Diagnostic review and revision

Abstract This chapter focuses on the advantages and hazards of diagnosing psychiatric illness in incarcerated individuals and highlights the importance of diagnostic accuracy in the correctional setting. As individuals with mental illness have become increasingly subjected to the criminal justice system, correctional facilities have become surrogates for long-term psychiatric care institutions. While this is an unfortunate phenomenon, it presents the field of psychiatry with several opportunities to facilitate an accurate diagnosis that are now scarce in civil society. These advantages include longer periods of close observation, ready access to collateral information, and minimization of confounding variables such as substance use. Conversely, correctional settings also raise certain impediments to accurate diagnosis, which may include concerns about secondary gain and countertransference. For incarcerated individuals, accurate diagnosis and subsequent use of evidence-based treatments have impacts beyond simply addressing symptoms; interventions can improve quality of life and meaningfully decrease the risk of recidivism.