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April 1975

Dimensional Diagnosis and the Medical Student's Grasp of Psychiatry

Author Affiliations

From the Department of Psychiatry (Drs. Hine and Williams) and the Department of Medicine (Dr. Williams), Duke University Medical Center, Durham, NC.

Arch Gen Psychiatry. 1975;32(4):525-528. doi:10.1001/archpsyc.1975.01760220137015

Two problems that interfere with the student's understanding and acceptance of psychiatric knowledge result largely from the use of a categorical model for psychiatric diagnosis. These two problems are: (1) the apparent inapplicability of the standard system of psychiatric diagnosis to real patients; and (2) the apparent irrelevance for general medical practice of psychiatric diagnosis and theory. Both problems may be avoided by presenting psychiatry in the framework of a multidimensional diagnostic schema that uses familiar terms but treats them as dimensions with severe, moderate, and mild degrees of impairment rather than as categories of mutually exclusive psychiatric diseases.

A teaching program is described in which detailed review of student interviews with psychiatric and especially nonpsychiatric patients is employed to demonstrate the usefulness of multidimensional psychiatric diagnosis.