Diagnosis vs. Prognosis in Mental Health

The terms diagnosis and prognosis are often used in mental health. While they are sometimes confused, they have different meanings. A diagnosis identifies the condition that is associated with a set of symptoms. A prognosis is a prediction about the course that a condition will take.

Diagnosis vs. Prognosis: Key Differences

What Is a Diagnosis in Mental Health?

A diagnosis in mental health is a determination of the condition that is causing the symptoms that a person is currently experiencing. Mental health professionals utilize the "Diagnostic and Statistical Manual of Mental Disorders" (DSM-5-TR), which lists the symptoms of different mental health conditions.

To make a diagnosis, a doctor or mental health professional will ask questions about symptoms. They may also perform a physical exam and order blood tests to help rule out medical conditions that might be causing symptoms. They may also take a family history, medical history, and adminster psychological assessments.

What Is a Prognosis in Mental Health?

People often confuse the terms prognosis and diagnosis. The difference between the two is that while a prognosis is a guess as to the outcome of treatment, a diagnosis is actually identifying the problem and giving it a name.

When making a prognosis, healthcare professionals are trying to predict:

• How long symptoms will last
• The likely outcome
• How the condition will progress
• How symptoms might change over time
• Whether symptoms will improve, worsen, or stay the same
• How quickly symptoms will progress
• Possible complications a person might experience
  

How a Prognosis Is Determined

Healthcare professionals often rely on statistics about condition outcomes in order to make a prognosis about any given condition. Because a prognosis is based on how people tend to do on average, it means that it isn't necessarily written in stone. 

A doctor or mental health professional may use a variety of assessments and methods to help them make a prediction about the course of a mental health condition.

A variety of different factors can also affect a person's prognosis. These factors include:

• Age at onset: With some conditions, early-onset may predict worse outcomes. For example, people who have early-onset schizophrenia in which symptoms emerge prior to age 13, typically have a poor prognosis.
• Sex and gender identity: Some conditions affect men and women differently. For example, depression may present differently in men than it does in women.
• Medical history and possible comorbidities: It is not uncommon for people to have more than one mental health or medical condition at the same time, which can complicate both diagnosis and the course the conditions take.
• Type and severity of symptoms: Acute onset predicts a better prognosis than if your symptoms are gradual.
• Nature and duration of symptoms: The presence of certain symptoms may be indicative of a more severe course of symptoms in the future. Symptoms that have been present for a long period may also indicate that the condition will be persistent.
• Treatment response: Past and current responses to treatment can also affect a person's prognosis. If past treatments have failed or the current treatment does not produce an adequate response, it might indicate a worse condition course.

A healthcare or mental health professional will also want to know about the type of social support you have in your life, which can significantly impact your prognosis. People who have good interpersonal relationships and a strong social support system tend to fare better.

Types of Prognoses

The following categories of prognoses are typically used:

• Excellent: This indicates that there is a strong likelihood that the person will fully recover with minimal detrimental impacts on their functioning and quality of life.
• Good: This implies that a person has a good chance of responding well to treatment and will have a good quality of life in the future.
• Fair: This prognosis would indicate that a person may have some response to treatment, but that their condition will likely have a notable impact on their life and ability to function.
• Poor: This indicates that their condition is unlikely to improve and that their quality of life will be significantly affected.
• Guarded: A mental health professional may use this term when they don't have enough information to predict the outcome.

Why Prognosis Is Important

Understanding prognosis can be important for a number of different reasons.

• Having a prognosis can help people to feel informed about their health
• It creates a base for future health and treatment decisions
• It allows people to plan for their future
• It can ease anxiety by letting people know what they may expect going forward
• It can give some idea of what treatment strategies or options are available.

Prognosis may be given before any treatment is undertaken so that the individual can weigh the benefits of different treatment options. In some cases, the treatment approach a person pursues may affect their prognosis, so such guesses can inform which treatments people opt to pursue.