Differential Diagnosis
- Single Most Likely Diagnosis
- Obsessive-Compulsive Disorder (OCD): The patient's ritual cleaning, preoccupation with being infected with HIV, and history of taking SSRIs and CBT suggest a diagnosis of OCD. The patient's symptoms have interfered with their daily life, as evidenced by their inability to complete college.
- Other Likely Diagnoses
- Anxiety Disorder: The patient's excessive worry about being infected with HIV and their ritual cleaning behaviors suggest a diagnosis of an anxiety disorder.
- Tic Disorder: The patient's history of motor tics in high school suggests a possible diagnosis of a tic disorder, such as Tourette's syndrome.
- Depressive Disorder: The patient's disheveled and unkempt appearance, as well as their inability to complete college, may suggest a diagnosis of a depressive disorder.
- Do Not Miss Diagnoses
- Psychotic Disorder: Although the patient does not appear to have any psychotic symptoms, it is essential to rule out a psychotic disorder, such as schizophrenia, as these conditions can be deadly if left untreated.
- Neurodegenerative Disorder: The patient's motor tics and ritual cleaning behaviors could be indicative of a neurodegenerative disorder, such as Huntington's disease, although this is less likely.
- Rare Diagnoses
- Hypochondriasis (Illness Anxiety Disorder): The patient's preoccupation with being infected with HIV could be indicative of hypochondriasis, although this diagnosis is less likely given the patient's ritual cleaning behaviors and history of taking SSRIs and CBT.
- Body Dysmorphic Disorder: The patient's disheveled and unkempt appearance could be indicative of body dysmorphic disorder, although this diagnosis is less likely given the patient's primary symptoms of ritual cleaning and preoccupation with HIV.