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Tests and diagnosis

By Mayo Clinic staff

To determine a diagnosis and check for any related complications, you may have these exams and tests:

  • Physical exam. Your doctor will try to rule out physical problems that could cause your symptoms.
  • Lab tests. These may include a check of your thyroid function or a screening for alcohol and drugs, for example.
  • Psychological evaluation. A doctor or mental health provider will talk to you about your symptoms, thoughts, feelings and behavior patterns. You may be asked to fill out a questionnaire to help answer these questions.

Determining which mental illness you have
Sometimes it's difficult to find out which particular mental illness may be causing your symptoms. But taking the time and effort to get an accurate diagnosis will help determine the appropriate treatment.

The defining symptoms for each mental illness are detailed in the Diagnostic and Statistical Manual of Mental Disorders (DSM) published by the American Psychiatric Association. Mental health providers use this manual to diagnose mental conditions, and insurance companies use it to reimburse for treatment. To be diagnosed with a particular mental illness, you must meet the criteria listed in the DSM.

Classes of mental illness
The main classes of mental illness are:

  • Mood disorders. These include disorders that affect how you feel emotionally, such as the level of sadness and happiness. Examples include depression and bipolar disorder.
  • Anxiety disorders. Anxiety is an emotion characterized by the anticipation of future danger or misfortune, accompanied by feeling ill at ease. Examples include generalized anxiety disorder, panic disorder, obsessive-compulsive disorder, phobias and post-traumatic stress disorder.
  • Substance-related disorders. These include problems associated with the misuse of alcohol and illegal or legal drugs.
  • Psychotic disorders. Psychotic disorders cause detachment from reality (delusions, paranoia and hallucinations). The most notable example is schizophrenia, although other classes of disorders can be associated with detachment from reality at times.
  • Cognitive disorders. Cognitive disorders affect your ability to think and reason. They include delirium, dementia and memory problems. Alzheimer's disease is an example of a cognitive disorder.
  • Developmental disorders. This category covers a wide range of problems that usually begin in infancy, childhood or the teenage years. They include autism, attention-deficit/hyperactivity disorder (ADHD) and learning disabilities.
  • Personality disorders. A personality disorder involves a lasting pattern of emotional instability and unhealthy behavior that causes problems in your life and relationships. Examples include borderline personality disorder and antisocial personality disorder.
  • Other disorders. These include disorders of impulse control, sleep, sexual functioning and eating. Also included are dissociative disorders, in which your sense of self is disrupted; somatoform disorders, in which there are physical symptoms with no clear cause; adjustment disorder, in which you have trouble coping during a stressful life event; and mental disorders that are due to general medical conditions.
Treatments and drugs Preparing for your appointment
References
  1. Psychotherapies. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/psychotherapies/index.shtml. Accessed July 24, 2012.
  2. Mental illness and the family: Recognizing warning signs and how to cope. Mental Health America. http://www.nmha.org/go/information/get-info/mi-and-the-family/recognizing-warning-signs-and-how-to-cope. Accessed July 23, 2012.
  3. Introduction. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 13, 2012.
  4. Brain stimulation therapies. National Institute of Mental Health. http://www.nimh.nih.gov/health/topics/brain-stimulation-therapies/brain-stimulation-therapies.shtml. Accessed July 24, 2012.
  5. Mental health medications. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/mental-health-medications/index.shtml. Accessed July 24, 2012.
  6. Mind/body connection: How your emotions affect your health. American Academy of Family Physicians. http://familydoctor.org/online/famdocen/home/healthy/mental/782.printerview.html. Accessed July 23, 2012.
  7. Mental illness surveillance among U.S. adults. Centers for Disease Control. http://www.cdc.gov/mentalhealthsurveillance/fact_sheet.html. Accessed July 23, 2012.
  8. Treatment approaches for drug addiction. National Institute on Drug Abuse. http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction. Accessed July 24, 2012.
  9. Understanding hospitalization for mental health. Depression and Bipolar Support Alliance. http://www.dbsalliance.org/site/Search?query=hospitalization&inc=10&x=0&y=0Accessed July 24, 2012.
  10. Salgado MF, et al. Family history of serious mental illness in bipolar I and bipolar II patients of the Mayo Bipolar Biobank. Biological Psychiatry. 2012;71:153S.
  11. Mental illness: Taking care of yourself. American Family Physician. 2008;78:363.
  12. Gold MS, et al. Psychosocial treatment of alcohol abuse and dependence. http://www.uptodate.com/index. Accessed June 2, 2012.
  13. Rackley S, et al. Depression in medically ill patients. Psychiatric Clinics of North America. 2012;35:231.
  14. Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed July 23, 2012.
  15. Sadock BJ, et al. Kaplan & Sadock's Comprehensive Textbook of Psychiatry. 9th ed. Philadephia, Pa.: Wolters Kluwer Health Lippincott Williams & Wilkins; 2009. http://ovidsp.ovid.com/ovidweb.cgi?T=JS&CSC=Y&NEWS=N&PAGE=booktext&D=books2&AN=01412563/9th_Edition/5&XPATH=/OVIDBOOK%5b1%5d/METADATA%5b1%5d/TBY%5b1%5d/EDITORS%5b1%5d. Accessed July 24, 2012.
  16. Li X, et al. Review of pharmacological treatment in mood disorders and future directions for drug development. Neuropsychopharmacology. 2012;37:77.
  17. McDowell AK, et al. Practical suicide-risk management for the busy primary care physician. Mayo Clinic Proceedings. 2011;86:792.
  18. Chamberlain AM, et al. Associations of preexisting depression and anxiety with hospitalization in patients with cardiovascular disease. Mayo Clinic Proceedings. 2011;86:1056.
  19. Index. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 13, 2012.
  20. Understanding suicide: Fact sheet 2012. Centers for Disease Control and Prevention. http://www.cdc.gov/ViolencePrevention/pub/Suicide_factsheet.html. Accessed July 23, 2012.
  21. What is mental illness: Mental illness facts. National Alliance on Mental Illness. http://www.nami.org/template.cfm?section=about_mental_illness. Accessed July 23, 2012.
  22. Schreiber J, et al. Suicidal ideation and behavior in adults. http://www.uptodate.com/index. Accessed March 13, 2012.
  23. Kung S (expert opinion). Mayo Clinic Rochester, Minn. Aug. 7, 2012.
  24. Adjustment disorders. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed Aug. 27, 2012.
DS01104 Sept. 15, 2012

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