Diagnosing Psychiatric Disorders

Diagnosing psychiatric disorders can be challenging, and below are some practical approaches for beginners.

Is the anxiety in the background of euthymia (normal mood)? If so, then it is likely a primary anxiety disorder, such as generalized anxiety disorder. If the anxiety is in the background of a depressed mood, then depression with anxious features should override a primary anxiety disorder diagnosis. Another thing to consider is if the patient’s “anxiety” is actually heightened excitement, restlessness, and fidgeting from hypomania. In this case, bipolar II should be considered. Some other clues would be if the anxiety is very episodic in nature (i.e. – months of having no anxiety symptoms at all).

Fig. 1

Is the psychosis occurring during a manic episode (mania with psychotic features)? Is the psychosis occurring in a depressive episode (depression with psychotic features)? If the psychosis only ever happens during periods of euthymia, then schizoaffective disorder should be considered.

Fig. 2