Check list
Posted: Fri Nov 21, 2025 5:27 am
Taken from GrokAI
Psychologists and psychiatrists diagnose mental health conditions using essentially the **same "checklist" approach** that medical doctors use for physical conditions. They match the patient’s symptoms, history, and functioning against **standardized, pre-defined diagnostic criteria** published in official manuals. These manuals function exactly like the ICD-10/ICD-11 for physical medicine, but for mental disorders.
### The Two Main Diagnostic Manuals (the "checklists")
1. **DSM-5-TR (Diagnostic and Statistical Manual of Mental Disorders, 5th Edition, Text Revision)**
- Published by the American Psychiatric Association (APA).
- The most widely used system worldwide, especially in the United States.
- Current version: DSM-5-TR (2022) – still the standard in 2025; DSM-6 is not expected for several more years.
2. **ICD-11 (International Classification of Diseases, 11th Revision) – Chapter 06: Mental, Behavioural or Neurodevelopmental Disorders**
- Published by the World Health Organization (WHO).
- Officially in effect since 2022 and increasingly used globally (especially in Europe, public health systems, and insurance outside the US).
- Very similar to DSM-5-TR in most diagnoses, but sometimes simpler or organized differently.
Both manuals work the same way:
For **every single disorder**, they list a **specific set of criteria (A, B, C, etc.)** that must be met. The clinician checks whether the patient meets the required number of symptoms, for the required duration, with the required severity/impact, while ruling out other explanations (substance use, medical conditions, etc.).
### Example: Major Depressive Disorder (DSM-5-TR criteria – almost identical in ICD-11)
To diagnose it, the clinician verifies:
A. Five (or more) of the following symptoms have been present during the same 2-week period and represent a change from previous functioning; at least one of the symptoms is either (1) depressed mood or (2) loss of interest/pleasure:
1. Depressed mood most of the day, nearly every day
2. Markedly diminished interest or pleasure in almost all activities
3. Significant weight loss/gain or appetite change
4. Insomnia or hypersomnia nearly every day
5. Psychomotor agitation or retardation
6. Fatigue or loss of energy
7. Feelings of worthlessness or excessive guilt
8. Diminished ability to think/concentrate or indecisiveness
9. Recurrent thoughts of death/suicidal ideation
B. The symptoms cause clinically significant distress or impairment in social, occupational, or other important areas.
C. The episode is not attributable to substances or another medical condition.
D. Not better explained by another mental disorder (schizoaffective, etc.).
E. No manic/hypomanic episode has ever occurred.
→ If all criteria are met → diagnosis = Major Depressive Disorder
→ If only some are met → possible Persistent Depressive Disorder, Adjustment Disorder, etc.
This exact checklist format exists for **every disorder**: schizophrenia, bipolar, ADHD, autism, PTSD, OCD, personality disorders, anorexia, substance use disorders, neurocognitive disorders, etc.
### How Clinicians Actually Do It in Practice
1. **Clinical interview** (often 45–90 minutes initially)
- Open-ended questions + specific probing for every criterion of suspected disorders.
2. **Structured or semi-structured diagnostic interviews** (optional but common in research or complex cases)
- SCID-5 (Structured Clinical Interview for DSM-5)
MINI (Mini International Neuropsychiatric Interview)
These are literal question-by-question scripts that guarantee every criterion is checked.
3. **Collateral information**
Family members, previous records, teachers (for children), etc.
4. **Psychological testing** (when needed)
- Personality inventories (MMPI-3, PAI)
- Neuropsychological tests for ADHD, dementia, etc.
- Symptom rating scales (PHQ-9 for depression, GAD-7 for anxiety, etc.)
5. **Differential diagnosis & rule-outs**
Always ask: Could this be due to thyroid disease, vitamin deficiency, drugs, trauma, grief, etc.?
Psychiatrists (being MDs/DOs) can order blood tests, brain scans, etc., to exclude medical causes.
6. **Dimensional & cultural considerations**
Modern diagnosis is not purely categorical anymore. Clinicians also rate severity, specifiers (e.g., “with anxious distress,” “with psychotic features”), and cultural formulation (how the person's culture affects symptom expression).
### Key Point
Yes, it really is a checklist system, just like physical medicine. The criteria are publicly available (you can buy the DSM-5-TR book or use ICD-11 online for free). Experienced clinicians often know the major criteria by heart and can diagnose quickly, but they are still required to confirm the full criteria are met for official diagnosis (insurance, treatment planning, research, legal purposes).
So, in short: psychologists and psychiatrists use the DSM-5-TR or ICD-11 as their diagnostic "checklists" – exactly parallel to how physicians use ICD-11 for diabetes, asthma, or heart failure. The process is systematic, criteria-based, and evidence-driven.