Essentials of Making an Accurate Psychiatric Diagnosis


A proper psychiatric diagnosis requires the ability to elicit information, identify symptoms, and recognize behavioral patterns. Dr Michael First, author of DSM-5 Handbook of Differential Diagnosis, summarizes key points in this brief video.

Dr Michael First, author of DSM-5 Handbook of Differential Diagnosis, summarizes his book in this brief video.

An expert on psychiatric diagnosis and assessment, Dr First is Professor of Clinical Psychiatry at Columbia University and a Research Psychiatrist at the Biometrics Department at the New York State Psychiatric Institute in New York.

He is a speaker at a preconference program for this year's PsychCongress. In this program, he focuses on the publication of DSM-5, for which he is Editorial and Coding Consultant, and he will give an overview of proper use of the manual. He will also discuss issues related to ICD-9 and ICD-10-CM coding, as well as the 6-step differential diagnosis framework from his book.

Published by American Psychiatric Publishing, Inc., the DSM-5 Handbook offers a framework for diagnosing patients, as described on the APPI Web site, below.

The handbook offers an assortment of approaches to differential diagnosis, and a number of features designed to benefit clinicians in the exam room, including:

  • A 6-step framework for diagnosing patients that proceeds from determining if the symptom is real to establishing the boundary between disorder and normality, with intermediary steps to rule out substance etiology and medical conditions, as well as to determine the primary disorder and to differentiate adjustment disorders from other mental disorders.
  • Twenty-nine symptom-oriented decision trees that provide detailed decision points to facilitate the process of generating the differential diagnosis based on the presenting symptoms and eliminate formulating premature conclusions.
  • Sixty-six differential diagnosis tables, one for each of the most important DSM-5® disorders, cross-referenced with the terminal branches of the decision trees presented in the handbook to provide a head-to-head comparison of each disorder, highlighting similarities and differences.
  • The DSM-5® classification, to facilitate coding and to provide an overview of all of the DSM-5® diagnoses that must be considered in formulating a differential diagnosis.
  • Alphabetical indexes of the decision trees and differential diagnosis tables to help readers readily locate desired material.


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