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Pinpointing Diagnosis of Mental Illness May Not Matter So Much

Research cited in an editorial suggests that when it comes to mental illness, nailing down the right diagnosis may not be so important in prescribing effective treatment.

The research findings from Mark Zimmerman, M.D., a clinical researcher at Rhode Island Hospital, appear online in the Journal of Clinical Psychiatry.

“During the past 35 years, we have witnessed a revolution in the treatment of psychiatric disorders,” said Zimmerman, director of outpatient psychiatry and the partial hospital program at Rhode Island Hospital. Zimmerman is also the director of the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, a study that integrated assessment tools and procedures of researchers into a hospital-affiliated outpatient practice.

“Prescription medicine and therapy are effective for a wide range of psychiatric disorders, thus the need for precise diagnosis is often unnecessary.”

Zimmerman and his research cohorts compared unstandardized, unstructured interviews to standardized, structured interviews used by clinicians across the country. They found that the semi-structured interview provides more diagnoses, a finding that was replicated in other studies.

While several of the initial reports from the MIDAS project identified problems with the detection of disorders, with regards to the diagnosis of bipolar disorder the researchers observed an opposite phenomenon — clinician over-diagnosis.

“Even if misdiagnosed, patients’ outcomes may not be worse because the medications prescribed are effective for a variety of conditions,” said Zimmerman.

“Most outpatients will find relief via antidepressant or antipsychotic medications. Medications such as selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors are effective for depression, almost all anxiety disorders, eating disorders, impulse-control disorders, substance use disorders, attention deficit disorder, and some somatoform disorders.

“Thus, it is possible that accurate and comprehensive diagnostic evaluations are not as critical once the provider determines the gross diagnostic distinction (i.e., distinguishing between psychotic, mood, and/or substance use disorders).”

While a diagnostic determination is an important function of the intake evaluation, it is not the sole objective, opined Zimmerman. Comprehensive diagnostic evaluations may be associated with greater patient satisfaction and adherence to prescribed courses of treatments, he pointed out.

The National Institute of Mental Health estimates that nearly one in five Americans suffers from mental illnesses as defined in the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders.

Source: Lifespan

Pinpointing Diagnosis of Mental Illness May Not Matter So Much

Rick Nauert PhD

Rick Nauert, PhDDr. Rick Nauert has over 25 years experience in clinical, administrative and academic healthcare. He is currently an associate professor for Rocky Mountain University of Health Professionals doctoral program in health promotion and wellness. Dr. Nauert began his career as a clinical physical therapist and served as a regional manager for a publicly traded multidisciplinary rehabilitation agency for 12 years. He has masters degrees in health-fitness management and healthcare administration and a doctoral degree from The University of Texas at Austin focused on health care informatics, health administration, health education and health policy. His research efforts included the area of telehealth with a specialty in disease management.

APA Reference
Nauert PhD, R. (2015). Pinpointing Diagnosis of Mental Illness May Not Matter So Much. Psych Central. Retrieved on August 17, 2018, from https://psychcentral.com/news/2015/07/27/pinpointing-diagnosis-of-mental-illness-may-not-matter-so-much/87368.html

 

Scientifically Reviewed
Last updated: 6 Oct 2015
Last reviewed: By John M. Grohol, Psy.D. on 6 Oct 2015
Published on PsychCentral.com. All rights reserved.