Psychiatric assessment and diagnosis

Psychiatric assessment is not a simple administrative questionnaire: it is a complex medical act grounded in clinical signs and symptoms. The psychiatrist analyses the form and content of thought, mood regulation, sensory perceptions, movement and cognitive functions. They draw on international diagnostic classifications, including DSM-5 and ICD-11, to establish a precise differential diagnosis, systematically ruling out organic conditions, whether endocrine, neurological or toxic, that could mimic a mental disorder.

The history-taking interview generally lasts between forty-five minutes and an hour. The practitioner carefully explores the patient’s personal and family history, the sequence in which symptoms emerged, emotional reactivity, sleep and appetite quality, and environmental stressors. They also assess subjective distress and its functional impact on social and professional life, without ever reducing the individual to a diagnostic label.

Psychiatric assessment is required for major depressive episodes with psychomotor slowing, sudden mood fluctuations suggestive of bipolar disorder, recurrent panic attacks, delusions or hallucinations, disabling obsessive-compulsive disorder (OCD), or acute suicide risk.

Diagnosis is not an end in itself, but the starting point of a therapeutic alliance. The psychiatrist explains their conclusions clearly, proposes treatment options, including appropriate medication, targeted psychotherapy and workplace adjustments, and coordinates follow-up with the general practitioner and treating psychologist.

Psychiatric assessment never becomes fixed in time: the initial diagnosis is continually reassessed as the clinical picture and response to care evolve. The psychiatrist provides regular follow-up to adjust recommendations, measure symptom reduction and prevent relapse by listening attentively to the patient’s experience.