What Does Rule Out Mean?

Understanding How an Accurate Diagnosis is Made

Therapists rule out various mental health issues when they meet with teens.
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The term "rule out" is used by mental health professionals in determining the most accurate diagnosis to explain the problems your teen is having. If your teen is having trouble concentrating, a therapist may want to rule out ADHD. Or, if your teen seems sad, a mental health professional may want to rule out depression. 

Figuring Out the Right Diagnosis

Finding an accurate diagnosis for troubled teens can be difficult and initially several possible mental health disorders may seem to explain your teen's emotional or behavioral problems. Because of this, the process of finding a correct diagnosis is conducted in a logical, step-by-step manner that considers all the possibilities, and then narrows them down to the diagnosis or diagnoses (sometimes more than one) that most closely match your teen's symptoms.

Getting the right diagnosis is extremely important in order to be able to successfully treat your teen's symptoms. It's a mental health professional's job to use different methods to figure out exactly which disorder in the Diagnostic and Statistical Manual - 5 (DSM-5) fits your teen best. 

An Example of the Difficulty of Diagnosis

Defiant behavior may be a symptom of several conditions, such as oppositional defiant disorder, depression, or substance abuse. But a little defiance may not necessarily signal a mental health issue. Oppositional behavior may also stem from past trauma or learned behavior from an unhealthy group of friends. 

The mental health professional evaluating this teen is likely to say, “First we will rule out depression, then we will consider other possibilities.”

Through this process, which is also done with medical conditions, the most accurate diagnosis is reached through a process of elimination, determining the best diagnostic fit by methodically discarding the ones that do not fit. 

Steps Mental Health Professionals Use to Rule Out Diagnoses

  1. The mental health professional gathers information about your teen. A thorough history is obtained and the clinician will consider information from a variety of sources, including the teen, parents, physician, and teachers. 
  2. Substance abuse issues are considered. If there is substance abuse involved, the clinician needs to figure out if your teen's symptoms are due to the substance abuse or if he is abusing the substance because of the psychiatric symptoms.
  3. Medical problems are considered. The next step is ruling out a medical condition as the cause of your teen's psychiatric symptoms. For example, an untreated thyroid condition can cause depression. 
  4. Environmental issues are assessed. Sometimes, mental health issues stem from stressful life events. Past trauma or a recent change, such as moving to a new city, may temporarily cause problems for a teen.
  5. Psychiatric issues are considered. Mental health providers will use the DSM-5 to consider potential mental health problems. Symptoms are compared and a clinician may establish a clear diagnosis. 
  1. The impact on your teen's life is considered. A clinician will consider how much functioning is impaired. A clinician will evaluate whether your teen's symptoms are impacting her education or her social life. 


View Article Sources
  • LeBano, Lauren. "Six Steps to Better DSM-5 Differential Diagnosis." Psych Congress Network (2014).