Differential Diagnosis for a 43-year-old with PHQ9 of 9 and GAD7 of 14
Single Most Likely Diagnosis
- Major Depressive Disorder (MDD) with Anxious Distress: The patient's PHQ9 score of 9 indicates moderate to severe depressive symptoms, and the GAD7 score of 14 suggests severe anxiety symptoms. The combination of these scores is consistent with MDD with anxious distress, which is a common presentation.
Other Likely Diagnoses
- Generalized Anxiety Disorder (GAD): The GAD7 score of 14 is indicative of severe anxiety symptoms, which could be the primary diagnosis if the depressive symptoms are secondary or less prominent.
- Anxiety Disorder due to Another Medical Condition: It is possible that the patient's anxiety symptoms are caused by an underlying medical condition, which would need to be ruled out with further evaluation.
- Substance-Induced Depressive or Anxiety Disorder: Substance use could be contributing to the patient's symptoms, and a thorough substance use history is necessary to assess this possibility.
Do Not Miss Diagnoses
- Bipolar Disorder: Although less likely, bipolar disorder can present with depressive and anxiety symptoms, and missing this diagnosis could lead to inappropriate treatment and poor outcomes.
- Post-Traumatic Stress Disorder (PTSD): Trauma can contribute to both depressive and anxiety symptoms, and PTSD is a potentially treatable condition that should not be missed.
- Thyroid Disorder: Thyroid dysfunction can cause both depressive and anxiety symptoms, and is a medical condition that can be easily evaluated and treated.
Rare Diagnoses
- Neurodegenerative Disorders (e.g., Frontotemporal Dementia): Although rare, neurodegenerative disorders can present with mood and anxiety symptoms, and should be considered in the differential diagnosis, especially if there are other cognitive or neurological symptoms.
- Mitochondrial Disorders: Some mitochondrial disorders can cause psychiatric symptoms, including depression and anxiety, and should be considered in patients with a suggestive family history or other systemic symptoms.