My role as a psychiatrist is to arrive at a diagnosis and understanding of an individual’s problem(s), and to devise a course of treatment. Diagnosis of psychiatric disorders is however often a complex process. For most children and adolescents referred to me, I begin by getting a detailed history from parents or other caretakers, interview their child, and then discuss my findings and recommendations with parents or caretakers. Each one of these steps usually requires a session of about an hour. I can usually arrive at a sufficient understanding of a child’s problem(s) using this format. The diagnostic process is often supplemented by my reading reports of previous evaluations and/or, when appropriate, talking to staff at the child’s school.
When my task is to evaluate an adult for ADHD or depression, an interview – or interviews – with the individual is usually sufficient. When an adult seeking an evaluation for Asperger’s Disorder consults me, I inform the individual that I usually begin with an interview of an hour and a half. I also note that interviewing someone who knows the referred individual well (e.g. parent, spouse or close friend) is very helpful in arriving at a diagnosis. However, I cannot tell in advance of seeing the referred individual how important talking to a collateral person will be in clarifying the diagnosis.
The information that I want to gather includes problems that an individual has in relating to and communicating with others in the present and in the past. Sometimes it is clear from the interview with the referred person, by his or her history and current problems that the diagnosis is – or is not – Asperger’s Disorder. In some cases, speaking to close family members and / or friends greatly clarifies the diagnosis. I have found that when an individual is referred to me, and that individual is married, or in a long-term relationship with another adult, that it sometimes makes sense to interview them together as long as both partners are comfortable with doing so. Please understand that I do not want to involve others if it will strain relations or cause discomfort to the referred person or others.