Differential Diagnosis
- Single most likely diagnosis
- Post-Traumatic Stress Disorder (PTSD): The patient's symptoms of dark, horror, restless, and weepy emotions that started after a CBT session and have persisted for 7 months suggest a traumatic response. The CBT session may have triggered a traumatic memory or experience, leading to the development of PTSD.
- Other Likely diagnoses
- Anxiety Disorder: The patient's history of agoraphobia, extreme health anxiety, and excessive ECGs suggests an underlying anxiety disorder. The symptoms of anxiety may have been exacerbated by the CBT session.
- Adjustment Disorder: The patient's new relationship and the CBT session may have triggered an adjustment disorder, characterized by emotional distress and significant impairment in social or occupational functioning.
- Depressive Disorder: The patient's persistent feelings of sadness, hopelessness, and weepiness may indicate a depressive disorder, which could be related to the traumatic experience or underlying anxiety.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Cardiac Conditions: The patient's history of 300 ECGs in a single month raises concerns about underlying cardiac conditions, such as arrhythmias or cardiomyopathy, which could be life-threatening if left untreated.
- Neurological Conditions: The patient's symptoms of restlessness and weepiness could be indicative of underlying neurological conditions, such as multiple sclerosis or Parkinson's disease, which require prompt diagnosis and treatment.
- Somatic Symptom Disorder: The patient's excessive health anxiety and preoccupation with bodily symptoms, such as the rash on their back, may indicate a somatic symptom disorder, which could lead to excessive medical testing and treatment.
- Rare diagnoses
- Complex Regional Pain Syndrome: The patient's rash on their back could be indicative of complex regional pain syndrome, a rare condition characterized by chronic pain and inflammation.
- Factitious Disorder: The patient's excessive medical testing and preoccupation with bodily symptoms may suggest factitious disorder, a rare condition in which individuals fabricate or exaggerate symptoms for attention and sympathy.
- Dissociative Disorder: The patient's symptoms of horror and restlessness could be indicative of a dissociative disorder, such as dissociative identity disorder or depersonalization disorder, which are rare and require specialized diagnosis and treatment.