- Mood Disorders
- Substance Misuse and Dependence
- Personality Disorders
- Risk, Suicide and Self-harm
Causes of psychiatric problems can be split into two areas: functional and organic.
- Functional: Depression, Anxiety, Mood disorders, schizophrenia
- Organic: Alzheimer’s and dementia, Delirium, Space occupying lesions, Iatrogenic, Other drugs
When forming a diagnosis you must always rule out organic causes first before moving onto to functional causes. You should think of it as a pyramid or hierarchy of diagnoses; only when each level has been ruled out can you proceed to the next. In this way you can accurately diagnose a functional problem that may not necessarily have a textbook presentation and might otherwise have been missed.
This process reminds me of a certain detective: ‘when you have eliminated the impossible, whatever remains, however improbable, must be the truth’
Diagnoses in psychiatry are very different to most other areas of medicine. There are no diagnostic tests, and no imaging available (in the majority of conditions). Instead diagnosis relies on identifying collections of individual symptoms that correlate to the ICD 10 (this is important, you will hear a LOT about this, its pretty much the bible for this EJR) of a specific condition.