Skip to main content
SpringerLink
Log in

A Cookbook Recipe for the Clinical and Phenomenologically Informed, Semi-structured Diagnostic Interview

  • Chapter
  • First Online:
The Clinician in the Psychiatric Diagnostic Process

Abstract

In the era of operational psychiatry, where mental disorders are defined on sets of polythetic diagnostic criteria and diagnoses regularly are derived from algorithms of structured diagnostic interviews, diagnostic assessment is often reduced to a matter of “symptom counting,” that is, only checking symptoms listed as criteria in the diagnostic manuals. This has led to a gradual disappearance of the basic clinical ability of making a comprehensive, semi-structured diagnostic interview. The purpose of our chapter is to reintroduce the clinical and phenomenologically oriented, semi-structured interview for psychopathological and differential-diagnostic assessment, which we consider the only adequate method for such an assessment. Here, we present the ingredients of this interview, describe how it ideally should be conducted, what information it must gather, and how all gathered information finally must be synthesized to make a comprehensive differential-diagnostic evaluation. We also explicate important epistemological, psychopathological, and phenomenological issues that are at stake in the interview (e.g., the notions of psychopathological Gestalt, prototype, epoché, and the psychopathological eidetic reduction) as well as highlight certain pitfalls the clinician must be attentive to when conducting the clinical diagnostic interview.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 159.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Notes

  1. 1.

    In the following, we simply refer to this interview as the clinical diagnostic interview.

  2. 2.

    For the sake of textual simplicity, we portray the clinician as female and the patient as male throughout the chapter.

References

  1. Cooper J, Kendell R, Gurland B, Sharpe L, Copeland J. Psychiatric diagnosis in New York and London. London: Oxford University Press; 1972.

    Google Scholar 

  2. APA: American Psychiatric Association. Diagnostic and statistical manual of mental disorders, third edition (DSM-III). Washington, DC: APA; 1980.

    Google Scholar 

  3. WHO: World Health Organization. The ICD-10 classification of mental and behavioural disorders: clinical descriptions and diagnostic guidelines. Geneva: WHO; 1992.

    Google Scholar 

  4. Andreasen NC. DSM and the death of phenomenology in America: an example of unintended consequences. Schizophr Bull. 2007;33(1):108–12.

    Article  Google Scholar 

  5. Hyman SE. The diagnosis of mental disorders: the problem of reification. Ann Rev Clin Psychol. 2010;6:155–79.

    Article  Google Scholar 

  6. Hyman SE. Diagnosing the DSM: diagnostic classification needs fundamental reform. Cerebrum. 2011;Mar-Apr:6.

    Google Scholar 

  7. Parnas J. A disappearing heritage: The clinical core of schizophrenia. Schizophr Bull. 2011;37(6):1121–30.

    Article  Google Scholar 

  8. Parnas J. Differential diagnosis and current polythetic classification. World Psychiatry. 2015;14(3):284–7.

    Article  Google Scholar 

  9. APA: American Psychiatric Association. Diagnostic and statistical manual of mental disorders, fifth edition (DSM-5). Arlington, VA: APA; 2013.

    Book  Google Scholar 

  10. Mølstrøm IM, Henriksen MG, Nordgaard J. Differential-diagnostic confusion and non-specificity of affective symptoms and anxiety: an empirical study of first-admission patients. Psychiatry Res. 2020; https://doi.org/10.1016/j.psychres.2020.113302.

  11. Nordgaard J, Sass L, Parnas J. The psychiatric interview: validity, structure and subjectivity. Eur Arch Psychiatry Clin Neurosci. 2013;263(4):353–64.

    Article  Google Scholar 

  12. Jansson L, Nordgaard J. The psychiatric interview for differential diagnosis. Switzerland: Springer; 2016.

    Book  Google Scholar 

  13. Henriksen MG, Englander M, Nordgaard J. Methods of data collection in psychopathology: the role of semi-structured, phenomenological interviews. Phenom Cogn Sci. 2021. https://doi.org/10.1007/s11097-021-09776-5.

  14. Kinsey A, Pomeroy W, Martin C. Sexual behavior in the human male. Philadelphia: WB Saunders Company; 1948.

    Google Scholar 

  15. Stanghellini G. Philosophical resources for the psychiatric interview. In: Fulford KWM, Davis M, Gipps RGT, Graham G, Sadler JZ, Stanghellini G, Thornton T, editors. The Oxford handbook of philosophy and psychiatry. Oxford: Oxford University Press; 2013. p. 321–56.

    Google Scholar 

  16. Widiger TA, Frances AJ, Pincus HA, et al., editors. DSM-IV sourcebook, vol. 4. Washington: American Psychiatric Press; 1992.

    Google Scholar 

  17. Kahn E. Schizoid und Schizophrenie im Erbgang. In: Rüdin E, editor. Studien über Vererbung und Entstehung geistiger Störungen, vol. IV. Berlin/Heidelberg: Springer; 1923.

    Google Scholar 

  18. Møller P, Husby R. The initial prodrome in schizophrenia: searching for naturalistic core dimensions of experience and behavior. Schizophr Bull. 2000;26(1):217–32.

    Article  Google Scholar 

  19. Friedlander ML, Phillips SD. Preventing anchoring errors in clinical judgment. J Consult Clin Psychol. 1984;52(3):366–71.

    Article  CAS  Google Scholar 

  20. Voytovich AE, Rippey RM, Suffredini A. Premature conclusions in diagnostic reasoning. Med Educ. 1985;60(4):302–7.

    CAS  Google Scholar 

  21. Skodlar B, Henriksen MG. Toward a phenomenological psychotherapy for schizophrenia. Psychopathology. 2019;52:117–25.

    Article  Google Scholar 

  22. Nordgaard J, Henriksen MG. Phenomenological psychopathology and quantitative research. In: Stanghellini G, Broome M, Fernandez A, FusarPoli P, Raballo A, Rosfort R, editors. The Oxford handbook of phenomenological psychopathology. Oxford: Oxford University Press; 2019. p. 941–51.

    Google Scholar 

  23. Parnas J, Zahavi D. The role of phenomenology in psychiatric classification and diagnosis. In: Maj M, Gaebel W, Lopez-Ibor JJ, Sartorius N, editors. Psychiatric diagnosis and classification. World Psychiatric Association’s Series on Evidence and Experience in Psychiatry. Chichester: Wiley; 2002. p. 137–62.

    Google Scholar 

  24. Zandersen M, Henriksen MG, Parnas J. A recurrent question: what is borderline? J Pers Disord. 2019;33(3):341–69.

    Article  Google Scholar 

  25. Parnas J. The core Gestalt of schizophrenia. World Psychiatry. 2012;11(2):67–9.

    Article  Google Scholar 

  26. Kendell R. The role of diagnosis in psychiatry. Oxford: Blackwell; 1975.

    Google Scholar 

  27. Rosch E. Natural categories. Cogn Psychol. 1973;4:238–50.

    Article  Google Scholar 

  28. Rosch E, Mervis C. Family resemblance. Cogn Psychol. 1975;7:238–50.

    Google Scholar 

  29. Jaspers K. General psychopathology, trans. Hoenig, J., & Hamilton, M. W. London: Johns Hopkins University Press; 1997.

    Google Scholar 

  30. Jansson L. Near-psychotic phenomena in a clinical context. In: Waters F, Stephane M, editors. The assessment of psychosis. New York: Routledge; 2015. p. 55–74.

    Google Scholar 

  31. Hay GG. Feigned psychosis—a review of simulation of mental illness. Br J Psychiatry. 1983;143:8–10.

    Article  CAS  Google Scholar 

  32. Humphreys M, Ogilvie A. Feigned psychosis revisited—a 20 year follow up of 10 patients. Psychiatr Bull. 1996;20:666–9.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Center for Subjectivity Research, Department of Communication, University of Copenhagen, Copenhagen, Denmark

    Mads Gram Henriksen

  2. Mental Health Center Amager, Copenhagen, Denmark

    Mads Gram Henriksen & Julie Nordgaard

  3. Mental Health Center Glostrup, Brøndby, Denmark

    Mads Gram Henriksen & Lennart Bertil Jansson

  4. Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark

    Lennart Bertil Jansson & Julie Nordgaard

Authors
  1. Mads Gram Henriksen
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Lennart Bertil Jansson
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Julie Nordgaard
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mads Gram Henriksen .

Editor information

Editors and Affiliations

  1. Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy

    Massimo Biondi

  2. Centre for Behavioural Sciences and Mental Health, Italian National Institute of Health, Rome, Italy

    Angelo Picardi

  3. Community Service for Prevention and Early Intervention in Mental Health, Rome 1 Local Health Unit, Rome, Italy

    Mauro Pallagrosi

  4. National Institute of Training, Italian Psychoanalytic Society, Rome, Italy

    Laura Fonzi

Rights and permissions

Reprints and permissions

Copyright information

© 2022 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Henriksen, M.G., Jansson, L.B., Nordgaard, J. (2022). A Cookbook Recipe for the Clinical and Phenomenologically Informed, Semi-structured Diagnostic Interview. In: Biondi, M., Picardi, A., Pallagrosi, M., Fonzi, L. (eds) The Clinician in the Psychiatric Diagnostic Process . Springer, Cham. https://doi.org/10.1007/978-3-030-90431-9_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-90431-9_3

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-90430-2

  • Online ISBN: 978-3-030-90431-9

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation