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Accurate diagnosis is most important in psychiatry

The Daily Record - 8/23/2019

As a psychiatrist, it is the best of both words to be able to treat someone medically while also supporting them emotionally. While Dr. Alcorn stated that he believes he is “dealing with a person, not a diagnosis,” I believe I am dealing with a person who has a diagnosis; it is not an either/?or.

I would argue that an accurate diagnosis is the MOST important piece of information, not only in psychiatry, but in any medical specialty because a diagnosis guides treatment.

Psychiatric medications, procedures and therapies are studied extensively. In general, treatments are approved because a study (or multiple studies) show that treatment is effective over placebo for patients with a specific diagnosis. We are lucky in psychiatry in that we have a wide range of treatments that are effective for specific diagnoses.

I agree with Dr. Alcorn in that the brain is capable of healing itself. However, “training the brain” can be done in a number of evidence-based ways — no wellness device required.

As physicians, we take an oath to “First, do no harm.” However, harm can come to a patient who is sold on a treatment that does not have evidence to support it when there are alternatives that have been proven effective.

Evidence-based styles of traditional “talk” therapy include: Cognitive Behavioral Therapy, EMDR (Eye Movement Desensitization and Reprocessing) therapy, Cognitive Processing Therapy, Dialectical Behavioral Therapy, and Exposure and Response Prevention Therapy.

Evidence-based procedures in psychiatry include: Electroconvulsive therapy, Transmagnetic Stimulation and Vagus Nerve Stimulation.

Psychiatric medications can alter the neurochemistry to allow many of the above therapies to work better.

The American Psychiatric Association has treatment guidelines for most major mental health diagnoses.

The guidelines are available to the public and can be a helpful addition to treatment discussions with one’s health-care provider or therapist. (https://?www.psychiatry.org/?psychiatrists/?practice/?clinical-practice-guidelines).

Molly Hawke, MD

Gahanna, Wooster High School Class of 2002

Board certified with the American Board of Psychiatry and Neurology