The diagnostic assessment of a patient with psychological problems is not different from diagnostic assessment of patients with complaints of physical origin. The physician formulates a working hypothesis based on history-taking of the presenting complaint, physical examination and additional tests. But there are also some differences between the psychiatric and somatic-diagnostic assessment.
The psychiatric assessment:
- Focuses on mental functions – such as emotion, thought and perception – and their possible dysfunctions.
- Entails a more in-depth exploration of the subjective experience of symptoms than the somatic-diagnostic process.
- Possible dysfunctions usually coincide with the anamnesis, while in a somatic-diagnostic process, the examination of physical functions and their possible dysfunctions usually takes place after the anamnesis has been completed.
- Is usually more extensive, because the physician not only records the complaints, but also focuses on the subjective experience and interpretation of these complaints.
- The aetiology is largely explained by the patient’s biography, psychiatric history and familial predisposition, while additional psychological or physical examinations have limited diagnostic value for most psychiatric pathology. Often, physical examination and additional psychological testing is conducted to exclude other non-psychiatric medical cause of the psychiatric symptomatology.
Mental functions of a patient may not only be disturbed, but are also the functions by which the patient informs you of their disturbance. This means that a patient is not always able to accurately express their complaints. In addition, these mental functions are the ones that enable you to conduct the psychiatric interview. In other words, mental functions are both the mean and target of the psychiatric interview.