How Psychiatrists Diagnose Mental Disorders: A Multimodal Approach
- Clinical interview: Chief complaint, HPI, psychiatric review of systems, substance use, trauma, family, social, developmental history.
- Mental Status Exam (MSE): Appearance, behavior, speech, mood/affect, thought process/content, perception, cognition, insight, judgment.
- Physical exam & labs: Rule out medical mimics (thyroid, B12, electrolytes, neuroimaging if indicated).
- Collateral information: Family, caregivers, prior records, pharmacy data.
- Standardized instruments: PHQ-9, GAD-7, MDQ, YMRS, PANSS, cognitive screens (MoCA, MMSE).
- DSM-5-TR / ICD-11 criteria application: Symptom threshold, duration, functional impairment, exclusion of substances/medical conditions.
Diagnosis is iterative; formulation integrates biological, psychological, social, and cultural factors (biopsychosocial model).
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