Skip to main content
SpringerLink
Log in

Person-Centered and Contextualized Diagnosis in Mental Health

  • Chapter
  • First Online:
Critical Thinking in Clinical Assessment and Diagnosis

Part of the book series: Essential Clinical Social Work Series ((ECSWS))

  • 3102 Accesses

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.

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

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 69.99
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

References

  • Adams, N., & Grieder, D. M. (2005). Treatment planning for person-centered care. Amsterdam: Elsevier.

    Google Scholar 

  • Alanen, Y. O. (1997). Schizophrenia: Its origins and need-adaptive treatment. London: Karnak.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (DSM-IV) (4th ed.). Washington DC: Author.

    Google Scholar 

  • American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5) (5th ed.). Arlington, VA: Author.

    Google Scholar 

  • Amering, M. (2010). Trialog—An exercise in communication between consumers, carers, and professional mental health workers beyond role stereotype. In: Conceptual explorations on person-centered medicine. International Journal of Integrated Care, 10, Supplement 10.

    Google Scholar 

  • Antonovsky, A. (1987). Unraveling the mystery of health. San Francisco: Jossey-Bass.

    Google Scholar 

  • Appleyard, J., Ghebrehiwet, T., & Mezzich, J. E. (2014). Development and implications of the Zagreb declaration on person-centered health professional education. International Journal of Person Centered Medicine, 4, 8–13.

    Google Scholar 

  • Banzato, C. E. M., Jorge, M. R., & Kastrup, M. (2009). Multiaxial schemas for psychiatric diagnosis. In I. M. Salloum & J. E. Mezzich (Eds.), Psychiatric diagnosis: Challenges and prospects. Chichester, UK: Wiley-Blackwell.

    Google Scholar 

  • Canguilhem, G. (1991). The Normal and the Pathological (1966). New York: Zone Books.

    Google Scholar 

  • Chinese Society of Psychiatry. (2001). Chinese classification of mental disorders, version 3 (CCMD-3). Jinan: Author.

    Google Scholar 

  • Christodoulou, G. N. (Ed.). (1987). Psychosomatic medicine. New York: Plenum.

    Google Scholar 

  • Christodoulou, G. N., Fulford, K. M. W., & Mezzich, J. E. (2008). Conceptual bases of psychiatry for the person. International Psychiatry, 5(1), 1–3.

    Google Scholar 

  • Cloninger, C. R., Salvador-Carulla, L., Kirmayer, L. J., Schwartz, M. A., Appleyard, J., Goodwin, N., et al. (2014). A time for action on health inequities: foundations of the 2014 Geneva declaration on person-and people-centered integrated health care for all. International Journal of Person Centered Medicine, 4, 69–89.

    Google Scholar 

  • de América Latina, A. P. (2004). Guía Latinoamericana de Diagnóstico Psiquiátrico. Guadalajara: Asociación Psiquiátrica de América Latina, Sección de Diagnóstico y Clasificación.

    Google Scholar 

  • de América Latina, A. P. (2012). Guía Latinoamericana de Diagnóstico Psiquiátrico, Versión Revisada (GLADP-VR). Lima: Asociación Psiquiátrica de América Latina, Sección de Diagnóstico y Clasificación.

    Google Scholar 

  • Fulford, K. W. M., Christodoulou, G. N., & Stein, D. J. (2011). Values and ethics: Perspectives on psychiatry for the person. International Journal of Person Centered Medicine, 1, 131–133.

    Article  Google Scholar 

  • Garrabe, J., & Hoff, P. (2011). Historical views on psychiatry for the person. International Journal of Person Centered Medicine, 1, 125–127.

    Article  Google Scholar 

  • Ghebrehiwet, T. (2013). Effectiveness of team approach in health care: Some research evidence. International Journal of Person Centered Medicine, 3, 137–139.

    Google Scholar 

  • Heath, I. (2005). Promotion of disease and corrosion of medicine. Canadian Family Physician, 51, 1320–1322.

    Google Scholar 

  • Ierodiakonou, C. S. (2011). The psychology of Aristotle, the philosopher. London: Karnak.

    Google Scholar 

  • International College of Person Centered Medicine. (2012). Geneva declaration on person centered care for chronic diseases. International Journal of Person Centered Medicine, 2, 153–154.

    Google Scholar 

  • International College of Person Centered Medicine. (2013). Geneva declaration on person centered health research. International Journal of Person Centered Medicine, 3, 107–108.

    Google Scholar 

  • International College of Person Centered Medicine. (2014a). The Zagreb declaration on person centered health professional education. International Journal of Person Centered Medicine, 4, 6–7.

    Google Scholar 

  • International College of Person Centered Medicine. (2014b). Geneva declaration on person-and people-centered integrated health care for all. International Journal of Person Centered Medicine, 4, 67–68.

    Google Scholar 

  • Jablensky, A. (2005). Categories, dimensions and prototypes: Critical issues for psychiatric classification. Psychopathology, 38, 201–205.

    Article  Google Scholar 

  • Jouanna, J. (1999). Hippocrates (M. B. Debevoise, Trans.). Baltimore: Johns Hopkins University Press.

    Google Scholar 

  • Kendell, R., & Jablensky, A. (2003). Distinguishing between the validity and the utility of psychiatric diagnoses. American J Psychiatry, 160, 4–12.

    Article  Google Scholar 

  • Kirmayer, L. J. (2000). Broken narratives: Clinical encounters and the poetics of illness experience. In C. Mattingly & L. Garro (Eds.), Narrative and the Cultural Construction of Illness and Healing (pp. 153–180). Berkeley: University of California Press.

    Google Scholar 

  • Laín-Entralgo, P. (1982). El Diagnóstico Médico: Historia y Teoría. Barcelona: Salvat.

    Google Scholar 

  • Mariátegui, J. (1992). La concepción del hombre y de la enfermedad en el antiguo Perú. Revista de Neuropsiquiatría, 55, 156–166.

    Google Scholar 

  • McWhinney, I. R. (1989). A textbook of family medicine. Oxford: Oxford University Press.

    Google Scholar 

  • Mezzich, J. E. (2005). Positive health: Conceptual place, dimensions and implications. Psychopathology, 38, 177–179.

    Article  Google Scholar 

  • Mezzich, J. E. (2007). Psychiatry for the person: Articulating medicine’s science and humanism. World Psychiatry, 6, 65–67.

    Google Scholar 

  • Mezzich, J. E. (2011a). The Geneva conferences and the emergence of the international network of person-centered medicine. Journal of Evaluation in Clinical Practice, 17(333–336), 2011.

    Google Scholar 

  • Mezzich, J. E. (2011b). The construction of person-centered medicine and the launching of an international college. International Journal of Person Centered Medicine, 2, 6–10.

    Google Scholar 

  • Mezzich, J. E. (2012). Towards a health experience formulation for person-centered integrative diagnosis. International Journal of Person Centered Medicine, 2, 188–192.

    Google Scholar 

  • Mezzich, J. E., Banzato, C. E. M., Cohen, P., Cloninger, C. R., et al. (2005). Report of the American Psychiatric Association Committee to evaluate the DSM multiaxial system. Presented to the APA Assembly, Atlanta, May 21, 2005.

    Google Scholar 

  • Mezzich, J. E., Berganza, C. E., von Cranach, M., Jorge, M. R., Kastrup, M. C., Murthy, R. C., et al. (2003). Essentials of the WPA international guidelines for diagnostic assessment (IGDA). British Journal of Psychiatry, 182(Suppl), 45.

    Google Scholar 

  • Mezzich, J. E., Caracci, G., Fabrega, H., & Kirmayer, L. J. (2009a). Cultural formulation guidelines. Transcultural Psychiatry, 46, 383–405.

    Article  Google Scholar 

  • Mezzich, J. E., Salloum, I. M., Cloninger, C. R., Salvador-Carulla, L., Kirmayer, L., Banzato, C. E., et al. (2010). Person-centered integrative diagnosis: Conceptual bases and structural model. Canadian Journal of Psychiatry, 55, 701–708.

    Google Scholar 

  • Mezzich, J. E., Snaedal, J., van Weel, C., & Heath, I. (2009b). The international network for person-centered medicine: Background and first steps. World Medical Journal, 55, 104–107.

    Google Scholar 

  • Miles, A., & Mezzich, J. E. (2011). Advancing the global communication of scholarship and research for personalized healthcare: The International Journal of Person Centered Medicine. International Journal of Person Centered Medicine, 1, 1–5.

    Article  Google Scholar 

  • Mises, R., Quemada, N., Botbol, M., Burzsteijn, C., Garrabe, J., Golse, B., et al. (2002). French classification for child and adolescent mental disorders (CFTMEA). Psychopathology, 35, 176–180.

    Article  Google Scholar 

  • Otero, A. A. (1998). Tercer Glosario Cubano de Psiquiatría (GC-3). La Habana: Hospital Psiquiátrico de La Habana.

    Google Scholar 

  • Patwardhan, B., Warude, D., Pushpangadan, P., & Bhatt, N. (2005). Ayurveda and traditional Chinese medicine: A comparative overview. Evidence-based Complementary and Alternative Medicine, 2, 465–473.

    Article  Google Scholar 

  • Probst, B. (2013). The life and death of axis IV: Caught in the quest for a theory of mental disorder. Research on Social Work Practice, 24(1), 123–131.

    Article  Google Scholar 

  • Robins, E., & Guze, S. (1970). Establishment of diagnostic validity in psychiatric illness: Its application to schizophrenia. American Journal of Psychiatry, 126(7), 983–987.

    Article  Google Scholar 

  • Rogers, C. R. (1961). On becoming a person: A therapist’s view of psychotherapy. Boston: Houghton Mifflin.

    Google Scholar 

  • Salloum, I. M., & Mezzich, J. E. (2011). Conceptual appraisal of the person-centered integrative diagnosis model. International Journal of Person Centered Medicine, 1, 39–42.

    Article  Google Scholar 

  • Salloum, I. M., & Mezzich, J. E. (2009). Psychiatric diagnosis: Challenges and prospects. Chichester, UK: Wiley-Blackwell.

    Book  Google Scholar 

  • Salvador-Carulla, L., Cloninger, C. R., Thornicroft, A., Mezzich, J. E. & the 2013 Geneva Declaration Consultation Group (2013). Background, structure and priorities of the 2013 Geneva declaration on person-centered health research. International Journal of Person Centered Medicine, 3, 109–113.

    Google Scholar 

  • Schaffner, K. F. (2009). The validity of psychiatric diagnosis: Etiopathogenic and clinical approaches. In I. M. Salloum & J. E. Mezzich (Eds.), Psychiatric diagnosis: Challenges and prospects. Chichester, UK: Wiley-Blackwell.

    Google Scholar 

  • Seyer, J. (2012). Development of the health improvement card developed by the world health professions alliance. Paper presented at the 5th Geneva Conference on Person-centered Medicine. International College of Person Centered Medicine, May 2012.

    Google Scholar 

  • Tournier, P. (1940). Médicine de la Personne. Neuchatel: Delachaux et Niestle.

    Google Scholar 

  • WHOQOL Group. (1994). The development of the World Health Organization quality of life assessment instrument (the WHOQOL). In J. Orly & W. Kuyken (Eds.), Quality of life assessment: International perspectives. Heidelberg: Springer.

    Google Scholar 

  • World Health Organization. (1946). Constitution of the World Health Organization. Geneva: Author.

    Google Scholar 

  • World Health Organization. (1996). Multiaxial classification of child and adolescent psychiatric disorders. Cambridge, UK: Cambridge University Press.

    Book  Google Scholar 

  • World Health Organization. (1997). Multiaxial presentation of the ICD-10 for use in adult psychiatry. Cambridge, UK: Cambridge University Press.

    Book  Google Scholar 

  • World Health Organization. (2001). International classification of functioning and health (ICF). Geneva: Author.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. International Center for Mental Health, Mount Sinai School of Medicine, New York, NY, USA

    Juan E. Mezzich & Ada M. Mezzich

Authors
  1. Juan E. Mezzich
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Ada M. Mezzich
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. School of Social Work, Smith College, Northampton, Massachusetts, USA

    Barbara Probst

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Mezzich, J.E., Mezzich, A.M. (2015). Person-Centered and Contextualized Diagnosis in Mental Health. In: Probst, B. (eds) Critical Thinking in Clinical Assessment and Diagnosis. Essential Clinical Social Work Series. Springer, Cham. https://doi.org/10.1007/978-3-319-17774-8_10

Download citation

Publish with us

Policies and ethics

Search

Navigation