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Is diagnosis enough to guide interventions in mental health? Using case formulation in clinical practice

Craig A Macneil12*, Melissa K Hasty12, Philippe Conus23 and Michael Berk2456

Author Affiliations

1 Early Psychosis Prevention & Intervention Centre (EPPIC), and Orygen Youth Health Research Centre, Orygen Youth Health, 35 Poplar Road, Parkville, Melbourne, Victoria, 3052, Australia

2 Orygen Research Centre, 35 Poplar Road, Parkville, Victoria, 3052, Australia

3 Treatment & Early Intervention in Psychosis Program (TIPP), Département de Psychiatrie CHUV, Université de Lausanne, Clinique de Cery, 1008 Prilly, Switzerland

4 School of Medicine, Deakin University, 1 Gheringhap Street, Geelong, Victoria, 3220, Australia

5 Department of Psychiatry, The University of Melbourne, Level 1 North, Main Block, Royal Melbourne Hospital, Victoria, 3050, Australia

6 Mental Health Research Institute, Kenneth Myer Building, 30 Royal Parade, Parkville Victoria, 3052, Australia

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BMC Medicine 2012, 10:111  doi:10.1186/1741-7015-10-111

Published: 27 September 2012


While diagnosis has traditionally been viewed as an essential concept in medicine, particularly when selecting treatments, we suggest that the use of diagnosis alone may be limited, particularly within mental health. The concept of clinical case formulation advocates for collaboratively working with patients to identify idiosyncratic aspects of their presentation and select interventions on this basis. Identifying individualized contributing factors, and how these could influence the person's presentation, in addition to attending to personal strengths, may allow the clinician a deeper understanding of a patient, result in a more personalized treatment approach, and potentially provide a better clinical outcome.

Formulation; diagnosis; cognitive behavioral therapy; psychological intervention, case conceptualization