The Purpose Of Diagnosis

Diagnosis of psychological symptoms using the DSM-IV entails classifying observable symptoms, or reports

DSM-IV

of such symptoms, into discrete categories termed mental disorders. A mental disorder (defined above) represents a pattern of behavior or psychological features that in some way causes the person distress or impairment. Moreover, a mental disorder is conceptualized in the DSM-IV as a problem or dysfunction that resides within an individual, rather than a problem that results from a conflict between that individual and society. This caveat is important because it is supposed to prevent the misuse of diagnostic labels for the purpose of social control, applying them to individuals whose values or beliefs differ from those of the majority.

Assigning a diagnosis using the DSM-IV does not necessarily suggest that the etiology (cause) of the symptoms is known, but only than an individual's symptoms meet the criteria for the particular mental disorder. For example, two individuals might meet the criteria for a diagnosis of Major Depressive Disorder, but might develop these symptoms after a very different set of circumstances; one person might experience these symptoms only after a series of troubling setbacks (e.g., financial, legal, and relationship problems) while another might experience these symptoms after an apparently unstressful period. Although one might imagine that the etiology of the depression differs for these two individuals, they would both receive the same diagnosis using the DSM.

Assigning a diagnostic label may have profound implications for the person receiving the diagnosis. On the one hand, diagnostic labels may allow individuals to receive the treatment they are seeking. On the other hand, such labels may have a stigmatizing effect for the person diagnosed. Consider, for example, how you might think about yourself, and how others might begin to think about you and to treat you, if they learned you had received a diagnosis of a severe psychosisschizophrenia. Diagnostic labels convey a wealth of information, some of it intended, some of it not. Because assigning a diagnostic label may have profound effects on how people may view the person who receives the label, the diagnosis of mental disorders should be taken seriously, and should have the potential for some clear benefits for those diagnosed.

What, then, is the purpose of diagnosing mental disorders? First, diagnosis should help us identify a homogeneous group of individuals. For example, many different disorders may entail delusions —beliefs that most persons in an individual's culture would regard as false, such as the belief that one can read verbatim another's thoughts. Yet despite similarity in this particular symptom, individuals with delusions may differ in important ways. Delusions are associated in some cases with the ingestion of psycho-active substances (e.g., amphetamines), in others with a disturbance in mood (e.g., mania or depression), and in others with hallucinations and disorganization of thought (e.g., schizophrenia). These different diagnoses, while sharing a symptom in common, may differ in other important ways. By identifying patterns of symptoms that tend to occur together, important differences between individuals with a common symptom may be identified, such as the cause of the disorder, the most effective treatments, or the prognosis for the future.

Second, diagnosis should help in the planning of treatment. For example, the delusional behavior that can be seen in both mania and schizophrenia will typically be treated by different drugs. Similarly, knowing that the delusional behavior results from use of psychoactive substances suggests a different intervention; i.e., stopping use of the substance causing the symptom.

Third, diagnosis can facilitate communication among professionals. A diagnostic label provides a succinct means of conveying information. For example, if, after an assessment interview, a mental health professional determines that an individual needs to be referred to another mental health professional or facility, the diagnostic label can summarize much of the information. Of course the diagnosis does not summarize all relevant information, but can reduce the amount of description required to round out the assessment picture. Another instance in which diagnostic labels facilitate communication is the case of communication between mental health professionals and insurance providers. Given particular diagnoses, insurance providers will authorize reimbursement for particular treatments, without the need to review the entire assessment interview.

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  • Gimja
    What is the purpose of mental health diagnosis?
    30 days ago

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