A question about diagnosis and symptoms-feedback welcomed

[firemonkey]

What should diagnosis be based on? How you are off meds/med not being taken consistently? Or how you are with meds being taken consistently?

I ask this because my dx has been changed back to schizophrenia. I was asked about mood symptoms, but found it hard to answer as since being on depot(2009) my mood symptoms have not been much of a problem (mildly depressive at times)

This was the situation mood wise when meds weren’t taken regularly.: irritability,inner tension, busy mind,depression,contentious,impatient,

I was puzzled by this comment:

In the context of a diagnosis of autism spectrum disorder now having been made and the depressive symptoms being mild when they occurred in the past, I’m changing the diagnosis back to schizophrenia.

[Joker]

@firemonkey

What should diagnosis be based on? How you are off meds/med not being taken consistently?

It should be based on presentation before treatment, which does raise the question of whether long term treatment is needed. Once you’re on a med regime, it seems very hard to get off it due to the nasty withdrawal symptoms if you go too fast

@firemonkey

my mood symptoms have not been much of a problem (mildly depressive at times)

Have you been taking additional treatment for mood, other than the standard SZ meds (AP’s)?

@firemonkey

In the context of a diagnosis of autism spectrum disorder now having been made and the depressive symptoms being mild when they occurred in the past, I’m changing the diagnosis back to schizophrenia.

This is all pretty much academic, and I am guessing they’re just focusing on the presenting symptoms that you currently have

Don’t forget they write everything down in your notes, so it seems that whoever it is that has made this decision must have gone through your history for a significant amount of time to arrive at this conclusion. I would try and confirm if this has happened, and if not, I would be contacting PALs to report this person for negligence as they should not ■■■■ with people’s labels unless they have done their homework and can prove a proper case for this.

[firemonkey]

@Joker

It should be based on presentation before treatment, which does raise the question of whether long term treatment is needed. Once you’re on a med regime, it seems very hard to get off it due to the nasty withdrawal symptoms if you go too fast

That’s my thought on the matter… That presentation pre/off treatment should be the diagnostic yardstick.

@Joker

Have you been taking additional treatment for mood, other than the standard SZ meds (AP’s)?

No,but the ones I’ve been on have mood stabilising properties.

@Joker

This is all pretty much academic, and I am guessing they’re just focusing on the presenting symptoms that you currently have

That would appear to be the case re current symptoms. This was the situation after my previous appointment 2 Oct 2019. Letter dated 3Oct.2019

I brought him back to review the diagnosis…I have changed it from schizophrenia to schizoaffective disorder based on my further exploration today indicating he has,in the past, had phases of both low and high mood in the context of concurrently experiencing psychotic symptoms

[Joker]

It seems the homework may well have been done. I would still force the issue for them to check. Maybe it’s worth trusting this NHS trust more than your previous one, as you have said yourself they were the ones who sorted the ASD issue the other Trust in Essex missed for all those years…

Sometimes these things require some fine tuning.

I suffered majorly due to a diagnosis of Drug-Induced Psychosis when I was 17, as I was on AP’s for a couple of years, and eventually relapsed off meds and was placed in a very vulnerable and dangerous situations where I was lucky to have no been killed or put in prison - but got told I had Paranoid Schizophrenia.

That’s why I view the diagnostic process as very significant, as without it people treating cannot get it right.

If the mood issues exist, but are more of a side issue, they may not diagnose it, or in your case, they might review. They tell me I have depression and anxiety, but I have no official diagnosis, and I am treated with meds for the anxiety.

Either way if it results in better treatment and understanding I don’t think it’s a bad thing.

I would however be making a complaint about the mis-diagnosis - if that’s the case, as this can cause so many problems with being put on potentially damaging meds you don’t need.

Overall I think you have more faith in this team vs. your previous, so I would consider if it was me how strongly I felt the quality of treatment where you are now is vs. what the others were like, and whether you can have faith

I cannot answer that, as I have only been treated by the same trust all my life as I have not moved out of my hometown yet

Wish you the best with it @firemonkey I am just giving you my thoughts on the issues relating to your thread. I hope it doesn’t come across wrong - Just trying to help you if I can as you have my respect.

[firemonkey]

Thanks for you comments @Joker

The current pdoc and the depot nurse are much better than what I had in Essex . My query is of an academic/intellectual nature than a ‘I don’t like them any more’ nature. I don’t think being asked about mood on the spot helped matters. My autobiographical memory is rather crap at the best of times . Trying to instantly recall and mention past symptoms isn’t easy. Quite frankly, I’m the kind to go into ‘brain fart’ mode in such a situation .

It’s episodic and in remission with some breakthrough psychotic symptoms.