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.
Paul Appelbaum, MD
Director, Division of Law, Ethics, and Psychiatry
PAUL S. APPELBAUM, M.D. was previously A.F. Zeleznik Distinguished Professor and Chairman,Department of Psychiatry; and Director, Law and Psychiatry Program, University of Massachusetts Medical School.
He is the author of many articles and books on law and ethics in clinical practice. Dr. Appelbaum is Past President of the American Psychiatric Association, the American Academy of Psychiatry and the Law, and the Massachusetts Psychiatric Society, and has served as Chair of the Council on Psychiatry and Law for the American Psychiatric Association.
