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.1
At a Glance
A diagnosis identifies a person’s current condition, whereas a prognosis describes the condition’s implications for future health. A diagnosis is usually obtained by taking a medical history, looking at present symptoms, conducting clinical exams, and ruling out other conditions. A prognosis, on the other hand, is often based on a healthcare provider’s knowledge of the typical course of a condition as well as the treatments that a person chooses to pursue.
Diagnosis vs. Prognosis: Key Differences
- Identifies the problem or condition
- Determined by examination of the signs and symptoms
- Comes before the prognosis
- Focuses on the person’s current condition
- May require assessments, physical examination, and medical history
- A prediction about the condition’s course or outcome
- Determined by looking at past cases and current response
- Comes after the diagnosis
- Focuses on the future development of the condition
- May require looking at knowledge of typical disease progression, co-morbid conditions, current functioning, and available treatments
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.
Each condition has specific diagnostic criteria that should be met to make a diagnosis. Such criteria include the condition’s symptoms, how many symptoms must be present, how long these symptoms must occur, and other conditions that must be ruled out.
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.2
Simply put, a prognosis is a prediction, whereas a diagnosis states what’s already there.
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
A prognosis also makes predictions about how a condition will affect a person’s quality of life. It is used as a best guess for how the condition will affect your life in the future.
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.
Lab tests, medical history, psychological assessments, diagnostic criteria, and symptom severity can also influence how they determine an individual’s prognosis.
A variety of different factors can also affect a person’s prognosis. These factors include:3
- 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.4
- Sex and gender identity: Some conditions affect men and women differently. For example, depression may present differently in men than it does in women.5
- 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.
Recap
Prognosis is a best guess about the future course and impact of a condition, but that doesn’t mean it is set in stone. Individual prognosis with any condition can depend on a variety of factors including your medical history, general health, severity of symptoms, sex, age, and lifestyle factors.
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.
What This Means For You
Everyone is different, and the course of your own condition may vary depending on a wide variety of factors. Your doctor or therapist can give you an educated guess. However, it is essential to remember that this guess is not a guaranteed outcome. Working with a trusted medical or mental health professional can help you or your loved one understand what to expect and make plans to manage your mental health condition.