Diagnosis of psychiatric disorders not as important as outcomes

Nailing the diagnosis of a psychiatric disorder may not be important in prescribing effective treatment, according to Mark Zimmerman, M.D., a clinical researcher at Rhode Island Hospital. His opinion editorial was published 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 and 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.

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This is true, Risperdal treats both schizophrenia and bipolar, so I am covered either way