Underdiagnosing and overdiagnosing psychiatric comorbidities: Insights into common diagnostic oversights

Monica Ramirez Basco, Colette Jacquot, Christina Thomas, Jennifer M. Knack

Research output: Contribution to journalShort surveypeer-review

2 Scopus citations


There is no substitute for being thorough in conducting a diagnostic evaluation. This includes taking the time to gather information from the patient and significant others, going over prior medical records, and/or observing the patient over time and updating the diagnosis if appropriate. Keep in mind the importance of probing for comorbidities, of not jumping to conclusions about their presence when a patient presents with a few striking symptoms, and of the need to interpret symptoms correctly. Clinicians may be forced to draw quick diagnostic conclusions with limited information in busy practice settings or when patients are acutely ill. In these cases, it is important to follow up after patients have been stabilized, to reevaluate diagnoses when patients seem to be nonresponsive to treatment, and to consider the possibility that comorbid problems may be interfering with treatment outcome. Even when the clinician is familiar with DSM-IV criteria, it is easy to forget the details over time. Most diagnostic tools provide a reminder of symptoms that are common to each category of diagnosis. If it is impractical to use such tools, it is prudent to review DSM-IV criteria when new patients present for treatment. This allows clinicians to recalibrate their assessments, refresh their memories, and reduce drift over time of how diagnoses are derived. By taking time to be thorough in diagnosing primary and comorbid psychiatric disorders, the clinician can facilitate treatment selection and treatment outcome.

Original languageEnglish (US)
Pages (from-to)8-10
Number of pages3
JournalPsychiatric Times
Issue number12
StatePublished - Oct 1 2008

ASJC Scopus subject areas

  • Phychiatric Mental Health
  • Psychiatry and Mental health


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