Current Medical Diagnosis & Treatment in Psychiatry

Purpose of Clinical Reasoning

It is through clinical reasoning that clinicians collect, weigh, and combine the information required to reach diagnosis; decide which treatment is required; monitor treatment effectiveness; and change their plans if treatment does not work. The study of clinical reasoning, therefore, concerns the intellectual processes that underlie diagnosis and the planning and implementation of treatment.

Diagnosis has three purposes: to aid research, to summarize information, and to guide treatment. For clinicians, the chief purpose of diagnosis is to summarize information in such a way as to guide treatment. In one approach to diagnosis, the clinician matches a pattern of clinical phenomena elicited from the patient against the idealized patterns of disease entities and chooses the diagnosis that best fits. In another approach, the clinician attempts to understand the particular environmental, biological, psychological, and existential factors that have both led to the current problem and perpetuated it. The first approach, therefore, seeks commonality and lends itself to generic treatment planning. The second approach stresses uniqueness and the adaptation of treatment to the individual. In good clinical practice the two approaches are complementary.

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