Differential Diagnosis
- Single most likely diagnosis
- C) Avoidant personality disorder: The patient's difficulty in asserting himself, inability to establish close relationships due to fear of being perceived as "different," and a general pattern of social avoidance and feelings of inadequacy are characteristic of avoidant personality disorder. His desire for close relationships and affection, but difficulty in achieving them, further supports this diagnosis.
- Other Likely diagnoses
- D) Generalized anxiety disorder: The patient describes himself as overly cautious and pessimistic, which could indicate a pattern of excessive worry about everyday things, characteristic of generalized anxiety disorder. However, the primary issues seem to revolve around social interactions and self-perception rather than widespread anxiety.
- E) Schizoid personality disorder: While the patient has few friends and difficulty making new ones, his desire for close relationships and affection does not align with the typical schizoid personality disorder traits, where individuals usually do not desire close relationships.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- OB) Autism spectrum disorder: Although less likely given the patient's self-described empathy and desire for social interaction, autism spectrum disorder can sometimes present with social difficulties that might be mistaken for personality disorders. It's crucial to consider this diagnosis, especially given the patient's difficulty in establishing relationships and being perceived as "different."
- Rare diagnoses
- A) Adjustment disorder: This diagnosis seems less likely as the patient's issues are long-standing and not directly tied to a specific stressor or adjustment period, such as the recent job change.
- Other rare personality disorders or conditions that could present with similar symptoms but are not listed among the options might include dependent personality disorder or social anxiety disorder, though these would not be considered "rare" in the context of differential diagnosis for social and anxiety-related disorders.