The effectiveness of all psychiatric treatment is based on a good diagnosis. A therapy will not work well if the diagnosis is not correct or is not complete. A diagnosis in Psychiatry is incomplete if all aspects that are involved in the configuration of the patient's disease have not been taken into account.
The four axes of psychiatric diagnosis
A good diagnosis must take into account four axes:
- The axis 1 is the psychiatric diagnosis itself, for example: depression.
- The axis 2 corresponds to the characteristics of the patient's personality .
- The axis 3 corresponds to the organic diseases that may be related to the disease presented by the patient.
- And axis 4 refers to the psychosocial environment surrounding the patient and of course also influences their emotional state and recovery.
It is important to be clear about these axes, since a patient with depression and a stable psychosocial environment, without concomitant illnesses and in turn with a balanced personality, will not need the same treatment than a patient with the same diagnosis of depression but with a dependent personality, who suffers from a somatic illness that is related to depression such as hypothyroidism or anemia and a psychosocial environment with stress situations such as a job dismissal.
How to get a complete psychiatric diagnosis
When a good treatment is sought, the psychiatry specialist not only looks for the correct pharmacological treatment, but also a correct psychotherapeutic approach based on the information of the axes of the disorder.
In order to deal with all these axes together, it is essential to work as a team with several professionals in psychology and psychiatry, who according to their specialization can approach the different axes with the patient.
When a psychiatric treatment is not obtaining good results, it is most likely that the diagnosis has not been complete, and therefore the treatment chosen is not the correct one. When the four axes are taken into account for the diagnosis and a treatment is chosen accordingly, it is very difficult that good results are not obtained.