I have 2 male pts in early-mid 30s that I'm sure are ASD based on their past HX and current presentations. I read that MDQ/ BSDS can have false positives for bipolar when in fact it's ASD or it's comorbid. Have recommended to both to get Neuropsych testing to help differentiate sx since one has prior dx of ADHD / ODD in childhood, but both report undercurrent of depression since childhood and few other sx that make me think it's ASD. How do you differentiate bipolar from ASD in male pts? I usually try meds to see how they react, even I'm not 99% sure. One had responded to Abilify 2mg and 4 mg dose as I might expect ASD and not bipolar pts to. However, he's got situational stressors in mix (estranged wife still lives in home w/ his and PT's parents). Makes for muddy waters. He reported Abilify 2mg made his anger/ irritability go away, but also decreased motivation. I keep nudging both pts to seek Neuropsych testing to better understand themselves and clear up dx. But neither has pursued it yet.