What does R/O mean (as part of a diagnosis)?

I recently acquired my psychiatric records for transfer to a new doctor out-of-state. I thought I was Bipolar II, but the diagnosis my psychiatrist wrote every visit was Mood NOS (R/O bipolar).

What does that mean? I know the "Mood NOS" indicates a mood disorder not defined in the DSM-IV, but was he trying to rule out bipolar every time he saw me? In this context, does "R/O" really mean something more like "maybe?"

I'm confuzzed.

r/o = rule out

It seems to me that he was working on a more clear dx? Highly suspecting it was a mood disorder of some kind, with his primary focus being to rule out (or confirm) a highly suspected Bipolar?

I'm not even close to a professional, but that might be one way to interpret it?

KD

*** edited to add:

It could read to me too that he's ruled out the obvious bipolar, but I don't think that would be the case because I don't think he'd allow you to continue to think that your dx. if he'd specifically ruled it out?

It means he didn't know yet.

Any dx with NOS is a wastebasket diagnosis.

All my best,
Okie

* hugs*

if im not mistaken, NOS means Not otherwise specified.

Yes, Not Otherwise Specified is indeed a diagnosis (in my opinion) when they "cannot fit" you into anything else in a clean way, or they dont know for sure.

R/O is rule out, at least in my schoolin'.

Yes, r/o is rule out. They do thyroid function tests to r/o thyroid disorder, for example. Or a patient shows signs of different diagnoses and the doctor applies the most likey diagnosis but is open to the possiblity of a different or additional diagnosis.

NOS is not otherwise specified so the diagnosis provided is the most likely diagnosis, based on all the data the doctor had at that time.

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Teenie331 said:
I recently acquired my psychiatric records for transfer to a new doctor out-of-state. I thought I was Bipolar II, but the diagnosis my psychiatrist wrote every visit was Mood NOS (R/O bipolar).

What does that mean? I know the "Mood NOS" indicates a mood disorder not defined in the DSM-IV, but was he trying to rule out bipolar every time he saw me? In this context, does "R/O" really mean something more like "maybe?"

I'm confuzzed.

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Confused... well that's common. I'm confused all the time
Your doctor wrote shorthand that says "Mood Disorder, Not Otherwise Specified, Rule Out for Bipolar Disorder"
He thinks you have a Mood Disorder, more than likely in his mind, Bipolar Disorder (many kinds of Bipolar which we can include Cyclothymia here or under broader category of Mood Disorders). Mood Disorders are Bipolar Disorders, Major Depressive Disorders, and Dysthymia (aka Dysthymic Disorder). So he thinks you have one of those, but he can't specify.

He just meant he couldn't pin it down.. and depending on how long you saw him for, I either would or would not be surprised. If you saw him for awhile, and he still didn't know, I'd think he was a quack.
Did he refer you, or did your parents refer you to a new one?

The NOS is probably the best thing in the DSM, in my opinion. Why? Because rarely does someone have a disorder that fits so exactly and neatly into the criteria that they have established.

I am diagnosed with bipolar NOS. This is because my mood swing patterns do not follow what is outlined in the DSM.

R/O is something that is noted when the evaluating doctor does not yet have enough information to diagnose you with something that includes a need for futher observation/evaluation on symptom patterns, frequency and duration of symptoms, etc.

It is written down as part of the diagnosis to note that there are reasons to believe that you may be bipolar because you do have some presenting symptoms that follow that pattern-- but not enough information is yet present.

yeah. i don't have much to add to what has already been said, really. sometimes NOS can be about a person not fitting the paradigmatic profile of a particular disorder, whereas other times NOS can be about having insufficient information to determine whether a particular disorder applies or not. Sounds like your doc was making a note to suggest that it is more the latter at this stage.

Good explanation here:

http://en.allexperts.com/q/Bipolar-D...ondering-1.htm

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pinksoil said:
The NOS is probably the best thing in the DSM, in my opinion. Why? Because rarely does someone have a disorder that fits so exactly and neatly into the criteria that they have established.

I am diagnosed with bipolar NOS. This is because my mood swing patterns do not follow what is outlined in the DSM.

R/O is something that is noted when the evaluating doctor does not yet have enough information to diagnose you with something that includes a need for futher observation/evaluation on symptom patterns, frequency and duration of symptoms, etc.

It is written down as part of the diagnosis to note that there are reasons to believe that you may be bipolar because you do have some presenting symptoms that follow that pattern-- but not enough information is yet present.

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It will be interesting to see the DSM-V yah?

Well, actually, I've been seeing him for four years... and I promise, he's not a quack - he was chief resident in psychiatry (like eight or ten years ago). Anyway, I'm thinking the issue is that I do not fit into the classic definition of bipolar disorder because I do not have true manic episodes, only hypomanic. I'm bipolar II, as far as I know. Maybe there isn't a DSM diagnosis for that specifically.

I was changing providers because I moved to NY for Physician Assistant school at Stony Brook. I tried the psychiatrists at the student health center, but that didn't go well, so I'm trying to find someone out of the blue. I think I have it covered, though.

By the way, I'm 24... my parents had nothing to do with any of this. (Did you see my age somewhere?) I promise I'm not offended - I'm just curious.

my pdoc told me that he has to write down the dx everytime because he is required to for the health care coverage. Insurance, private, state, or provincial, all require a diagnosis indicator. If he felt your dx was mood disorder NOS (r/o bipolar) then he would be required to write that in every time unless he felt some reason to change it. My pdoc even showed me the sheets so i could see (i wanted to know what he wrote down all the time).

When I first started going to my pdoc my dx was bipolar NOS as I did not display all the symptoms of bipolar. Later, apparently I did as it was changed to bipolar 1. Then sometimes (rarely) it has been bipolar 1 --in complete remission; or currently it is mixed episode--moderate. I also get a dx code on my receipt each time I see her for ins. purposes.

Well, I'd better get to bed. I'm coming out of a hypomanic period & I've been given a lot of sedating meds as I wasn't sleeping much at all. NOw, can hardly keep my eyes open some nights.--Suzy

There is a specific dx for Bipolar II - but I'm not too sure how (for example) your health insurance might cover that. Ditto for Borderline Personality... Sometimes... Diagnostics can be a fairly 'creative' enterprise (which is precisely why there isn't much point getting too hung up on a dx)