The Clinical Diagnosis of Psychopathology in Mental Health

In recent years, the study of the neurological and cognitive aspects of human behavior has gained particular relevance. This growing interest has highlighted the limitations of certain classical approaches, such as psychoanalysis, which — although foundational in understanding the psychic apparatus — often lack scientifically validated tools for clinical assessment and diagnosis.

The purpose of this article is to explore the diagnostic evaluation process, as well as the neuropsychological and therapeutic approaches within the current context. Through a critical and updated perspective, it will analyze contemporary methodologies that allow for a more precise understanding of the brain bases of mental disorders, paving the way for more effective and evidence-based interventions.

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What is Psychopathology?

The World Health Organization (WHO, 2023) defines psychopathology as the discipline that studies mental, emotional, and behavioral disorders, focusing on their origin, development, manifestations, and treatment.

Therefore, psychopathology seeks to understand human mental suffering not only from a clinical perspective but also by considering its social, cultural, and biographical context. In other words, it is not merely about classifying symptoms, but about understanding the subjective experience of psychological distress and how it affects the daily life of those who experience it—thus representing a multifactorial integration essential for the proper intervention of individuals.

How Is a Psychopathology Assessed?

To achieve an effective and accurate detection of mental disorders, it is essential to consider the aspects that, according to the World Health Organization (WHO), influence the development of psychopathology. These aspects are grouped into what are known as biopsychosocial markers, which allow for a comprehensive understanding of the origin and evolution of mental disorders.

Biological Factors

In the assessment process, biological factors are fundamental, as they include the hereditary load transmitted through genetics, which gives the body’s cells a kind of functional “memory” that directly influences the regulation of key systems, such as the central nervous system (CNS), as well as other complex systems like the digestive or respiratory systems, among others.

Although the genetic component serves as a crucial starting point for understanding the origin of certain psychopathologies, there are other relevant biological variables. These include structural alterations of the CNS, such as brain malformations, perinatal hypoxia, neurological diseases, as well as traumatic brain injuries or the presence of abnormal bodies (e.g., cysts or tumors), all of which can negatively affect a person’s quality of life and contribute to the development of psychopathological symptoms (Bolton & Gillett, 2019).

Psychological Factors

Psychological factors encompass a wide range of elements, including cognitive processes, emotions, personality, and life experiences—all of which are fundamental to understanding human behavior. These elements are integrated into mental schemas, which directly influence how individuals interpret reality, respond to different situations, and regulate their behavior (Beck, 2020).

One of the most relevant aspects within this category is emotional regulation, as it helps explain how a person experiences, processes, and expresses emotions, providing key indicators of possible internal conflicts or psychological disorders. Likewise, human psychological development is shaped by past experiences, which act as fundamental learning processes in building identity and ways of relating to the environment. In some cases, these experiences may generate psychological vulnerability, especially when individuals have faced adverse situations such as abandonment, abuse, or unstable environments.

Social Factors

To better understand the main complexities of mental health, it is necessary to examine the social factor and socioeconomic status of each individual. Currently, we observe significant deprivation among vulnerable populations; thus, an individual’s mental health is deeply conditioned by their social environment and by the structural conditions in which their daily life unfolds. Far from being an exclusively biological or individual phenomenon, psychological well-being is built through interaction with factors such as socioeconomic status, access to support networks, community inclusion, and opportunities for development. In vulnerable populations — such as those living in poverty, forced migration, or social exclusion — these factors become even more influential, as they limit access to essential resources for emotional and psychological care.

Socioeconomic status influences mental health in multiple ways. Some of the most evident examples include access to health services, education, housing, and employment, but it also shapes an individual’s sense of self-worth and control over their life. People with low income are often exposed to constant levels of stress, insecurity, discrimination, and violence, all of which increase the likelihood of developing disorders such as depression, anxiety, addictions, or adjustment disorders.

In rural communities or migrant populations, for example, family dynamics are often disrupted by the need to seek employment away from home. This phenomenon can lead to feelings of abandonment, migratory grief, and social disconnection, directly affecting the emotional development of children, adolescents, and older adults who remain in situations of psychosocial vulnerability. Moreover, the scarcity of mental health services in these regions frequently prevents early detection of disorders, thereby worsening their course.

The Diagnostic Process in Mental Disorders

One of the most frequently discussed topics is understanding how the evaluation and diagnosis of mental disorders are carried out. This process requires a comprehensive approach that considers not only observable clinical symptoms but also the biological, psychological, and social conditions that influence their onset, development, and maintenance. This integrative perspective, known as the biopsychosocial model, acknowledges that psychological distress cannot be understood solely from a medical or behavioral dimension; rather, it emerges from the interaction between the individual’s body, mind, and environment.

The main tools used for diagnosis are the International Classification of Diseases, 11th Revision (ICD-11), published by the World Health Organization (WHO), and the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR), developed by the American Psychiatric Association (APA). These manuals provide systematic and standardized criteria for identifying mental disorders. However, both have recognized the need to contextualize diagnosis, expanding their focus toward the social determinants of mental health.

What Should Be Implemented for Diagnosis: ICD or DSM?

For clinical diagnosis, both the International Classification of Diseases (ICD) and the Diagnostic and Statistical Manual of Mental Disorders (DSM) are valid tools. However, the ICD-11, developed by the World Health Organization (WHO), is the globally recommended guideline. The ICD holds a significant advantage: it has been officially adopted by health systems in more than 190 countries, making it the international standard for the diagnosis of diseases, including mental and behavioral disorders. Furthermore, its approach seeks to integrate physical and mental health from a broader and more accessible perspective — something crucial in diverse contexts and multicultural realities (WHO, 2022).

On the other hand, the DSM-5-TR, developed by the American Psychiatric Association (APA), has a major influence on research and clinical practice in countries such as the United States. Nevertheless, its use is more limited in institutional contexts outside the U.S. For official clinical purposes, particularly in hospitals and public health systems, the use of the ICD-11 is recommended, as its diagnostic categories are harmonized with those of the DSM-5, yet structured in a more simplified and universally applicable way (First, Reed, Hyman, & Saxena, 2015). Although both systems are complementary, the ICD-11 should be considered the primary tool for clinical psychological diagnosis due to its legal recognition and integration into global health systems.

Complementary Tools for Clinical Diagnosis

For an adequate evaluation and diagnostic confirmation, the use of complementary tools allows professionals to confirm or refine the diagnoses established during the initial clinical interview. Among the most relevant are structured and semi-structured interviews, such as the SCID-5 (Structured Clinical Interview for DSM-5 Disorders) and the CIDI(Composite International Diagnostic Interview for ICD-11 criteria). These instruments enable a systematic application of diagnostic criteria, reducing examiner bias and improving inter-rater validity (First et al., 2015).

Similarly, standardized psychometric batteries constitute a cornerstone of complementary assessment. Instruments such as the MMPI-2 (Minnesota Multiphasic Personality Inventory), the BDI-II (Beck Depression Inventory), and the SCL-90-R (Symptom Checklist) —to name a few— allow for the quantification of key psychological symptoms and traits, facilitating a more objective evaluation of the patient’s emotional, cognitive, and behavioral state (Kaplan & Sadock, 2020).

In cases where neurological involvement is suspected, neurophysiological assessment tools become highly relevant. Neuroimaging techniques, such as functional magnetic resonance imaging (fMRI) or positron emission tomography (PET), make it possible to observe brain activity in real time and have been essential in the study of disorders such as schizophrenia, bipolar disorder, and ADHD. Likewise, electroencephalography (EEG) is a non-invasive techniquethat measures electrical brain activity and is useful in diagnosing seizure disorders, delirium, or attentional disturbances, as well as in assessing levels of consciousness (American Psychiatric Association, 2022).

Conclusion

Understanding mental disorders requires a comprehensive approach that considers not only clinical symptoms but also the biological, psychological, and social factors that contribute to their onset and persistence. The biopsychosocial model enables this broader perspective, integrating diagnostic tools such as the ICD-11 and DSM-5-TR, as well as clinical interviews and psychometric tests, to provide a more precise evaluation tailored to the patient’s context.

Moreover, it is essential to acknowledge how the social environment, particularly in vulnerable populations, directly influences mental health. Factors such as poverty, migration, and limited access to basic services can exacerbate psychological disorders. Therefore, an effective intervention must be not only scientifically grounded, but also human, contextual, and committed to equity in access to mental health care—ensuring accurate diagnosis and appropriate treatment for all individuals.

References

1. American Psychiatric Association. (2022). Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision (DSM-5-TR). Washington, DC: APA Publishing.

2. Barlow, D. H., & Durand, V. M. (2022). Abnormal Psychology: An Integrative Approach (9th ed.). Cengage Learning.

3. Beck, J. S. (2020). Cognitive Behavior Therapy: Basics and Beyond (3rd ed.). The Guilford Press.

4. Bolton, D., & Gillett, G. (2019). The Biopsychosocial Model of Health and Disease: New Philosophical and Scientific Developments. Springer. https://doi.org/10.1007/978-3-030-11899-0

5. First, M. B., Reed, G. M., Hyman, S. E., & Saxena, S. (2015). The development of the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders. World Psychiatry, 14(1), 82–90. https://doi.org/10.1002/wps.20189

6. First, M. B., Reed, G. M., Hyman, S. E., & Saxena, S. (2015). The development of the ICD-11 Clinical Descriptions and Diagnostic Guidelines for Mental and Behavioural Disorders. World Psychiatry, 14(1), 82–90. https://doi.org/10.1002/wps.20189

7. Kaplan, H. I., & Sadock, B. J. (2020). Kaplan & Sadock. Sinopsis de psiquiatría: ciencias de la conducta psiquiatría clínica (12.ª ed.). Wolters Kluwer.

8. Organización Mundial de la Salud. (2022). Clasificación Internacional de Enfermedades 11ª revisión (CIE-11). https://icd.who.int/

9. Organización Mundial de la Salud. (2022). Informe mundial sobre la salud mental: transformar la salud mental para todos. OMS. https://www.who.int/es/publications/i/item/9789240064809

10. Organización Mundial de la Salud. (2023). Clasificación Internacional de Enfermedades para Estadísticas de Morbilidad y Mortalidad, 11ª revisión (CIE-11). OMS. Disponible en: https://icd.who.int/es