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Question:

I was evaluated by three different professionals. Two of them said I had bipolar II disorder and one said I had no signs of that illness. Due to the disagreement, a fourth professional diagnosed me based on the three previous assessments. This person never met me, so I am wondering whether his opinion can be accurate. Also, is it common practice for diagnoses to be made without examining the patient?

Answered by: Paul Appelbaum

In general, psychiatric diagnoses are made after a direct examination of the person. However, there are circumstances in which evaluations are made without a direct examination--usually when a legal or administrative issue is in question.

Sometime, though, mental health professionals may request consultations on difficult diagnostic issues from experienced colleagues. The consultant could examine you directly or listen to a presentation of your situation and review your records. In either case, the consultant's opinion should be one more piece of information that the professional primarily responsible for your care takes into account in formulating a diagnosis and treatment plan.

If none of the professionals with whom you have been in contact is primarily responsible for your care, a first step toward clarifying the situation would be for you to designate such a person, and allow him or her to integrate the opinions of the other assessors.