Explain Rule Out to me...

[Alisonlg]

When a psychiatrist gives a diagnosis and says "rule out XYZ," what exactly does that mean? Does that mean they have absolutely ruled out that as a possible diagnosis (as if to say, "I've considered it and this kid doesn't have it!")? Does it mean, "I'm thinking this child might have this, so I need to keep my eyes open and rule it out over time? Or what?

 

[smallworld]

Rule out means the diagnosis is still a possibility, but the psychiatrist can't positively make the diagnosis because he needs more time to observe.

Both J and A have a rule out on BiPolar (BP). In my son's case, the psychiatrist suspects he has BiPolar (BP) and is treating him as such, but he doesn't want to make a firm diagnosis until my son gets to the other side of puberty. In my daughter's case, the psychiatrist hasn't decided yet whether she had an idiosynchratic reaction to an SSRI (and would do fine with other SSRIs) or whether her reaction was the start of BiPolar (BP).

Does M have a rule out on a diagnosis?

 

[Alisonlg]

Well, I still haven't really gotten the diagnosis's yet. I FINALLY got the discharge summary from M's FIRST psychiatric hospital admit back in March and it has "ODD, rule out ADHD, rule out learning disabilities" as his discharge diagnosis.

Then, his admit diagnosis on his THIRD psychiatric hospital admit was "ODD, Intermittant Explosive Disorder, rule out BiPolar (BP)," and there was something else, but it was given to me verbally and we were interrupted, so I didn't get it all.

So, I was trying to figure out if the psychiatrist meant with the rule out that he thought M definately wasn't BiPolar (BP) or it meant that he was considering the diagnosis. The SW was trying to explain what a rule out meant to me, but like I mentioned, we were interrupted and then our meeting ended. She was basically saying, "You don't want to pin a label like BiPolar (BP) on a kid his age..." and that was that.