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Diagnosis in psychiatry 

Diagnosis in psychiatry
Chapter:
Diagnosis in psychiatry
Author(s):

John E. Cooper

and Norman Sartorius

DOI:
10.1093/med/9780199669493.003.0014
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date: 22 November 2017

A diagnosis is best defined as the underlying cause of the presenting symptoms; it is expressed in the terms and concepts of the healer or contemporary doctor. Modern medical knowledge allows physicians and surgeons to make many diagnoses based upon aetiology that lead immediately to specific treatment, but limited knowledge of brain and psychological functions does not allow psychiatrists to do this for many psychiatric patients. The diagnostic process in contemporary psychiatry depends upon interviewing, followed by summarizing the symptoms identified in terms of a chosen diagnostic system. The diagnostician’s perception of the symptoms is rapid, and subject to interpretation; standardised interview and rating schedules, such as the PSE, SCAN, DIS and CIDI have been developed for research purposes that minimise the variation between interviewers. There is still debate about whether to identify diagnostic categories by means of narrative descriptions or lists of criteria or both. In clinical practice there are drawbacks to relying only upon lists of criteria. A dimensional approach to diagnosis is often debated, but the lack of dimensions which can be measured reliably remains a major problem.

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