordingly. The chapter illustrates this same process applied to conditions of acute abdominal, limb, headache, and spine emergencies. In the second part of the chapter, emergencies arising in the context of pain treatments are discussed, including overdose and withdrawal from opioids, benzodiazepines, and other pain-active medications as well as pump and device complications.

Influence of Dissimulation on Indexes of Response Consistency for the MMPI

1985 ◽  
Vol 57 (3) ◽  
pp. 1013-1014 ◽  
Author(s):  
Nicholas T. Gallucci
Keyword(s):  
Minnesota Multiphasic Personality Inventory ◽  
Medical Center ◽  
Psychiatric Patients ◽  
Personality Inventory ◽  
Veterans Administration ◽  
Disability Benefits ◽  
Administration Medical ◽  
Random Responding ◽  
Clinical Scales ◽  
Response Consistency

Whether indexes of consistent responding on the Minnesota Multiphasic Personality Inventory (MMPI) measured dissimulation versus random responding was evaluated with Veterans Administration Medical Center psychiatric patients who were applying for disability benefits. Elevations on the Test-Retest index and Carelessness scale did not correspond with motivation to dissimulate. Comparing profiles without elevated validity indexes and with Carelessness scales that were either elevated or not elevated, the clinical scales were uniformly higher for profiles with heightened Carelessness scales.

scholarly journals Assessment of violence risk in 440 psychiatric patients in China: examining the feasibility and acceptability of a novel and scalable approach (FoVOx)

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaoling Zhong ◽  
◽  
Rongqin Yu ◽  
Robert Cornish ◽  
Xiaoping Wang ◽  
...  
Keyword(s):  
Mental Health ◽  
Risk Factors ◽  
Risk Assessment ◽  
Decision Making ◽  
Clinical Decision Making ◽  
Psychiatric Patients ◽  
Clinical Decision ◽  
Violence Risk ◽  
Violence Risk Assessment ◽  
Risk Categories

Abstract Background Violence risk assessment is a routine part of clinical services in mental health, and in particular secure psychiatric hospitals. The use of prediction models and risk tools can assist clinical decision-making on risk management, including decisions about further assessments, referral, hospitalization and treatment. In recent years, scalable evidence-based tools, such as Forensic Psychiatry and Violent Oxford (FoVOx), have been developed and validated for patients with mental illness. However, their acceptability and utility in clinical settings is not known. Therefore, we conducted a clinical impact study in multiple institutions that provided specialist mental health service. Methods We followed a two-step mixed-methods design. In phase one, we examined baseline risk factors on 330 psychiatric patients from seven forensic psychiatric institutes in China. In phase two, we conducted semi-structured interviews with 11 clinicians regarding violence risk assessment from ten mental health centres. We compared the FoVOx score on each admission (n = 110) to unstructured clinical risk assessment and used a thematic analysis to assess clinician views on the accuracy and utility of this tool. Results The median estimated probability of violent reoffending (FoVOx score) within 1 year was 7% (range 1–40%). There was fair agreement (72/99, 73% agreement) on the risk categories between FoVOx and clinicians’ assessment on risk categories, and moderate agreement (10/12, 83% agreement) when examining low and high risk categories. In a majority of cases (56/101, 55%), clinicians thought the FoVOx score was an accurate representation of the violent risk of an individual patient. Clinicians suggested some additional clinical, social and criminal risk factors should be considered during any comprehensive assessment. In addition, FoVOx was considered to be helpful in assisting clinical decision-making and individual risk assessment. Ten out of 11 clinicians reported that FoVOx was easy to use, eight out of 11 was practical, and all clinicians would consider using it in the future. Conclusions Clinicians found that violence risk assessment could be improved by using a simple, scalable tool, and that FoVOx was feasible and practical to use.

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