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Chapter 2 - Assessment, Formulation and Diagnosis

Published online by Cambridge University Press:  04 April 2024

By
David Kingdon ,
George Stein  and
Paul Rowlands
Edited by
David Kingdon ,
Paul Rowlands  and
George Stein
David Kingdon
Affiliation:
University of Southampton
Paul Rowlands
Affiliation:
Derbyshire Healthcare NHS foundation Trust
George Stein
Affiliation:
Emeritus of the Princess Royal University Hospital
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Summary

Collaborative psychiatric management is founded on a person-centred, holistic assessment leading to a diagnostic formulation that guides decision making. Formulation around the individual person, including their unique history and worldview, can be described with presenting, precipitating, predisposing, perpetuating and protective factors as well as the life context for the individual patient. Allied with this, diagnosis – in which the patient’s unique presentation can be evaluated as sharing characteristics and patterns with other patients – can allow for the individual plan to be guided by a wider frame of reference and knowledge. Such diagnostic frameworks have been developed over millennia and across cultures. As well as being important for individual patient care, they are essential for research and service planning. The development of these diagnostic frameworks is discussed with particular reference to the main international classifications of ICD-11 and DSM-5. It is common for people to have more than one diagnosis, and diagnostic hierarchies are considered. Criticisms of the construct of psychiatric diagnosis are reviewed, and an approach to conducting and describing collaborative psychiatric assessment is described.

Keywords

assessmentdiagnosisformulationholisticcollaborativeperson-centred
Type
Chapter
Information
Seminars in General Adult Psychiatry , pp. 30 - 63
Publisher: Cambridge University Press
Print publication year: 2024

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