How do you diagnose a Psychiatric Disorder without any specific investigations?

• A common question that my patients ask me is to look at their face and make a diagnosis!!
• Well that’s not possible!!
• Like other medical specialities, psychiatrist follow a medical model of diagnosis.
• The mental health professional first takes a detailed history of your illness, does a complete physical and mental status examination and sends for appropriate laboratory & radiological examination before arriving at a diagnosis.
• Please note Psychiatric illness can occur as a single diagnosis (Depression, Schizophrenia, Anxiety etc) or can be co-morbid (dual diagnosis) eg. Depression & Diabetes, Anxiety & Hypertension or can be a result of the specific condition, eg. Drug induced Depression/Anxiety/Psychosis; Substance Induced (Alcohol) Psychosis etc
• Though, a specific biomarker is not available to make a diagnosis, an experienced psychiatrist puts together all the pieces of the jigsaw puzzle to arrive at a diagnosis.
• Psychiatrist usually follow ICD or DSM classification of Mental disorders to arrive at a diagnosis.
• However, recent findings in genetics and genomics, neurobiology, cognitive neuroscience, neuroimaging and pharmacology are presenting an accelerating array of challenges to the conventional wisdom regarding the aetiology, classification, and treatment of psychiatric conditions, and forcing a reappraisal of research methods and approaches.
• This challenge, while perhaps particularly nuanced and contentious as a consequence of addressing complex human behaviour, is certainly not unique to psychiatry. Every field in medicine has relied to one degree or another on descriptive approaches and confronted the ambiguities at the boundaries of disease.