ABSTRACT
After completing the Database Record, using the Symptom Filter to sort the presenting symptoms into eight major categories, and noting the presence of potential biological, psychological, and social predispositions to psychiatric disorders, the next step in developing the overall formulation is to construct a multiaxial DSM-IV differential diagnosis using the Database Record as a guide. The differential diagnosis is the list of potential Diagnostic and Statistical Manual of Mental Disorders-IV diagnoses the patient may have. The importance of developing a comprehensive, but not overly inclusive, differential diagnosis cannot be overemphasized. Two common errors must be assiduously avoided when developing a differential diagnosis. The first is failing to account for all of the data obtained from the psychiatric interview. The second common error is failing to develop as broad a differential diagnosis as the data will support. Once a differential diagnosis is constructed, it will be necessary to identify one or more presumptive or “working” diagnoses to direct one's interventions.
