Person-Centered and Contextualized Diagnosis in Mental Health

Abstract

A model for person-centered and contextualized diagnosis of mental health [person-centered integrative diagnosis (PID)] is presented in this chapter within the larger framework of person-centered psychiatry and medicine. As the authors note, this is a departure from the prevalent disease-centered model—a departure predicated on both ethical and scientific grounds—representing a more sophisticated, comprehensive, and diagnostically valid evolution of the multiaxial approach found in DSM-III and IV. Among the cardinal features of PID are: diagnosis of a person’s whole health (both ill and positive health); considering diagnosis as both a formulation and an interactive process among clinicians, patients, and families; and the use of categories, dimensions, and narratives as descriptive tools. Its multilevel informational structure encompasses health status, health contributors, and health experience and expectations, integrating standardized and idiographic components. The chapter traces the history and methodological basis for the development of PID, as well as offering an example of the PID approach in the Latin American Guide of Psychiatric Diagnosis. It then shows how this model can be applied to produce a comprehensive diagnostic formulation and discusses the implications of such an approach for advancing effective and interdisciplinary mental health care.