The Diagnostic Decision-Making Process: Factors Influencing Diagnosis and Changes in Diagnosis

In their study of four groups of patients diagnosed as either psychotic or nonpsychotic, the authors found that disturbed ideation and disordered speech content were the two most important diagnostic considerations and that in the absence of such widely used indicators of differential diagnosis, prognostic inferences were given undue weight. They suggest that when a patient's diagnostic status is ambiguous, special attention should be given to clinical observations of such categories as forms of speech, motor activity, and object relations instead of to subjective impressions, which tend to be misleading.