Psychological diagnosis: yes or no?

Beyond the usefulness of diagnosis, naming a mental state can be problematic.

Since the beginnings of psychology as a science in charge of the study of the mind and human behavior, numerous investigations have been carried out to determine the origins, consequences and perpetuating factors of the vast majority of psychological disorders.

But... does this initiative to give names to psychological phenomena have any drawbacks?

Research on mental disorders

The American Psychiatric Association (APA) and the World Health Organization (WHO) are two of the organizations that have invested the most time and effort in trying to understand in greater depth and provide clarification about how mental disorders work. provide clarification about how mental disorders work.The information on the symptoms associated with each one of them, how to detect them (how many symptoms must be present in order to establish an accurate diagnosis and for how long), etc. This information is reflected in the corresponding diagnostic manuals: the Diagnostic and Statistical Manual of Mental Disorders (DSM-V) and the International Classification of Diseases (ICD-10).

Since the 1990s, the APA and other institutions such as the National Institute for Health and Care Excellence (NICE) have also been responsible for testing which treatments are the most effective for each type of disorder, trying to establish empirical validations of different ways of carrying out a therapeutic process.

Specifically, Division 12 of the APA, created in 1993 a working group on the promotion and dissemination of psychological treatments based on its research findings, leading to the development of treatment guides with a theoretical-practical basis adapted to the adapted to the characteristics of each disorder.

On the other hand, NICE's action encompasses the provision of information, education and guidance, the promotion of prevention and the proposal of ways of proceeding in primary care and specialized services.

Different perspectives from which to investigate

The main difference we can find between one body and the other is how the APA focuses on research into "classic" or "pure" disorders, while NICE addresses issues that do not necessarily meet a clinical diagnosis, but rather but rather implements strategies to improve mental health in general (pregnancies (pregnancy, adherence to treatment, suspected childhood abuse, well-being in old age, etc.).

In the case of the APA, purism" is a factor that often limits clinical action because it is rare for a disorder to appear in its purest and easily recognizable form, but rather it usually meets criteria for other disorders (comorbidity) or presents variations of greater complexity.

Therefore, in psychology today we have a wide margin of research not only on the different types of disorders that we can find, but also on the most appropriate ways to approach them (to date).

Is psychological diagnosis useful?

Usually, the procedure when some kind of psychological treatment is to be carried out is to to begin with an assessment phase. In this phase, the clinical interview provides us with a great deal of information about the situation of the patient in question.

Depending on the current of therapy from which each psychologist works, the interviews may have a more open or more structured format, but they will always have the objective of knowing in the greatest depth the functioning and environment of the person in front of them. the functioning and environment of the person in front of us..

The assessment phase can allow us to establish a diagnosis if a disorder exists, since some of the difficulties that are presented in consultation (known as Z codes) are not included in the diagnostic manuals because they are considered critical situations/changes in the life cycle rather than mental disorders (cases of separation, marital dissatisfaction, difficulties in managing the behavior of children, bereavement, etc.).

In the case of a disorder, in the assessment phase (in which, in addition to interviews, standardized questionnaires can be used) we will have been able to clarify the symptomatology, the course and the evolution of the patient's condition, as well as to give a name to the patient's experience.as well as to give a name to the experience he/she is living.

This diagnosis, based on what has already been mentioned, allows us in a very useful way to know what difficulty we are dealing with and to establish the most appropriate treatment mode for each person, so that we address the problem in the most effective and efficient way possible.

Should we always offer a diagnosis?

As health professionals we must bear in mind that each person is completely different from any otherWhat we would convey to one patient may be harmful to another.

The diagnosis helps professionals to understand and clarify the situation in front of us, as well as to map out and plan our course of action to solve it. However, we must be very careful in making diagnoses, as there are several dangers:

The label may indirectly become a definition of the person.

That is, we no longer speak of "X has schizophrenia", but we can incur "X is schizophrenic".

Diagnosis can lead to victimization of the patient

Whether wisely or unwisely, establishing a diagnosis can lead to the person being absorbed by his or her label: "I can't do X because I am schizophrenic".I can't do X because I am agoraphobic".

Under-diagnosis can lead to a state of confusion in the patient.

If not enough information is provided and the patient does not understand what is really happening to him/her, he/she is very likely to "fill in" the information gaps with data that he/she can extract from less reliable sources than a health professional, generating negative and unrealistic expectations about his or her mental state..

Diagnostic labeling can generate feelings of guilt.

"Something I have done to deserve this".

Conclusion

With this in mind, it goes without saying that it is extremely difficult for psychologists not to establish a mental diagnosis of the situation that we are presented with, since diagnostic labels make it easier for us to understand the information in our mental schemas..

But, in spite of this, if the patient does not directly request a diagnosis for some reason, it is likely that he/she does not need to know what name the experience he/she is going through bears, and simply seeks to resolve it.

On the other hand, if we find a strong insistence on "labeling" what is going on, it is important to first clarify whether the request has a solid basis in the person, or influenced and pushed by other means with which it is related (social links, data on the Internet, etc.). (social ties, internet data, etc.).